Evidence map›Paper›PMID 29228929›Full record

Trial reportBMC pulmonary medicine2017

Virtual bronchoscopic navigation without X-ray fluoroscopy to diagnose peripheral pulmonary lesions: a randomized trial.

Fumihiro Asano, Takashi Ishida, Naofumi Shinagawa, Noriaki Sukoh, Masaki Anzai, Kenya Kanazawa, Akifumi Tsuzuku, Satoshi Morita

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pulmonary medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04571476 nacompletednot on this mapstarted 2021, after this paper: background citation

Diagnostic Value of Ultrathin and Thin Bronchoscope for Peripheral Pulmonary Lesions: A Prospective Randomized Controlled Multicenter Study

TypeinterventionalSponsorShanghai Chest HospitalRan2021 to 2022Enrolled578ConditionsPeripheral Pulmonary LesionArmsUltrathin bronchoscope, Thin bronchoscope, Virtual bronchoscopic navigation combined with endobronchial ultrasound, Guide sheath
NCT07135297 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Novel Thin Bronchoscope Versus Ultrathin Bronchoscope for the Diagnosis of Peripheral Pulmonary Nodules: A Multicenter, Randomised Trial

TypeinterventionalSponsorShanghai Chest HospitalRan2025 to 2026Enrolled465ConditionsLung Cancer (Diagnosis)ArmsUltrathin bronchoscope (UTB), Thin bronchoscope (TB1), Thin bronchoscope (TB2)
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.

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  4. Virtual bronchoscopic navigationTherapeutic advances in respiratory disease
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Fumihiro AsanoDepartment of Pulmonary Medicine, Gifu Prefectural General Medical Center, 4-6-1, Noishiki, Gifu, 500-8717, Japan. asano-fm@ceres.ocn.ne.jp.
Takashi IshidaDepartment of Pulmonary Medicine, Fukushima Medical University, 1, Hikariga-oka, Fukushima City, 960-1295, Japan.
Naofumi ShinagawaFirst Department of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
Noriaki SukohDepartment of Pulmonary Diseases, National Hospital Organization Hokkaido Cancer Center, 4-2-3-54, Kikusui, Shiroishi-ku, Sapporo, 003-0804, Japan.
Masaki AnzaiDepartment of Pulmonary Medicine, Fukui University School of Medicine, 23-3, Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Kenya KanazawaDepartment of Pulmonary Medicine, Fukushima Medical University, 1, Hikariga-oka, Fukushima City, 960-1295, Japan.
Akifumi TsuzukuDepartment of Pulmonary Medicine, Gifu Prefectural General Medical Center, 4-6-1, Noishiki, Gifu, 500-8717, Japan.
Satoshi MoritaDepartment of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Fukushima Medical University · JPGifu Prefectural General Medical Center · JPHokkaido University · JPKyoto University · JPSapporo National Hospital · JPUniversity of Fukui · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransbronchial biopsy for peripheral pulmonary lesions is generally performed under X-ray fluoroscopy. Virtual bronchoscopic navigation (VBN) is a method in which virtual images of the bronchial route to the lesion are produced based on CT images obtained before VBN, and the bronchoscope is guided using these virtual images, improving the diagnostic yield of peripheral pulmonary lesions. VBN has the possibility of eliminating the need for X-ray fluoroscopy in the bronchoscopic diagnosis of peripheral lesions. To determine whether VBN can be a substitute for X-ray fluoroscopy, a randomized multicenter trial (non-inferiority trial) was performed in VBN and X-ray fluoroscopy (XRF) -assisted groups.

methodsThe non-inferiority margin in the VBN-assisted group compared with the XRF-assisted group was set at 15%. The subjects consisted of 140 patients with peripheral pulmonary lesions with a mean diameter > 3 cm. In the VBN-assisted group, the bronchoscope was guided to the lesion using a VBN system without X-ray fluoroscopy. In the XRF-assisted group, the same bronchoscope was guided to the lesion under X-ray fluoroscopy. Subsequently, in both groups, the lesion was visualized using endobronchial ultrasonography with a guide sheath (EBUS/GS), and biopsy was performed. In this serial procedure, X-ray fluoroscopy was not used in the VBNA group.

resultsThe subjects of analysis consisted of 129 patients. The diagnostic yield was 76.9% (50/65) in the VBN-assisted group and 85.9% (55/64) in the XRF-assisted group. The difference in the diagnostic yield between the two groups was -9.0% (95% confidence interval: -22.3% ~ 4.3%). The non-inferiority of the VBN-assisted group could not be confirmed. The rate of visualizing lesions by EBUS was 95.4% (62/65) in the VBN-assisted group and 96.9% (62/64) in the XRF-assisted group, being high in both groups.

conclusionsOn EBUS/GS, a bronchoscope and biopsy instruments may be guided to the lesions using VBN without X-ray fluoroscopy, but X-ray fluoroscopy is necessary to improve the accuracy of sample collection from lesions. During transbronchial biopsy for peripheral pulmonary lesions, VBN cannot be a substitute for X-ray fluoroscopy.

trial registrationUMIN-CTR (UMIN000001710); registered 16 February 2009.

Indexed as

LungLung NeoplasmsAgedBiopsyBronchoscopyComparative Effectiveness ResearchDimensional Measurement AccuracyEndosonographyFemaleFluoroscopyHumansImage-Guided BiopsyMaleMiddle AgedTomography, X-Ray ComputedBronchoscopyEndobronchial ultrasonographyGuide sheathLung cancerPeripheral pulmonary lesionTransbronchial biopsyVirtual bronchoscopic navigationX-ray fluoroscopy

Identifiers

PMID29228929
PMCPMC5725971
OpenAlexW2773861784

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.