Аннотация:Abstract Background and objective The yield of biopsy performed during bronchoscopy is reduced if the lesion is smaller than 30 mm. We evaluated the performance of a new diagnostic technique combining endobronchial ultrasonography with a guide sheath ( EBUS‐GS ) and a virtual bronchoscopic navigation system, L ung P oint ( B roncus T echnologies, I nc., M ountain V iew, CA , USA ), for the diagnosis of small (≤30 mm) peripheral pulmonary lesions ( PPL ). Methods Between M ay 2011 and D ecember 2011, we recruited 68 consecutive patients presenting with a PPL 30 mm or less in diameter determined by chest computed tomography. We used the L ung P oint system before bronchoscopy to identify the bronchus into which the bronchoscope should be advanced. We used a thin bronchoscope. EBUS‐GS was performed using an endoscope ultrasonography system equipped with a 20‐ MHz mechanical radial‐type probe. We used a guide sheath with an external diameter of 1.95 mm, thin forceps and brushing. Results The diagnostic yield of the 68 PPL was 77.9%; it was 83.7% and 68.0% for the malignant and benign lesions, respectively. Notably, three cases were diagnosed by transbronchial needle‐aspiration cytology alone. Univariate and multivariate analyses showed that the EBUS probe localization was the most significant contributor to successful diagnosis (diagnostic yield: within vs adjacent to the lesion = 92.1% vs 60.0%, respectively; P = 0.004 and P = 0.003, respectively). Conclusions The combination of EBUS‐GS and L ung P oint was useful for diagnosing small PPL .
