Advances in bronchoscopic diagnosis of lung cancer

PURPOSE OF REVIEW: In this chapter we will discuss two bronchoscopic advances in the diagnosis and staging of lung cancer. RECENT FINDINGS: Endobronchial ultrasound utilizes a flexible ultrasound probe fed through the working channel of a bronchoscope to image and biopsy lesions and lymph nodes beyond the wall of the bronchus. Electromagnetic navigation and guidance involves a specialized electromagnetic table with a computer program that maps the endobronchial tree and then helps navigate a bronchoscope to a particular lesion or lymph node. SUMMARY: We review a number of recent studies that utilize endobronchial ultrasound and electromagnetic navigation and guidance and analyze their performance characteristics for lung cancer diagnosis and staging as well the clinical applications of both technologies. Both are likely to play an increasing and integral role in the diagnosis and staging of lung cancer in the near future. Endobronchial ultrasound will likely have its greatest impact on mediastinal lymph node staging while electromagnetic registration may impact both staging and diagnosis of peripheral lesions.