Fiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE study

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dc.contributor.authorBowling, Mark R.
dc.contributor.authorFolch, Erik E.
dc.contributor.authorKhandhar, Sandeep J.
dc.contributor.authorKazakov, Jordan
dc.contributor.authorKrimsky, William S.
dc.contributor.authorLeMense, Gregory P.
dc.contributor.authorLinden, Philip A.
dc.contributor.authorMurillo, Boris A.
dc.contributor.authorNead, Michael A.
dc.contributor.authorPritchett, Michael A.
dc.contributor.authorTeba, Catalina V.
dc.contributor.authorTowe, Christopher W.
dc.contributor.authorWilliams, Terence
dc.contributor.authorAnciano, Carlos J.
dc.date.accessioned2020-04-13T17:16:10Z
dc.date.available2020-04-13T17:16:10Z
dc.date.issued2019-03-08
dc.description.abstractFiducial markers (FMs) help direct stereotactic body radiation therapy (SBRT) and localization for surgical resection in lung cancer management. We report the safety, accuracy, and practice patterns of FM placement utilizing electromagnetic navigation bronchoscopy (ENB). Methods: NAVIGATE is a global, prospective, multicenter, observational cohort study of ENB using the superDimension™ navigation system. This prospectively collected subgroup analysis presents the patient demographics, procedural characteristics, and 1-month outcomes in patients undergoing ENB-guided FM placement. Follow up through 24 months is ongoing. Results: Two-hundred fifty-eight patients from 21 centers in the United States were included. General anesthesia was used in 68.2%. Lesion location was confirmed by radial endobronchial ultrasound in 34.5% of procedures. The median ENB procedure time was 31.0 min. Concurrent lung lesion biopsy was conducted in 82.6% (213/258) of patients. A mean of 2.2 ± 1.7 FMs (median 1.0 FMs) were placed per patient and 99.2% were accurately positioned based on subjective operator assessment. Follow-up imaging showed that 94.1% (239/254) of markers remained in place. The procedure-related pneumothorax rate was 5.4% (14/258) overall and 3.1% (8/258) grade ⩾ 2 based on the Common Terminology Criteria for Adverse Events scale. The procedure-related grade ⩾ 4 respiratory failure rate was 1.6% (4/258). There were no bronchopulmonary hemorrhages. Conclusion: ENB is an accurate and versatile tool to place FMs for SBRT and localization for surgical resection with low complication rates. The ability to perform a biopsy safely in the same procedure can also increase efficiency. The impact of practice pattern variations on therapeutic effectiveness requires further study.en_US
dc.identifier.doi10.1177/1753466619841234
dc.identifier.urihttp://hdl.handle.net/10342/8095
dc.subjectelectromagnetic navigation bronchoscopy, fiducial, lung cancer, prospective clinical study, stereotactic body radiation therapyen_US
dc.titleFiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE studyen_US
dc.typeArticleen_US
ecu.journal.nameTherapeutic Advances in Respiratory Diseaseen_US
ecu.journal.pages1-11en_US
ecu.journal.volume13en_US

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