Biomedical subjects

Fumihiro Asano

Publications and source records attributed to Fumihiro Asano.

8 recordsLinked to original sources

PubMed2007

Virtual bronchoscopic navigation system shortens the examination time--feasibility study of virtual bronchoscopic navigation system.

Computed tomography (CT)-guided transbronchial biopsy (TBB) using an ultrathin bronchoscope with simulation by virtual bronchoscopy (VB) is effective for diagnosing small peripheral pulmonary lesions. However, we occasionally lose the proper bronchi to the lesion when a bronchoscope is inserted into peripheral bronchi with severe rotation. To overcome this problem, the virtual bronchoscopic navigation system that can display real-time VB images during TBB procedures in comparison with actual bronchi has been developed. We evaluated the usefulness of the virtual bronchoscopic navigation system for CT-guided TBB using an ultrathin bronchoscope (navigation method) to diagnose small peripheral pulmonary lesions, and compared the results to those with previous method that uses VB images in a simulation (simulation method). We performed CT-guided TBB using an ultrathin bronchoscope for 69 patients with 71 small peripheral pulmonary lesions (mean diameter, 13.7 mm) between November 2002 and November 2005 with the navigation method. CT-guided TBB with the navigation method was performed safely without any serious complications for all patients. Mean time to the initial scan, time to the first biopsy and total examination time were 5.3, 8.5 and 24.5 min, respectively. Fifty lesions (70%) were diagnosed by this procedure. Compared to simulation method, diagnostic sensitivity was higher in the navigation method, but the difference was not significant. However, the time to the first biopsy and total examination time were significantly shorter in the navigation method than in the simulation method (p<0.05). In summary, the virtual bronchoscopic navigation system was safely used, effective for diagnosing small peripheral pulmonary lesions, and useful for shortening the examination time of CT-guided TBB using an ultrathin bronchoscope.

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PubMed2006

A virtual bronchoscopic navigation system for pulmonary peripheral lesions.

STUDY OBJECTIVES: We performed ultrathin bronchoscopy for pulmonary peripheral lesions using a system that displays virtual bronchoscopy (VB) images to the lesion simultaneously with actual images and navigates the bronchoscope to the target bronchus. We then evaluated the system with regard to its usefulness and problems. DESIGN: A pilot study. SETTING: A tertiary teaching hospital. PATIENTS: The subjects were consecutive patients with small pulmonary peripheral lesions (< or = 30 mm). INTERVENTIONS: Using this system, the rotation, advancement, and retreat of VB images were possible, and the bronchus into which the bronchoscope was to be advanced was displayed. VB images were displayed along with actual images, and the ultrathin bronchoscope was advanced to the target bronchus under direct vision. Under CT and radiographic fluoroscopy, a pair of forceps was inserted into the lesion via the bronchoscope. Thin-section CT images were obtained; after confirming the advancement of the bronchoscope into the target bronchus and the arrival of the forceps at the lesion, a biopsy was performed. RESULTS: Study subjects included 37 patients with 38 lesions. VB images to a median of the sixth- (third- to ninth-) order bronchi could be produced. Using this system, the ultrathin bronchoscope could be advanced into the planned route for 36 of the 38 lesions (94.7%). The system was used for a median of 2.6 min, and the median examination time was 24.9 min. The biopsy forceps could be advanced to the lesion in 33 of the 38 lesions (86.8%), and diagnosis was possible for 31 lesions (81.6%). CONCLUSIONS: This navigation system is useful for ultrathin bronchoscopy for pulmonary peripheral lesions.

Adult↗

PubMed2005

Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation.

STUDY OBJECTIVES: We evaluated the feasibility, safety, and efficacy of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS) and virtual bronchoscopy (VB) navigation for small peripheral pulmonary lesions < or = 30 mm in diameter. DESIGN: Pilot study. SETTING: A national university hospital. PATIENTS: We performed TBB using EBUS-GS with VB navigation for 29 patients with 30 small peripheral pulmonary lesions (average diameter, 18.6 mm) between January 1, 2004, and August 31, 2004. INTERVENTIONS: VB images were reconstructed from helical CT data. TBB was then performed using EBUS-GS with VB navigation. RESULTS: In all patients, TBB was performed safely with no complications. Bronchi seen on VB imaging were highly consistent with the actual structures confirmed using fiberoptic bronchoscopy. Following VB navigation, the endobronchial ultrasonography (EBUS) probe was inserted into third- to sixth-generation bronchi. Twenty-four lesions (80%) were visualized on EBUS images. Average durations of the initial EBUS examination of lesions, first biopsy, and the total procedure were 9.56 min, 11.99 min, and 25.72 min, respectively. Nineteen lesions (63.3%) were diagnosed from histopathologic or cytologic examination. Diagnostic sensitivities were 44.4% (8 of 18) for lesions < 20 mm in mean diameter and 91.7% (11 of 12) for lesions 20 to 30 mm in mean diameter. CONCLUSIONS: In summary, TBB using EBUS-GS with VB navigation was safely performed and was effective in diagnosing small peripheral pulmonary lesions.

Adult↗

PubMed2004

A barium marking method using an ultrathin bronchoscope with virtual bronchoscopic navigation.

CT scanning in a 77-year-old woman showed a ground-glass opacity pattern shadow(9 x 7 mm) in the right lower lobe. To allow identification of the location of the lesion during thoracoscopic surgery, preoperative barium marking was performed using an ultrathin bronchoscope and virtual bronchoscopic navigation. Virtual bronchoscopy was performed based on thin-section CT images, and virtual bronchoscopic images to the target sites were obtained. Subsequently, using virtual bronchoscopic images to right B8aiibetax, B6biibeta for navigation, an ultrathin bronchoscope was advanced to this site under direct observation. A special catheter for ultrathin bronchoscopy was advanced to sites near the lesion, and barium was infused. Barium was clearly observed by radiographic fluoroscopy during thoracoscopic surgery and was useful for determining the area for resection. Pathological examination of the resected specimen revealed atypical adenomatous hyperplasia. There were no complications with this method, and a number of target areas could be readily marked in a short time. This method may be useful before thoracoscopic surgery for small peripheral pulmonary lesions.

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PubMed2004

Ultrathin bronchoscopic barium marking with virtual bronchoscopic navigation for fluoroscopy-assisted thoracoscopic surgery.

STUDY OBJECTIVES: To facilitate marking and to reduce its complications, we performed barium marking using an ultrathin bronchoscope with virtual bronchoscopic (VB) navigation before thoracoscopic surgery for small pulmonary peripheral lesions. We then evaluated the feasibility, safety, and efficacy of this technique. DESIGN: A pilot study. SETTING: A tertiary teaching hospital. PATIENTS: The subjects were consecutive patients with small pulmonary peripheral lesions (ie, </= 10 mm) showing a CT scan-confirmed pure ground-glass opacity pattern between December 2001 and August 2003. INTERVENTIONS: VB images to the planned marking sites near each lesion were produced from helical CT scan data. Based on these images, an ultrathin bronchoscope was advanced to the target bronchus under direct vision. Under CT scan and radiographic fluoroscopy, a catheter was inserted to the planned site via the bronchoscope, and barium sulfate suspension was instilled for marking. RESULTS: The subjects were 23 patients (8 men and 15 women) who had a total of 31 lesions. The bronchial branching patterns seen in VB images were highly consistent with those confirmed using the ultrathin bronchoscope. Therefore, the ultrathin bronchoscope could be guided under direct vision to a median of the sixth generation bronchi (range, fourth to ninth generation bronchi) toward the planned marking sites. Marking was achieved without causing complications in any of the patients. The median marking time was 23.5 min, and the median shortest distance between the barium marker and the lesion was 4 mm (within 10 mm in 27 lesions). In patients undergoing thoracoscopic surgery, all barium-marked sites were identified by intraoperative radiographic fluoroscopy, and all lesions were resected. A pathologic examination demonstrated primary lung cancer in 17 lesions (bronchioloalveolar carcinoma, 15; adenocarcinoma, 2), atypical adenomatous hyperplasia in 12 lesions, and pneumonia in 2 lesions. CONCLUSIONS: This method can be readily performed without complications and is a useful marking method before thoracoscopic surgery for small pulmonary peripheral lesions.

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PubMed2003

[A barium marking method using an ultrathin bronchoscope with virtual bronchoscopic navigation].

CT scanning of a 77-year-old woman showed a ground-glass opacity pattern shadow (9 x 7 mm) in the lower lobe of the right lung. To allow identification of the location of the lesion during thoracoscopic surgery, preoperative barium marking was performed using an ultrathin bronchoscope and virtual bronchoscopic navigation. Virtual bronchoscopy was performed based on thin-section CT images, and virtual bronchoscopic images to the target sites were obtained. Subsequently, using virtual bronchoscopic images to the right B8aii beta x, B6bii beta for navigation, an ultrathin bronchoscope was advanced to this site under direct observation. A special catheter for ultrathin bronchoscopy was advanced to sites near the lesion, and barium was infused. The barium was clearly observed by fluoroscopy during thoracoscopic surgery and was useful for determining the resection area. Pathological examination of a resected specimen revealed atypical adenomatous hyperplasia. There were no complications with this method, and a number of target areas could be readily marked in a short time. This method may be useful before thoracoscopic surgery for small peripheral pulmonary lesions.

Adenoma↗

PubMed2002

[CT-guided transbronchial diagnosis using ultrathin bronchoscope for small peripheral pulmonary lesions].

We performed computed tomography (CT)-guided transbronchial diagnosis on 23 patients, using an ultrathin bronchoscope (external diameter, 2.8 mm) for small peripheral pulmonary lesions (< or = 2 cm). The mean size of the lesions was 1.4 x 1.1 cm. After examination using a conventional bronchoscope (external diameter, 6.3 mm), an ultrathin bronchoscope and a biopsy apparatus were advanced to the lesion under CT and X-ray fluoroscopic guidance. The location of the biopsy apparatus at each lesion was confirmed by thin-section CT, and a biopsy was performed. The ultrathin bronchoscope reached the 5th-11th bronchus (mean, 7.1 +/- 1.5th), at a point 3.6 +/- 0.9 bronchi peripheral to the site reached using a conventional bronchoscope. In 20 of the 23 patients, the biopsy apparatus could be guided to the lesion. The diagnosis rate, by disease, was 81.8% (9/11) for lung cancer, 66.7% (2/3) for metastatic lung cancer, and 77.8% (7/9) for inflammation; the overall rate being 78.3% (18/23). CT-guided transbronchial diagnosis using an ultrathin bronchoscope is useful for diagnosing small peripheral pulmonary lesions because the bronchoscope can be readily inserted into peripheral areas and guided to lesions, and the site of sample collection can be accurately determined.

Adult↗

PubMed2002

[Early image of squamous cell carcinoma in the peripheral lung field on high-resolution CT scan].

A 65-year-old man presented with the shadow of an abnormal nodule in the left lower lung field in a chest radiograph. We diagnosed this as an old inflammatory change because prior chest radiographs had shown the same nodule in the same lung field. However, a high-resolution CT scan showed a hazy ground-glass opacity (GGO) near the nodule. Two years later, this GGO changed into a small nodule. After a CT-guided transbronchial lung biopsy performed by ultra-thin fiberoptic bronchoscopy, we diagnosed this nodule as squamous cell carcinoma. We speculated that the hazy GGO detected in the peripheral lung field on high-resolution CT two years before diagnosis may have been an early image of squamous cell carcinoma.

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