Preoperative localization of pulmonary nodules: virtual bronchoscopic navigation vs a 4‑hook localization needle

Both virtual bronchoscopic navigation (VBN) and puncture with a 4‑hook localization needle are viable methods for localizing pulmonary nodules. However, there is a paucity of research that compares these 2 approaches.

This study aimed to assess and compare the efficacy of and complications associated with these 2 approaches to pulmonary nodule localization.

We analyzed 223 patients who underwent VBN (n = 98) or needle localization (n = 125) of pulmonary nodules between April 2020 and December 2022. Each study group was divided into 2 subgroups, namely the solitary‑nodule group and the 2‑nodule group. We collected and analyzed data on localization time, accuracy, success rate, and complications in each group.

In the solitary‑nodule subgroup, the mean (SD) distance between the localization point and the pulmonary nodule was 6.2 (6.1) mm for the needle‑localization group and 8.6 (4.8) mm for the VBN‑localization group (P = 0.01). In the 2‑nodule subgroup, the mean (SD) distance did not significantly differ and amounted to 8.7 (4.6) mm for the needle‑localization group and 8.4 (4.4) mm for the VBN‑localization group. However, the mean (SD) time required for localization was shorter in the VBN‑localization group (17.2 [2.6] min) than in the needle‑localization group (26.6 [3.9] min; P <0.001), which indicated that VBN was more efficient in 2‑nodule localization. The solitary nodule- and 2‑nodule-localization procedures differed significantly in terms of complications, such as pneumothorax and bleeding, with fewer complications reported in the VBN‑localization group.

In comparison with needle localization, VBN localization was associated with fewer complications. In the case of 2 pulmonary nodules, VBN localization outperformed the needle approach, with shorter localization time, fewer complications, and no radiation exposure.