Interventional pulmonology (IP) allows comprehensive assessment of patients with benign and malignant airway, lung parenchymal and pleural disease. This relatively new branch of pulmonary medicine utilises advanced diagnostic and therapeutic techniques to treat patients with pulmonary diseases.
Endobronchial ultrasound revolutionized assessment of pulmonary nodules, mediastinal lymphadenopathy and lung cancer staging allowing minimally-invasive, highly accurate assessment of lung parenchymal and mediastinal disease, with both macro- and microscopic tissue characterization including molecular signature analysis. High spatial resolution, new endobronchial imaging techniques including Autofluorescence Bronchoscopy (ABI), Narrow Band Imaging (NBI), Optical Coherence Tomography and confocal microscopy enable detailed evaluation of airways with increasing role in detection and treatment of malignancies arising in central airways. Precision in peripheral lesion localization has been increased through innovative navigational techniques including Navigational Bronchoscopy (NB) and Electromagnetic Navigation (EMN). Pleural diseases can be assessed with the use of non-invasive pleural ultrasonography, with high sensitivity and specificity for malignant disease detection. Medical pleuroscopy is a minimally-invasive technique improving diagnostic safety and precision of pleural disease and pleural effusion assessment.
In this review we discuss the newest advances in diagnostic modalities utilized in IP, indications for their use, their diagnostic accuracy, efficacy, safety and challenges in application of these technologies in assessment of thoracic diseases.
