Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access

Miyake, Kotaro; Oki, Masahide; Suzuki, Hidekazu; Saka, Hideo; Sasada, Shinji; Okamoto, Norio; Imabayashi, Tatsuya; Kogure, Yoshihito; Shiroyama, Takayuki; Hirata, Haruhiko; Nagatomo, Izumi; Takeda, Yoshito; Kumanogoh, Atsushi

doi:https://doi.org/10.1136/thorax-2025-223218

Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access

Miyake, Kotaro; Oki, Masahide; Suzuki, Hidekazu et al.

Thorax, 2025, 81, 33-41

アクセス数:52件（2026-02-15 21:48 集計）

固定URL: https://hdl.handle.net/11094/103671

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タイトル	Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access
著者	NRID 1000080726787 1000080726787 researchmap permalink kotaro_researchmap kotaro_researchmap Scopus Author ID 55856984400 55856984400 著者名 Miyake, Kotaro
	著者名 Oki, Masahide
	著者名 Suzuki, Hidekazu
	著者名 Saka, Hideo
	著者名 Sasada, Shinji
	著者名 Okamoto, Norio
	著者名 Imabayashi, Tatsuya
	著者名 Kogure, Yoshihito
	NRID 1000060860062 1000060860062 researchmap permalink shiroyama_t shiroyama_t Scopus Author ID 36476578400 36476578400 著者名 Shiroyama, Takayuki
	NRID 1000030546867 1000030546867 researchmap permalink hh_resmed hh_resmed Scopus Author ID 7202342767 7202342767 著者名 Hirata, Haruhiko
	NRID 1000010570583 1000010570583 ORCID 0000-0001-5382-4327 0000-0001-5382-4327 researchmap permalink saxon-w saxon-w Scopus Author ID 13404305500 13404305500 著者名 Nagatomo, Izumi
	NRID 1000040452388 1000040452388 researchmap permalink yoshi10 yoshi10 Scopus Author ID 7404001848 7404001848 著者名 Takeda, Yoshito
	NRID 1000010294125 1000010294125 ORCID 0000-0003-4749-7117 0000-0003-4749-7117 researchmap permalink read0051725 read0051725 Scopus Author ID 6602726311 6602726311 著者名 Kumanogoh, Atsushi
キーワード等	Bronchoscopy
キーワード等	Lung Cancer
内容	Miyake K., Oki M., Suzuki H., et al. Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access. Thorax 81, 33 (2026); https://doi.org/10.1136/thorax-2025-223218.
抄録	Background Bronchoscopic limitations in reaching peripheral pulmonary lesions (PPLs) can compromise biopsy sensitivity, especially for small PPLs. Therefore, we developed the balloon dilatation for bronchoscope delivery (BDBD) technique to dilate bronchial pathways and facilitate bronchoscope advancement into the periphery. This study evaluated the diagnostic performance and safety profile of transbronchial biopsy using this technique. Methods This multicentre, single-arm, prospective study included patients with bronchus sign-positive PPLs measuring <20 mm. Bronchoscopy was performed using ultrathin or thin bronchoscopes under conscious sedation. When the bronchoscope could not advance further, the BDBD technique was used to approach closer to the target, followed by biopsies. The primary endpoint was the diagnostic sensitivity for malignancy in specimens obtained through the specified procedure, defined as bronchoscope advancement using balloon dilatation, direct biopsy site visualisation and absence of serious adverse events. Results Eighteen of 22 patients who underwent bronchoscopy with the BDBD technique were ultimately diagnosed with cancer. BDBD enabled bronchoscope advancement in all 18 cases without serious complications, allowed direct biopsy site visualisation in 17 and detected cancer in 14. Thus, the diagnostic sensitivity for malignancy was 77.8% (14/18). Beyond these cases, one patient who met all procedural criteria was diagnosed with cryptococcosis. Another patient was diagnosed with cancer without direct visualisation. On average, BDBD enabled bronchoscope advancement by 2.3 bifurcations. Conclusion In this small observational study, BDBD appeared to be a promising technique for improving the diagnostic sensitivity of bronchoscopy for small PPLs. Further validation is necessary in large cohorts.
出版者	BMJ Publishing Group
収録物名	Thorax
巻(号)	81
ページ	33-41
刊行年月	2025-11-17
言語	英語
ハンドルURL	https://hdl.handle.net/11094/103671
PISSN	00406376
eISSN	14683296
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1136/thorax-2025-223218
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Thorax. 2025, 81, p. 33-41
DC.title	Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access
DC.creator	Miyake, Kotaro
	Oki, Masahide
	Suzuki, Hidekazu
	Saka, Hideo
	Sasada, Shinji
	Okamoto, Norio
	Imabayashi, Tatsuya
	Kogure, Yoshihito
	Shiroyama, Takayuki
	Hirata, Haruhiko
	Nagatomo, Izumi
	Takeda, Yoshito
	Kumanogoh, Atsushi
DC.publisher	BMJ Publishing Group
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-11-17
DC.identifier	https://doi.org/10.1136/thorax-2025-223218
DC.subject	Bronchoscopy
DC.subject	Lung Cancer
DC.description	Miyake K., Oki M., Suzuki H., et al. Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access. Thorax 81, 33 (2026); https://doi.org/10.1136/thorax-2025-223218.
DCTERMS.abstract	Background Bronchoscopic limitations in reaching peripheral pulmonary lesions (PPLs) can compromise biopsy sensitivity, especially for small PPLs. Therefore, we developed the balloon dilatation for bronchoscope delivery (BDBD) technique to dilate bronchial pathways and facilitate bronchoscope advancement into the periphery. This study evaluated the diagnostic performance and safety profile of transbronchial biopsy using this technique. Methods This multicentre, single-arm, prospective study included patients with bronchus sign-positive PPLs measuring <20 mm. Bronchoscopy was performed using ultrathin or thin bronchoscopes under conscious sedation. When the bronchoscope could not advance further, the BDBD technique was used to approach closer to the target, followed by biopsies. The primary endpoint was the diagnostic sensitivity for malignancy in specimens obtained through the specified procedure, defined as bronchoscope advancement using balloon dilatation, direct biopsy site visualisation and absence of serious adverse events. Results Eighteen of 22 patients who underwent bronchoscopy with the BDBD technique were ultimately diagnosed with cancer. BDBD enabled bronchoscope advancement in all 18 cases without serious complications, allowed direct biopsy site visualisation in 17 and detected cancer in 14. Thus, the diagnostic sensitivity for malignancy was 77.8% (14/18). Beyond these cases, one patient who met all procedural criteria was diagnosed with cryptococcosis. Another patient was diagnosed with cancer without direct visualisation. On average, BDBD enabled bronchoscope advancement by 2.3 bifurcations. Conclusion In this small observational study, BDBD appeared to be a promising technique for improving the diagnostic sensitivity of bronchoscopy for small PPLs. Further validation is necessary in large cohorts.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
DC.format	103671
citation_title	Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access
citation_author	Miyake, Kotaro
	Oki, Masahide
	Suzuki, Hidekazu
	Saka, Hideo
	Sasada, Shinji
	Okamoto, Norio
	Imabayashi, Tatsuya
	Kogure, Yoshihito
	Shiroyama, Takayuki
	Hirata, Haruhiko
	Nagatomo, Izumi
	Takeda, Yoshito
	Kumanogoh, Atsushi
citation_publisher	BMJ Publishing Group
citation_language	英語
citation_date	2025-11-17
citation_journal_title	Thorax
citation_volume	81
citation_firstpage	33
citation_lastpage	41
citation_doi	https://doi.org/10.1136/thorax-2025-223218
citation_public_url	https://hdl.handle.net/11094/103671

Balloon dilatation for bronchoscope delivery: first-in-human trial of a novel technique for peripheral lung field access

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