Related Experiment Video
Updated: May 14, 2026
Robotic-assisted Bronchoscopy Combined with Multimodal Imaging for Targeted Lung Cryobiopsies
Published on: July 19, 2024
Real-world comparison of shape-sensing robotic-assisted bronchoscopy and virtual bronchoscopic navigation for
Mengzhen You1,2, Yalun Li1,2, Liguo Wang3,4,5
1Department of Pulmonary and Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Regional Medical Center for National Institute of Respiratory Disease, Zhejiang University, No.3 Qingchun East Road, Hangzhou, 310016, People's Republic of China.
Background:
Robotic-assisted bronchoscopy (RAB) may improve diagnosis of peripheral pulmonary lesions (PPLs), particularly when lesion localization and sampling are technically demanding. However, direct real-world comparisons between shape-sensing RAB (ss-RAB) and virtual bronchoscopic navigation (VBN) remain limited.
Methods:
We retrospectively reviewed patients who underwent navigational bronchoscopy for PPLs at a single center. Propensity score matching (PSM) was used to balance baseline characteristics between the ss-RAB and VBN groups. Diagnostic yield, tool-in-lesion (TIL) rate, sensitivity for malignancy, adverse events, and learning curves of ss-RAB were evaluated. Learning curves were assessed using cumulative sum analysis based on procedure time and diagnostic success.
Results:
Following 1:1 PSM, 234 patients were included, with 117 in each group. Final malignancy prevalence was 74.8% overall. Diagnostic yield was higher with ss-RAB than with VBN (85.5% vs. 70.1%; OR 2.39, 95% CI 1.25-4.56). TIL rate was also more frequently achieved with ss-RAB (99.1% vs. 88.9%). Sensitivity for malignancy was 95.6% for ss-RAB compared with 81.2% for VBN. The diagnostic advantage of ss-RAB was most evident in small (< 15 mm), peripheral, bronchus-sign-negative, and upper-lobe lesions, whereas performance was similar in larger or more central nodules. Procedure-related complications were infrequent and comparable between groups. Learning-curve analysis for ss-RAB showed a reduction in procedure time after approximately 23 cases and an earlier improvement in diagnostic success around the 13th case.
Conclusions:
In a real-world setting, ss-RAB was associated with higher diagnostic yield and TIL rates compared with the VBN-based comparator arm without compromising safety. The observed benefit of ss-RAB was greater in lesion subgroups with higher procedural difficulty. In experienced centers, procedural performance with ss-RAB improved after a relatively short learning phase.
