Related Experiment Video
Updated: Jun 13, 2026
Robotic-assisted Bronchoscopy Combined with Multimodal Imaging for Targeted Lung Cryobiopsies
Published on: July 19, 2024
Comparative performance of shape-sensing robotic-assisted bronchoscopy and CT-guided transthoracic biopsy in
Dakota McNierney1, Cody Messick2, Morgan Reeve1
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Phoenix, AZ, United States.
Background:
Lung cancer is the leading cause of cancer mortality. Nonsurgical biopsies are obtained by computed tomography-guided transthoracic biopsy (CTTB) or bronchoscopically. Due to previous limitations in conventional flexible bronchoscopic techniques, the development of robotic-assisted bronchoscopy (RAB) platforms have emerged. We aim to compare the outcomes of shape-sensing RAB (ssRAB) and CTTB using a strict diagnostic yield (DY) definition.
Study Design And Methods:
This is a single center observational study. Data was collected from adults (age ≥ 18) who underwent a lung biopsy with CTTB or ssRAB between March 21, 2023 and August 31, 2024. The primary outcome was DY. The secondary outcomes were molecular adequacy, time to treatment for new non-small cell lung cancer (NSCLC) diagnoses, procedure complications, and procedure duration.
Results:
A total of 638 patients (ssRAB N = 489, CTTB N = 149) were included. DY for ssRAB was 84.3 % vs 80.5 % in CTTB (p = 0.347). Compared to CTTB, the ssRAB group had a lower incidence of pneumothorax (PTX) (1.4 % vs 29.5 %, p < 0.001), PTX requiring a chest tube placement (1.4 % vs 4.7 %, p = 0.039), and pulmonary hemorrhage (0.2 % vs 14.1 %, p < 0.001). Molecular adequacy was 89.6 % in ssRAB vs. 79.1 % CTTB (p = 0.022). Adjusted analysis found a similar DY between ssRAB and CTTB [adjusted OR (95 % CI): 1.14 (0.82; 1.60)] but increased molecular adequacy for ssRAB vs CTTB [adjusted OR (95 % CI): 2.21 (1.18; 4.16)], and lower incidence of PTX for ssRAB vs CTTB [adjusted OR (95 % CI): 0.04 (0.01; 0.08)]. Time from biopsy to treatment initiation for new NSCLC diagnoses was faster with ssRAB compared to CTTB [adjusted mean difference (95 % CI): -22.276 (-29.983--14.547) days]; however, a longer procedure time (adjusted mean difference (95 % CI): 10.572 [8.653; 12.491] minutes).
Interpretation:
These findings suggest ssRAB may have a comparable diagnostic yield to CTTB but potentially provide superior quantity sufficient biopsies for molecular analysis at a lower complication rate. Adjusting for confounding variables, ssRAB may have fewer complication rates, superior molecular adequacy, and fewer days from biopsy to treatment initiation for new NSCLC diagnoses.
