Randomised Controlled Trial of Pre-Procedure Virtual Bronchoscopy Planning Compared To Conventional Computed Tomographic Planning For Endobronchial Ultrasound Guide Sheath Procedures

The iLogic inReach (superDimension) software creates a virtual bronchoscopic map as well as a three dimensional external map of the bronchial tree from information obtained from CT scan data. It also provides simultaneous review of CT scan images in three different planes (coronal, axial, sagittal). The bronchoscopist will use this software to map a pathway to the target lesion and will then review the intended pathway by virtual bronchoscopy. This planning method will take 5-30 minutes. The EBUS GS system consists of a radial ultrasound probe which is inserted into a flexible guide sheath in the working channel of the bronchoscope. Ultrasound images help the bronchoscopist determine the density of the tissue which the radial probe is passing through. Normal lung produces a "snow storm" appearance whereas mass lesions show a well defined border which represents the change in density between normal aerated lung and the solid mass. The radial ultrasound probe is then removed and the pre-measured biopsy forceps and cytology brushes are then pass through the guide sheath to sample the target lesion.