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Author Spotlight: Expanding Interventional Pulmonology Research with Robotic-Assisted Bronchoscopy

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Intraprocedural real-time imaging and tissue sampling in peripheral bronchoscopy.

Grant Senyei¹, Brain D Shaller², Christopher Di Felice¹

¹Department of Pulmonary Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.

Current Opinion in Pulmonary Medicine

|October 9, 2025

Summary

This summary is machine-generated.

Navigational bronchoscopy for peripheral lung lesions is improving. Real-time imaging helps correct CT-to-body divergence, increasing diagnostic accuracy for lung biopsies.

Keywords:

augmented fluoroscopy computed tomography-body divergence cone beam computed tomography digital tomosynthesis lung nodule navigation bronchoscopy robotic bronchoscopy

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Area of Science:

Pulmonology
Medical Imaging
Interventional Pulmonology

Background:

Peripheral lung lesions present diagnostic challenges.
Computed tomography (CT)-guided transthoracic needle aspiration is the standard for tissue diagnosis.
Navigational bronchoscopy is increasingly used but faces challenges in diagnostic yield.

Purpose of the Study:

To review advances in navigational bronchoscopy for peripheral lung lesions.
To highlight techniques improving diagnostic yield.
To emphasize the role of intraprocedural imaging.

Main Methods:

Integration of advanced intraprocedural imaging: cone beam CT, digital tomosynthesis, augmented fluoroscopy.
Techniques to identify and correct CT-to-body divergence.
Methods to confirm biopsy tool placement within the lesion.

Main Results:

Advanced imaging improves diagnostic accuracy in peripheral bronchoscopy.
Real-time imaging compensates for lesion movement and navigational errors.
Accurate tool-in-lesion confirmation enhances biopsy success.

Conclusions:

Real-time imaging is crucial for increasing diagnostic accuracy in peripheral bronchoscopy.
Identifying and correcting CT-to-body divergence is vital.
Technological advancements enhance the ability to sample peripheral lung lesions effectively.