Journal of Bronchology & Interventional Pulmonology最新文献

{"title":"Optimal Number of Pleural Biopsies During Pleuroscopy (OPTIBIOP).","authors":"Jeeyune Bahk, Axel Duval, Sung Choi, Kimia Ganjaei, Mary B Beasley, Abhinav Agrawal, Udit Chaddha","doi":"10.1097/LBR.0000000000001080","DOIUrl":"10.1097/LBR.0000000000001080","url":null,"abstract":"<p><strong>Background: </strong>There is currently no evidence-based standard for the number of pleural biopsies required during pleuroscopy to achieve diagnostic adequacy. This study evaluated the cumulative diagnostic yield of sequential pleural biopsy aliquots obtained during rigid pleuroscopy.</p><p><strong>Methods: </strong>We conducted a prospective, single-center observational pilot study of adult patients undergoing pleuroscopy. Biopsy specimens were obtained according to routine practice and submitted in sequential aliquots: aliquot 1 (biopsies 1 to 3), aliquot 2 (4 to 6), aliquot 3 (7 to 9), and aliquot 4 (≥10). Pathologic evaluation was performed sequentially to determine the earliest aliquot yielding a definitive diagnosis. Cumulative diagnostic yield, the need for additional aliquots for comprehensive biomarker testing, and complications were evaluated.</p><p><strong>Results: </strong>A definitive diagnosis was achieved in all 104 patients. The median number of biopsies performed was 10 (IQR 6 to 14). The diagnostic yield for aliquot 1 (≤3 biopsies) was 93%. Among the 7% of cases requiring subsequent aliquots for diagnosis, 6 had diffuse parietal pleural abnormalities on pleuroscopy, while 1 had discrete lesions. Of the 17 patients who required comprehensive biomarker testing, 10 (59%) needed samples beyond the first aliquot. No major complications were reported.</p><p><strong>Conclusion: </strong>While most diagnoses can be established with 3 or fewer biopsies, cases requiring additional biopsies were more frequently associated with diffuse pleural disease. These findings support tailoring the biopsy strategy to pleural morphology: lesion-directed sampling for focal disease and broader sampling for diffusely abnormal or benign-appearing pleura, especially when malignancy is suspected, or comprehensive biomarker testing is required.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linear Endobronchial Ultrasound With a Lung Target: Analysis of the Stather Canadian Outcomes Registry for Chest Procedures (SCOPE).","authors":"Héctor José Peroni, Daniel Stollery, Kirk Graff, Nicholas Romatowski, Elaine Dumoulin, Inderdeep Dhaliwal, Christopher A Hergott, Alex Chee, Chrystal Chan, Chung-Chun Tyan, Erik Vakil, Marc Fortin, Paul MacEachern, Alain Tremblay","doi":"10.1097/LBR.0000000000001076","DOIUrl":"10.1097/LBR.0000000000001076","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that allows for the evaluation of mediastinal and hilar lymph nodes. It has also been described in limited studies for the evaluation of central pulmonary lesions.</p><p><strong>Objectives: </strong>Our study aimed to describe the diagnostic performance of linear EBUS in pulmonary lesions, the sensitivity for malignancy, and its suitability as an adjunctive test for lung cancer.</p><p><strong>Methods: </strong>We analyzed procedures from the Stather Canadian Outcomes Registry for Chest Procedures (SCOPE) database that included sampling of at least 1 intrapulmonary lesion with linear EBUS. Diagnostic yield (DY) and sensitivity were calculated using the standard definitions. Suitability for molecular testing was evaluated in the lung cancer cohort, in which lung lesion sampling was the only diagnostic site.</p><p><strong>Results: </strong>Four hundred and 10 records were identified, one of which was excluded for lack of follow-up data. The most frequent final diagnosis was lung cancer in 346/409 cases (84.6%). DY for the lung EBUS-TBNA was 370/409 (90.5%), and sensitivity for malignancy was 358/372 (96.2%). The sensitivity of linear EBUS lung TBNA for lung cancer was 331/346 (95.7%). The data set did not record failed attempts at lung lesion localization with linear EBUS, during which no sample was collected.</p><p><strong>Conclusion: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an effective and safe diagnostic tool for lung lesions visible on ultrasound. Lesion size is associated with improved DY. Lung cancer ancillary testing is feasible in almost all cases.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambient Sound Pressure Levels in the Bronchoscopy Suite: Contrasting Flexible, Rigid, and Robotic-Assisted Bronchoscopy.","authors":"Rastko Rakočević, Chelsea Dwyer, Kam S Ho, Robert M Reed, Kevin G Lazo, Soumya Ashok, An Thi Nhat Ho, Bryan C Husta, Robert P Lee, Mohit Chawla, Stella E Hines, Ying Zhen, Jennifer Larbi, Emily Feuerstein, Sameer Kaza, Or Kalchiem-Dekel","doi":"10.1097/LBR.0000000000001078","DOIUrl":"10.1097/LBR.0000000000001078","url":null,"abstract":"<p><strong>Background: </strong>Operating room noise can result in provider- and patient-related adverse outcomes. The recommended sound pressure threshold in medical settings is 35-45 dB(A). This study aimed to quantify sound pressure across different types of bronchoscopy procedures.</p><p><strong>Methods: </strong>Sound meters were placed in the bronchoscopy suite. Ambient sound pressure levels were measured continuously during flexible, rigid, and robotic bronchoscopy procedures. Procedures were classified as \"quiet\" or \"loud\" using the median equivalent continuous sound pressure level (Leq). A logistic regression model was used to identify associations between the type of bronchoscopy and \"loud\" or \"quiet\" procedures.</p><p><strong>Results: </strong>A total of 186 procedures were analyzed, of which 64% were flexible, 11% were rigid, and 25% were robotic. Across all procedures, the median Leq was 56.8 (55.1 to 58.1) dB(A). Leq was 58.2 (57.5 to 58.9), 59.4 (58.6 to 60.5), and 57.9 (57.5 to 58.4) dB(A) for flexible, rigid, and robotic bronchoscopy, respectively (P<0.0001). In comparison to flexible bronchoscopy, rigid bronchoscopy was more likely to be loud, while robotic bronchoscopy was less likely to be loud.</p><p><strong>Conclusion: </strong>This is the first study to quantify sound pressure levels during bronchoscopy procedures. Across all types of bronchoscopy procedures, sound pressure levels exceeded those recommended by guidelines for the medical setting and were considered a moderate degree of noise. Rigid bronchoscopy was associated with higher sound pressure levels, whereas robotic-assisted bronchoscopy was associated with lower sound pressure levels when compared with flexible bronchoscopy. Future studies are needed to explore the potential deleterious effects of bronchoscopy noise on operators and patients to inform preventive measures.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness and Safety of Robotic-Assisted Bronchoscopy Across Diverse Patient Heights: A Subset Analysis of a Multicenter, Prospective, Observational Trial.","authors":"Camilla Gomes, Brandon Cowan, Heather Benz, Paul Morris, Damaris Pederson, Michael Schwiers, Calvin Sze Hang Ng","doi":"10.1097/LBR.0000000000001075","DOIUrl":"10.1097/LBR.0000000000001075","url":null,"abstract":"<p><strong>Background: </strong>Outcomes of robotic-assisted bronchoscopy (RAB) in patients of small stature remain uncertain due to concerns about their potentially smaller lung volumes. We assess the effectiveness and safety of RAB across height variations.</p><p><strong>Methods: </strong>This is a subset analysis of TARGET, a multicenter, prospective, observational study using the MONARCH Robotic Bronchoscopy Platform, which enrolled patients with lung lesions undergoing RAB across 21 sites. RAB safety and effectiveness were compared across height quartiles by assessing reach, measured through radial endobronchial ultrasound (r-EBUS) confirmation and the distance from the bronchoscope tip to the lesion, and access, evaluated by the diagnostic yield (DY). Comparisons across groups were performed via ANOVA, the Kruskal-Wallis test, or Fisher exact test as appropriate.</p><p><strong>Results: </strong>A total of 679 patients were analyzed, categorized into height quartiles: <160.02 cm (N=182), 160.03 to 167.64 cm (N=189), 167.65 to 175.26 cm (N=140), and >175.27 cm (N=168). Mean nodule size was 20.9 mm, with a distance from the pleura of 15.7 mm; 47.2% were in the outer third of the lung, with no significant differences across quartiles. r-EBUS localization succeeded in 91.7% of cases, with no quartile differences (P=0.95). The mean distance from the bronchoscope tip to the lesion was 22.6 mm, consistent across groups (P=0.84). Intermediate DY was higher in the third quartile of height, but no significant differences were observed for strict or liberal DY. Pneumothorax and bleeding rates were 4.1% and 2.4%, respectively, with no significant differences across quartiles (P=0.33 and 0.93, respectively).</p><p><strong>Conclusion: </strong>Our findings demonstrate a comparable effectiveness and safety profile of RAB across varying heights.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating False Multistation N2 Upstaging From Cross-Contamination During EBUS-TBNA Without ROSE: Insights From a Monte Carlo Analysis.","authors":"Ala-Eddin S Sagar, Sami M Bennji, Ihab Alshelli, Sarah Alrasheed, Liju Ahmed","doi":"10.1097/LBR.0000000000001070","DOIUrl":"10.1097/LBR.0000000000001070","url":null,"abstract":"<p><strong>Background: </strong>The ninth TNM edition distinguishes single-station (N2a) from multistation (N2b) disease, increasing concern for cross-contamination between N2 lymph nodes during EBUS staging when ROSE is unavailable. The absolute probability and clinical impact of this phenomenon are uncertain. We estimated a theoretical upper bound on false upstaging and the number of needle changes required to prevent one false upstage.</p><p><strong>Methods: </strong>A Monte Carlo decision model simulated mediastinal staging in 100,000 virtual patients across published estimates of occult N2 prevalence, probability of a single-station involvement, and contamination rates. Outcomes were the probability of false N2b upstaging and the number of additional needle changes needed to prevent one false upstage (NNC). Sensitivity analyses varied the contamination rate, single-station probability, and sampling order.</p><p><strong>Results: </strong>False upstaging in central cN0 disease was ∼0.5% to 0.8% in the base case, increasing to 1.4% in higher-risk scenarios. cN1 disease showed slightly higher probabilities. Needle-change efficiency was low; preventing one false upstage required roughly 250 to 350 extra needle changes in central cN0 and >1000 in peripheral cN0. Sensitivity analysis showed comparable influence of contamination rate, single-station probability, and sampling order.</p><p><strong>Conclusion: </strong>The risk of spurious upstaging during EBUS staging without ROSE is small but not negligible, concentrated in central cN0 and cN1 tumors. When ROSE is not available, routine needle change between N2 stations provides minimal benefit for most patients. In cases where ROSE is not available and resources are limited, a selective strategy targeting high-risk contexts may offer the best balance between accuracy and procedural efficiency.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Diagnostic Yield for Peripheral Lung Nodule Biopsies With Changes in Navigational Bronchoscopy Platforms, Tools, and Intraoperative Imaging Guidance.","authors":"Jason Beattie, Raymond Parrish, Paula Aranguren, Laith Ayasa, Annika Bharwani, Alma Burbano, Fahim Pyarali, Alex Chee, Chenchen Zhang, Fayez Kheir, Kai Swenson, Mihir Parikh, Adnan Majid","doi":"10.1097/LBR.0000000000001071","DOIUrl":"10.1097/LBR.0000000000001071","url":null,"abstract":"<p><strong>Background: </strong>Recent growth of navigational bronchoscopy has included use of new platforms and tools, the benefit of which remains under study.</p><p><strong>Research question: </strong>Does diagnostic yield differ between: (a) electromagnetic navigation bronchoscopy versus shape-sensing robotic-assisted bronchoscopy; (b) ssRAB versus ssRAB with cone-beam CT (ssRAB-CBCT); and (c) nodule sampling with versus without cryobiopsy?</p><p><strong>Methods: </strong>This single-center retrospective study evaluated the diagnostic performance of navigational bronchoscopy cases with acquisition of new platforms and tools at a bronchoscopy referral center between 2016 and March 2024. Diagnostic yield was evaluated for the primary procedural target, with yield defined as per ATS/ACCP guidelines.</p><p><strong>Results: </strong>A total of 185 ENB cases, 371 ssRAB cases, and 54 ssRAB-CBCT cases were available for comparison. Diagnostic yield was 57% for ENB, 72% for ssRAB and 78% for ssRAB-CBCT (ENB vs. ssRAB P=0.001; ssRAB vs. ssRAB-CBCT P=0.307). Diagnostic yield was 78% for ssRAB/ssRAB-CBCT procedures that used cryobiopsy versus 69% for procedures that did not (P=0.035). Nodule size differed between procedure types: median size 27 mm (IQR 17 to 35 mm) for ENB, 21 mm (IQR 16 to 30 mm) for ssRAB (P=0.001 for ENB vs. ssRAB), and 17 mm (IQR 13 to 25) for ssRAB-CBCT (P=0.004 for ssRAB vs. ssRAB-CBCT). Differences were found between ENB and ssRAB procedures regarding nodule location in the peripheral third of lung (ENB 50% vs. ssRAB 62%, P=0.009) and presence of a bronchus sign (ENB 81% vs. ssRAB 43%, P=<0.001), whereas other nodule characteristics were similar between groups.</p><p><strong>Conclusion: </strong>Acquisition of new tools for navigational bronchoscopy was associated with increased diagnostic yield despite performing biopsies on increasingly difficult cases.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Flow Nasal Cannula Versus Conventional Oxygen Therapy During Bronchoscopy: A Meta-Analysis of Randomized Controlled Trials.","authors":"Ricardo Miranda Fliess de Castro, Isabela Murray Lefevre, Shayan Mahapatra, Hamlet Ghukasyan, Hilario de Sousa Francelino, Jafar Aljazeeri","doi":"10.1097/LBR.0000000000001063","DOIUrl":"10.1097/LBR.0000000000001063","url":null,"abstract":"<p><strong>Background: </strong>Hypoxemia is a frequent complication during bronchoscopy, and optimal oxygenation strategies remain clinically important. Previous evidence suggests that high-flow nasal cannula (HFNC) may outperform conventional oxygen therapy (COT).</p><p><strong>Methods: </strong>A meta-analysis of randomized controlled trials (RCTs) was conducted by searching PubMed, Embase, and Cochrane databases for studies comparing HFNC with COT in adult patients undergoing flexible bronchoscopy. Outcomes included the incidence of hypoxemia, lowest SpO2, procedure duration, patient comfort, and sedation dose. Pooled data were analyzed using a random-effects model, with results reported as risk ratios (RR), mean differences (MD), or standardized mean differences (SMD), as appropriate. Heterogeneity was assessed using the Cochran Q test and I2 statistic.</p><p><strong>Results: </strong>Fourteen RCTs (n=2480) were included: 1263 patients (50.9%) received HFNC. HFNC significantly reduced the risk of hypoxemia (RR, 0.41; 95% CI: 0.29-0.59; P<0.0001) and increased minimum SpO2 (MD, +5.10 percentage points; 95% CI: 3.30-6.91; P<0.0001). There was no significant difference in patient comfort (SMD, -0.07; 95% CI: -0.25 to 0.11; P=0.46) and procedure time (MD, -0.73 min; 95% CI: -1.73 to 0.27; P=0.154). Sedation requirements were slightly higher in the HFNC group (SMD, 0.17; 95% CI: 0.04-0.29; P=0.008).</p><p><strong>Conclusion: </strong>HFNC significantly reduces hypoxemic events and improves oxygenation compared with COT during bronchoscopy. Although anesthetic use slightly increased, there was no difference in procedure time or patient comfort.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Tracheobronchomalacia and Excessive Dynamic Airway Collapse on Dynamic CT Images.","authors":"Paolo de Angelis, Jae Cho, Martina Rama, Fleming Mathew, Mihir S Parikh, Adnan Majid, Michael S Kent, Jennifer L Wilson, Sidhu P Gangadharan","doi":"10.1097/LBR.0000000000001069","DOIUrl":"10.1097/LBR.0000000000001069","url":null,"abstract":"<p><strong>Background: </strong>Expiratory central airway collapse (ECAC) is caused by anterior displacement of the posterior membrane (EDAC) or weakening of the cartilaginous walls (TBM). Differentiating the 2 is challenging, resulting in misdiagnosis and missed opportunities for patients. We investigated how accurately providers identify each pathology on computed tomographic (CT) images.</p><p><strong>Methods: </strong>Images from 100 patients who underwent tracheobronchoplasty (TBP) were reviewed by 4 airway experts and categorized into TBM, EDAC, normal airway, or unknown by majority consensus. Selected images of patients with TBM (n=9) and EDAC (n=9) were distributed to respondents. Linear regression was used to investigate overall accuracy; inter-rater agreement was measured using Fleiss' kappa (κ).</p><p><strong>Results: </strong>We recruited 35 surgeons and 35 pulmonologists. Most practiced at an academic center (68.5%) and cared for patients with ECAC (61.4%). Among surgeons, 14 (40.0%) performed ≥5 complex airway cases yearly, and 13 (37.1%) performed TBP. Only 1 (1.5%) assigned the correct diagnosis to all 18 patients, while 13 (18.6%) identified <50.0% of the correct diagnoses. Inter-rater agreement for respondents was low (κ=0.21; 95% CI: 0.17-0.30; P<0.01). Predictors of accuracy included ≥10 years in practice (β=0.49; 95% CI: 0.03-0.95; P=0.03) and practicing pulmonology (β=0.72; 95% CI: 0.15-1.29; P=0.02).</p><p><strong>Conclusion: </strong>Distinguishing EDAC and TBM is challenging, with poor agreement among clinicians. Therefore, clinicians should consider referring any patient with ECAC early for multidisciplinary evaluation.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AIBAN-AI Bronchial Detection and Airway Navigation System.","authors":"Bruno Oliveira, Zhuoqi Cheng, Laura H Guldbrøn, Lars Konge, Thiusius R Savarimuthu, Kristoffer M Cold","doi":"10.1097/LBR.0000000000001073","DOIUrl":"10.1097/LBR.0000000000001073","url":null,"abstract":"<p><strong>Background: </strong>Accurate navigation within the lungs is critical for bronchoscopy procedures but remains challenging due to the complex airway anatomy. Artificial intelligence (AI) integrating real-time landmark detection and navigation guidance may enhance precision and safety.</p><p><strong>Methods: </strong>We developed an AI Bronchial detection and Airway Navigation system (AIBAN) for bronchoscopy, combining airway lumen detection, anatomic localization, and navigation guidance. A YOLOv8-based detection module was used to identify 34 airway landmarks in real time. Next, an airway-level localization module estimated the bronchoscope's position using a hierarchical anatomic graph, identifying the deepest branch compatible with all coherent detections in each frame. A navigation module then recommended the next airway to follow along predefined anatomic paths, providing directional cues to perform a complete and systematic bronchoscopy.</p><p><strong>Results: </strong>AIBAN was developed on a data set of 18 bronchoscopy videos, using 15 for training and 3 for validation. In validation, the framework correctly identified the bronchoscope's location in 91.1% of the frames. In addition, 92.6% of predictions were within one airway branch of the true location, and 94.5% were within 2 branches. The navigation guidance performance was also promising, with the system following the correct anatomic pathway in 96.2% of test videos, demonstrating reliable guidance through the lungs.</p><p><strong>Conclusion: </strong>AIBAN enables accurate airway detection, localization, and navigation guidance in a simulation-based setting. It can provide reliable guidance along predefined paths and precise spatial positioning and is a promising tool for medical training and has potential for future clinical implementation.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Detection of PET-CT Negative Contralateral Hilar Lymph Node Metastasis in the Staging of Non-small cell Lung Cancer.","authors":"Arsal Tharwani, Brian Shaller, Carlos Aravena, Lucas Rathunde, Yash Sarda, Joseph Cicenia, Sonali Sethi, Manuel L Ribeiro Neto, Humberto Choi, Colin Gillespie, Thomas Gildea, Louis Lam, Atul Mehta, Michael Machuzak, Peter Mazzone, Yifan Wang, Francisco A Almeida","doi":"10.1097/LBR.0000000000001066","DOIUrl":"10.1097/LBR.0000000000001066","url":null,"abstract":"<p><strong>Background: </strong>The detection rate of contralateral hilar involvement in NSCLC during EBUS-TBNA staging is not well established.</p><p><strong>Methods: </strong>We conducted a retrospective observational single-center study of all EBUS-TBNA staging examinations performed from 2016 through 2020 to determine the incidence of PET and CT negative N3 hilar metastasis by EBUS-TBNA in patients with radiographic T1-T4, N0-N3, M0 NSCLC.</p><p><strong>Results: </strong>A total of 516 patients underwent EBUS-TBNA sampling of contralateral hilar lymph nodes. Metastatic non-small cell lung cancer was detected in one or more contralateral hilar lymph node stations in 5 patients (0.97%). Four of these patients had radiographic N2 or N3 disease on PET imaging. Patients with mediastinal N2/N3 disease by PET scan were at higher risk of having occult contralateral hilar disease as compared with mediastinal N0/N1 by PET (P=0.017). In individuals radiographically staged as mediastinal N3 by CT scan, 14 (95% CI: 3-78) patients would need to undergo EBUS-TBNA sampling of a CT negative contralateral hilar lymph node to identify malignant involvement of the latter. In cases radiographically staged as mediastinal N3 by PET scan, 25 (95% CI: 6-141) patients would need to undergo EBUS-TBNA sampling of a PET-negative contralateral hilar lymph node to identify malignancy involvement in this location.</p><p><strong>Conclusion: </strong>In patients with NSCLC undergoing EBUS staging for radiographic N0/N1 disease by PET, it is reasonable to not sample the contralateral hilar lymph node stations. In radiographic N2/N3 disease by PET or CT, sampling the contralateral hilar lymph node stations appears to be justified.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}