RT Journal Article SR Electronic T1 Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 1072 OP 1077 DO 10.1136/thx.2010.145490 VO 66 IS 12 A1 Ishida, Takashi A1 Asano, Fumihiro A1 Yamazaki, Koichi A1 Shinagawa, Naofumi A1 Oizumi, Satoshi A1 Moriya, Hiroshi A1 Munakata, Mitsuru A1 Nishimura, Masaharu A1 , YR 2011 UL http://thorax.bmj.com/content/66/12/1072.abstract AB Background Bronchoscopy using endobronchial ultrasound (EBUS) can help to diagnose small peripheral pulmonary lesions. However, although biopsy sites can be confirmed, a bronchoscope cannot be guided in EBUS. Virtual bronchoscopic navigation (VBN) can guide a bronchoscope with virtual images, but its value has not been confirmed.Methods This prospective multicentre study examines the value of VBN-assisted EBUS for diagnosing small peripheral pulmonary lesions. 199 patients with small peripheral pulmonary lesions (diameter ≤30 mm) were randomly assigned to VBN-assisted (VBNA) or non-VBN-assisted (NVBNA) groups. A bronchoscope was introduced into the target bronchus of the VBNA group using the VBN system. Sites of specimen sampling were verified using EBUS with a guide sheath under fluoroscopy.Results The diagnostic yield was higher for the VBNA than for the NVBNA group (80.4% vs 67.0%; p=0.032). The duration of the examination and time elapsed until the start of sample collection were reduced in the VBNA compared with the NVBNA group (median (range), 24.0 (8.7–47.0) vs 26.2 (11.6–58.6) min, p=0.016) and 8.1 (2.8–39.2) vs 9.8 (2.3–42.3) min, p=0.045, respectively). The only adverse event was mild pneumothorax in a patient from the NVBNA group.Conclusions The diagnostic yield for small peripheral pulmonary lesions is increased when VBN is combined with EBUS.Clinical trial number UMIN000000569.