Learning curve, safety and diagnostic yield of the Galaxy^TM, Noah Medical Group robotic bronchoscopy platform

Noah Medical Group (Reseda, CA) obtained Food and Drug Administration (FDA) approval for the robotic-assisted bronchoscopy (RAB) Galaxy^TM System in 2023. The platform utilizes electromagnetic navigation (EMN) and integrated digital tomosynthesis (DT) for precise nodule targeting. Real-world data on its performance remain limited. This study aimed to evaluate the diagnostic yield and safety of the Galaxy^TM system in the first year of its integration in an academic center.

We conducted a retrospective, single-center study at an academic interventional pulmonary program, reviewing RAB procedures performed with the Galaxy^TM system between February 2024 and February 2025. The primary outcomes were strict diagnostic yield and safety. Secondary analyses evaluated the impact of operator learning curve, biopsy modality [1.1-mm cryoprobe, 21-gauge fine-needle aspiration (FNA), and forceps], and nodule characteristics.

Ninety-one patients with 94 nodules (median size 2.1 cm) were included. Overall diagnostic yield was 68%. Yield improved from 61% in the first six months to 75% in the latter half of the study [P=0.44, odds ratio (OR) =1.289]. The 1.1-mm cryoprobe achieved the highest yield (80.6%), outperforming FNA (42.9%, P=0.01, OR =5.543) and forceps (51.2%, P=0.046, OR =3.867). Pneumothorax occurred in 13% of cases (all requiring chest tubes), and one case of self-limited massive hemoptysis was reported.

In this real-world descriptive study, the Galaxy^TM system demonstrated diagnostic performance comparable to the other EMN RAB. Outcomes were influenced by a learning curve and trainee participation. Routine use of the 1.1-mm cryoprobe may optimize yield.