{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:44:37Z","timestamp":1790819077837,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T00:00:00Z","timestamp":1562025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>The diagnostic yield of electromagnetic navigation bronchoscopy (ENB) is inferior to that of computed tomography (CT)\u2010guided needle biopsy for pulmonary nodules. One explanation for this is divergence between the nodule location on the pre\u2010procedure CT scan and its actual location during the procedure. Fluoroscopic ENB (F\u2010ENB) consists of digital tomosynthesis using a conventional C\u2010arm to re\u2010register the target lesion based on near real\u2010time imaging. We performed a retrospective review of ENB cases at our institution before and after introduction of F\u2010ENB to assess diagnostic yield.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive ENB procedures performed at our institution from 25 December 2017 to 25 August 2018 were reviewed. F\u2010ENB was introduced on 25 April 2018. Two cohorts were analysed: standard ENB (S\u2010ENB) from 25 December 2017 to 24 April 2018 and F\u2010ENB from 25 April 2018 to 25 August 2018. All procedural, demographic and diagnostic data were collected. Descriptive statistics, chi\u2010square, Wilcoxon test and Student's t\u2010test were used where appropriate. A multivariable regression analysis was performed to assess factors associated with diagnostic yield.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 101 and 67 nodules were biopsied in the S\u2010ENB and F\u2010ENB groups, respectively. Diagnostic yield was 54% in S\u2010ENB cohort and 79% in the F\u2010ENB group (<jats:italic>P<\/jats:italic> = 0.0019). Factors independently associated with a positive diagnosis were F\u2010ENB and a positive radial ultrasound view (odds ratio (OR): 3.57, 95% CI: 1.56\u20138.18 and OR: 3.74, 95% CI: 1.37\u201311.05, respectively). Complications were minimal (pneumothorax: 1.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of F\u2010ENB may increase the diagnostic yield of ENB and has a low complication rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13609","type":"journal-article","created":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T13:13:46Z","timestamp":1562073226000},"page":"206-213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Improved diagnostic yield for lung nodules with digital tomosynthesis\u2010corrected navigational bronchoscopy: Initial experience with a novel adjunct"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8540-487X","authenticated-orcid":false,"given":"Matt","family":"Aboudara","sequence":"first","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance","family":"Roller","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otis","family":"Rickman","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Lentz","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasleen","family":"Pannu","sequence":"additional","affiliation":[{"name":"The Division of Pulmonary Critical Care and Sleep Medicine The Ohio State University Wexner Medical Center  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.10.010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201505-0990OC"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1102873"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","unstructured":"De Koning H Van Der Aalst C Ten Haaf K Oudkerk M. 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