Navigated Bronchoscopy: A Technical Review

Reynisson, Pall J. MSc*; Leira, Håkon O. MD, PhD; Hernes, Toril N. PhD*,‡; Hofstad, Erlend F. MSc; Scali, Marta MSc*,§; Sorger, Hanne MD; Amundsen, Tore MD, PhD; Lindseth, Frank PhD‡,∥; Langø, Thomas PhD

Journal of Bronchology & Interventional Pulmonology: July 2014 - Volume 21 - Issue 3 - p 242–264
doi: 10.1097/LBR.0000000000000064
Review Article

Background: Navigated bronchoscopy uses virtual 3-dimensional lung model visualizations created from preoperative computed tomography images often in synchronization with the video bronchoscope to guide a tool to peripheral lesions. Navigated bronchoscopy has developed fast since the introduction of virtual bronchoscopy with integrated electromagnetic sensors in the late 1990s. The purposes of the review are to give an overview and update of the technological components of navigated bronchoscopy, an assessment of its clinical usefulness, and a brief assessment of the commercial platforms for navigated bronchoscopy.

Methods: We performed a literature search with relevant keywords to navigation and bronchoscopy and iterated on the reference lists of relevant papers, with emphasis on the last 5 years.

Results: The paper presents an overview of the components necessary for performing navigated bronchoscopy, assessment of the diagnostic accuracy of different approaches, and an analysis of the commercial systems. We were able to identify 4 commercial platforms and 9 research and development groups with considerable activity in the field. Finally, on the basis of our findings and our own experience, we provide a discussion on navigated bronchoscopy with focus on the next steps of development.

Conclusions: The literature review showed that the peripheral diagnostic accuracy has improved using navigated bronchoscopy compared with traditional bronchoscopy. We believe that there is room for improvement in the diagnostic success rate by further refinement of methods, approaches, and tools used in navigated bronchoscopy.

*Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU)

Deparment of Thoracic Medicine, St. Olavs Hospital

Department of Medical Technology, SINTEF, Trondheim

Department of Computer and Information Science, NTNU, Norway

§Dipartimento di Ingegneria Industriale, Pisa, Italy

Supported by SINTEF, the Ministry of Health and Social Affairs of Norway, through the National Centre of Competence for Ultrasound and Image-guided Therapy (Trondheim, Norway); the project 196726/V50 eMIT (enhanced Minimally Invasive Therapy) in the FRIMED program of the Research Council of Norway, the Norwegian University of Science and Technology (NTNU) through a PhD study; and Samarbeidsorganet in the project “Navigated bronchoscopy—A collaborative project between SINTEF and St. Olavs Hospital/NTNU.”

Disclosure: The authors are part of the Trondheim group studying navigated bronchoscopy.

Reprints: Thomas Langø, PhD, Department of Medical Technology, SINTEF, Trondheim 7465, Norway (e-mail: thomasl@sintef.no).

Received March 18, 2013

Accepted February 18, 2014

© 2014 by Lippincott Williams & Wilkins.