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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
Shape-sensing robotic-assisted versus electromagnetic navigation bronchoscopy for peripheral pulmonary lesions: a
Paras M Patel1,2, Vivek Athipatla3, Susmita Potti4
1Division of Interventional Pulmonology, Department of Internal Medicine, JPS Health Network, Fort Worth, TX, USA.
Journal of Thoracic Disease
|May 25, 2026
Summary
Shape sensing robotic assisted bronchoscopy (ssRAB) matches electromagnetic navigation bronchoscopy (ENB) for diagnostic yield in peripheral pulmonary lesions. ssRAB successfully biopsied smaller lesions and required fewer procedures for malignancy diagnosis.
Area of Science:
- Pulmonary Medicine
- Interventional Pulmonology
- Diagnostic Imaging
Background:
- Electromagnetic navigation bronchoscopy (ENB) and shape sensing robotic assisted bronchoscopy (ssRAB) are key tools for peripheral pulmonary lesion (PPL) sampling.
- Comparative data between ENB and ssRAB, especially without advanced 3D imaging, are limited.
- This study compares ENB and ssRAB performance by a single interventional pulmonologist in a large urban hospital.
Purpose of the Study:
- To compare the diagnostic yield, accuracy, and efficiency of ENB versus ssRAB for sampling PPLs.
- To evaluate the number of procedures needed for malignancy diagnosis and complication rates for both bronchoscopy techniques.
- To assess the feasibility of integrating ssRAB in large hospitals with limited advanced imaging and single-operator availability.
Main Methods:
- A single-center retrospective analysis included 359 patients (ENB: 226, ssRAB: 133).
- All procedures utilized radial endobronchial ultrasound and 2D fluoroscopy, excluding cone beam CT or digital tomosynthesis.
- Key outcomes measured were diagnostic yield, diagnostic accuracy, procedures for malignancy diagnosis, and complications.
Main Results:
- Both ENB and ssRAB demonstrated a strict diagnostic yield of 64%.
- Final diagnostic accuracy was comparable (ENB: 71.2%, ssRAB: 76%, P=0.39).
- ssRAB required fewer procedures for malignancy diagnosis (84.6% single procedure vs. 60.8% for ENB, P=0.007) and sampled smaller PPLs (1.7 cm vs. 2.4 cm, P<0.001).
Conclusions:
- ssRAB achieved similar diagnostic yield to ENB while being more effective for smaller PPLs and reducing the number of procedures for malignancy diagnosis.
- These findings support the integration of ssRAB into large hospital settings, even with a single interventional pulmonologist.
- ssRAB offers a viable alternative to ENB for PPL sampling, particularly when dealing with smaller lesions and aiming for efficient diagnosis.
