Evaluation of Endoscopically Deployed Radiopaque Tumor Models in Bronchoscopy. Issue 2 (April 2016)

• Record Type: Journal Article
• Authors: O'Shea, Conor; Ali Khan, Kashif; Nardelli, Pietro; Jaeger, Herman Alex; Kennedy, Marcus P.; Cantillon-Murphy, Pádraig
• Is Part Of: Journal of bronchology & interventional pulmonology. Volume 23:Issue 2(2016)
• Publication Date: 2016-04
• Subjects: simulating lung cancer -- radiopaque pulmonary tumor model -- soft tissue pulmonary fiducial; Bronchoscopy -- Periodicals; Lungs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Lung Diseases -- surgery -- Periodicals; Diagnostic Techniques, Respiratory System -- Periodicals; Bronchi; Bronchoscopy; Lungs -- Diseases; Periodicals; 616.23
• DOI: 10.1097/LBR.0000000000000269
• Languages: English
• ISSNs: 1944-6586

Abstract

Abstract : Background: Radiopaque markers and soft tissue models have been used extensively in clinical applications to target cancerous lesions and to calibrate and characterize imaging systems. However, the development of radiopaque, soft tissue models for pulmonary lesions is yet to be optimized. Such a material may improve endoscopic training techniques and also be useful to evaluate bronchoscopy navigation systems by the targeting and sampling of tumor models with computed tomography. Methods: This study investigates a modified agarose-based model and a novel contrast-infused tripe model to create clinically relevant pulmonary tumor models. An iodine-enhanced agarose model presents an injectable solution with high image contrast under computed tomography capable of reaching distal bronchial airways. The tripe solution presents a cheap and easily deployed method to quickly establish a fiducial marker that may be used during bronchial imaging system training and evaluation. Results: The iodine-enriched agarose model demonstrates desirable mechanical characteristics ex vivo, but has a number of limitations when administered in a live setting. The tripe solution presents a far more effective in vivo pulmonary tumor model and offers an effective radiopaque marker. However, the size of the tripe tumor samples required for effective insertion limits its ability to reach more distal airways. An iterative testing process was used to optimize the model composition, culminating in live animal investigations (n=3). Conclusion: Both contrast-infused agarose and tripe models present a promising analog to a pulmonary lesion and may act as a radiopaque marker for bronchoscopic training and biopsy evaluation.