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Navigated EBUS and Functional Imaging in Lung Cancer

Not Applicable
Completed
Conditions
Bronchial Neoplasms
Interventions
Device: navigated bronchoscopy
Registration Number
NCT02745002
Lead Sponsor
St. Olavs Hospital
Brief Summary

Electromagnetic navigation systems have proved feasible for precise intraoperative guiding during videobronchoscopy and endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), based on maps made of preoperative CT images. PET--CT, PET--MRI and fMRI can point out malignant lesions.

When fused into a research navigation system, functional imaging can add information of optimal sampling points in lung cancer staging. Correct image registration is then fundamental. This study is a build--on to NCT02493023, assessing the position and image registration accuracy and clinical feasibility of a multimodal image guiding system in patients referred for lung cancer staging by EBUS--TBNA.

Detailed Description

A research navigation platform displays the intraoperative position of the endoscope inside the airways, and shows its position in 3D maps made from the patients' own preoperative images (PET-- CT, PET--MRI or fMRI). Images are acquired ahead of study inclusion. The navigation system acquires position data, first from a videobronchoscope, then from an EBUS--scope (same sort of output data acquired from both endoscopes) equipped with a position sensor for electromagnetic tracking.

From intraoperative position data, the accuracy of the image--to--patient registration (for CT, PET--CT, PET--MRI and fMRI) and the navigation system accuracy are calculated.

Electromagnetic navigation fused with available image modalities can be used to navigate directly and precisely to the area with highest suspicion of malignancy. Multimodal image guiding systems with functional imaging may thereby lead to improvements in endoscopic lung cancer staging, f. i. in diagnostic yield, procedure time and safety.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
8
Inclusion Criteria
  • referred to thoracic department St Olavs Hospital due to suspicion of lung cancer
  • informed consent
Exclusion Criteria
  • pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
navigated bronchoscopynavigated bronchoscopy-
Primary Outcome Measures
NameTimeMethod
Endoscope position (measured in millimetres from origo in the x, y and z-plane) in 3 dimensional maps from preoperative CT, PET-CT, PET-MRI or fMRI images48 hours

intraoperative positional data of bronchoscope or endobronchial ultrasound scope (EBUS) measured and stored in navigation system software, used for registration and navigation system accuracy calculations

Secondary Outcome Measures
NameTimeMethod
duration of procedure48 hours

time from first entry of endoscope through vocal cords to final withdrawal of endoscope

patient reported satisfaction2 hours

enquiry on patients´ own experience 2 hours after end of navigated bronchoscopy/EBUS procedure

adverse events48 hours

procedure related adverse events or unexpected incidents registrated

Operator reported satisfaction48 hours

Enquiry on main operator´s experience immediately after end of navigated bronchoscopy/EBUS procedure

Diagnostic yield48 hours

Diagnostic success per TBNA sample defined as \>40 lymphocytes/high power field as reported by rapid onsite cytologist

Trial Locations

Locations (1)

Department of Thoracic Medicine, St Olavs Hospital

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Trondheim, Norway

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