Diagnosing a solitary pulmonary nodule using multiple bronchoscopic guided technologies: A prospective randomized...

Area of Science:

• Pulmonology
• Diagnostic Imaging
• Interventional Pulmonology

Background:

• Solitary pulmonary nodules (SPNs) detection rate is low, posing a challenge for early lung cancer diagnosis.
• Accurate and timely diagnosis of SPNs is critical for effective lung cancer treatment.

Purpose of the Study:

• To compare the diagnostic yield and safety of endobronchial ultrasonography with a guide sheath (EBUS-GS) versus EBUS-GS combined with virtual bronchoscopic navigation (VBN).
• To evaluate the efficacy of different bronchoscopic biopsy techniques for diagnosing SPNs.

Main Methods:

• A prospective, multicenter, randomized controlled trial involving 1010 subjects with SPNs.
• Patients were randomized into three groups: non-guided bronchoscopy biopsy (NGB), EBUS-GS guided biopsy (EBUS), and EBUS-GS with VBN guided biopsy (combined).
• Primary endpoint was the diagnostic yield of each group.

Main Results:

• Diagnostic yield was significantly higher for EBUS (72.3%) and the combined group (74.3%) compared to NGB (41.2%).
• The combined group showed a significantly shorter time to reach biopsy position (7.96 min) than the EBUS group (11.92 min).
• Diagnostic yield was higher for peripheral pulmonary lesions (PPLs) >20 mm.

Conclusions:

• Guided bronchoscopy techniques, including EBUS-GS and EBUS-GS with VBN, enhance diagnostic yield for peripheral pulmonary lesions.
• While diagnostic yields were similar between EBUS and the combined group, EBUS-GS with VBN significantly reduced procedure time.