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Single-Encounter Augmented Reality-Guided Localization for Resection of Suspected Early-Stage Lung Cancer: A
Zuodong Song1, Ziang Wang1, Haixia Yao2
1Department of Surgical Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
JAMA Surgery
|July 8, 2026
Summary
Augmented reality (AR)-guided localization for lung nodules is as effective as CT-guided localization for sublobar resection. AR offers reduced radiation, pain, and procedure time, making it a viable alternative.
Area of Science:
- Thoracic Surgery
- Medical Imaging
- Oncology
Background:
- Preoperative localization is crucial for successful sublobar resection of CT-detected pulmonary nodules.
- Conventional CT-guided localization involves multiple steps, leading to patient discomfort, radiation exposure, and potential complications.
Purpose of the Study:
- To compare the noninferiority of single-encounter augmented reality (AR)-guided percutaneous localization versus standard multiple-encounter CT-guided localization for sublobar resection.
Main Methods:
- A randomized noninferiority trial involving 270 patients across 5 centers.
- Patients were randomized to either single-encounter AR-guided localization or multiple-encounter CT-guided localization.
- Primary outcome was successful sublobar resection; secondary outcomes included accuracy, radiation, complications, and efficiency.
Main Results:
- Successful sublobar resection rates were high and noninferior between groups (98.5% AR vs. 99.3% CT).
- AR guidance showed significantly lower radiation exposure, preoperative pain, and shorter procedure times compared to CT guidance.
- No significant difference in localization accuracy was observed; CT group had a higher incidence of pneumothorax (29.4%).
Conclusions:
- Single-encounter AR-guided localization is noninferior to CT-guided localization for sublobar resection.
- AR guidance offers significant advantages in reducing radiation exposure, pain, and improving procedural efficiency.
- AR-guided localization presents a promising alternative to conventional CT-guided methods for pulmonary nodule resection.
