Robotic-assisted bronchoscopy on par with CT-guided biopsy for pulmonary nodules diagnosis

Robotic-assisted bronchoscopy (RAB) appears to be as reliable as computed tomography-guided transthoracic biopsy (CTTB) in sampling pulmonary nodules with similar or reduced complications, a study has shown.

“RAB, when available, … should be considered as a means for nodule biopsy, particularly when mediastinal staging is also clinically warranted,” the researchers said.

In this multicentre, retrospective study, the research team assessed the efficacy and diagnostic performance of RAB compared to CTTB for diagnosing pulmonary nodules suspected of lung cancer. Consecutive patients who underwent RAB and CTTB from January 2019 to March 2021 at Mayo Clinic Florida and Mayo Clinic Rochester, US, were included.

The researchers then compared clinical and demographic information, nodule characteristics, outcomes, and complications between RAB and CTTB.

Overall, 225 patients met the eligibility criteria: 113 in the RAB group and 112 in the CTTB group. Overall diagnostic yield was 87.6 percent and 88.4 percent for RAB and CTTB, respectively. For malignant disease, RAB demonstrated sensitivity and specificity of 82.1 percent and 100 percent, respectively, while the corresponding values for CTTB were 88.5 percent and 100 percent.

Of note, CTTB had a significantly higher complication rate than RAB (17 percent vs 4.4 percent; p=0.002).

“Currently, CTTB is the most accurate diagnostic approach for pulmonary nodules suspected of malignancy,” the researchers said. “Traditional bronchoscopy has shown suboptimal diagnostic sensitivity, but the emergence of RAB has the potential to improve diagnostic accuracy, maximize diagnostic yield, and complete mediastinal and hilar staging in a single procedure.”