Late Breaking Abstract - New Centre Experience In Virtual Bronchoscopic Navigation In Combination With Fused Fluoroscopy To Target Solitary Pulmonary Nodules

Background: The need to determine the aetiology of solitary pulmonary nodules (SPN) is high. The ArchimedesTM System combines virtual bronchoscopy navigation (VBN) with fused fluoroscopy (FF) in order to improve the guidance. Objective: To analyze the feasibility of ArchimedesTM interventions for the diagnosis of SPN. Methods: From 01-05/2020 16 patients with SPN were examined. Based on a specific CT scan the access way to the SPN was calculated and adjusted as needed. Interventions were done in general anesthesia with chest tube. Results: 16 Patients (43,8% female, 56,3% male) aged 64 years (±8,3) were included with a malignancy risk for the SPN (calculated with the Brock Model) of 40,6% (±19,3). SPN measured 14,9mm (±7,1). Localization were 43,8% left upper lobe, 25% right lower lobe, 25% right upper lobe, 6,3% middle lobe. The distance from the last reconstructed bronchus to the lesion was 21,5mm (± 12,7), the distance between target and pleura 20,1mm (± 16,8). Time for calculation 21 minutes (± 10,4), time to location of the SPN 14 minutes (±15,5). Bronchoscope with 4,2mm (93,8%) and 3mm (6,3%) outside diameter were used. The lesion could be seen in radial EBUS in 87,5% (50% adjacent, 25% central, 12,5% stop phenomenon). There were no major complications (25% mild bleeding managed by suction, no pneumothoraxes). Sensitivity was calculated 71,4%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 33,3% and accuracy 75%. Conclusion: A high diagnostic yield for small peripheral SPN can be achieved with ArchimedesTM interventions even if the distance from the last reconstructed bronchus to the target is over 20mm.