Related Experiment Video
Updated: Sep 12, 2026
Robotic-assisted Bronchoscopy Combined with Multimodal Imaging for Targeted Lung Cryobiopsies
Published on: July 19, 2024
Comparison of diagnostic yield between electromagnetic navigation bronchoscopy-guided forceps biopsy and
Taehun Kim1, Jae Woon Song2, Jung Hee Hong3
1Division of Pulmonary Medicine, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea.
Background:
Accurate diagnosis of peripheral lung lesions remains challenging, particularly for small nodules. Electromagnetic navigation bronchoscopy (ENB) improves access to peripheral airways but shows variable diagnostic yield. Radial probe endobronchial ultrasound-guided transbronchial cryobiopsy with a guide sheath (RP-EBUS-guided TBC with GS) allows semi-real-time lesion confirmation and acquisition of larger tissue samples. This study compared the diagnostic yield and safety of ENB-guided biopsy and RP-EBUS-guided TBC.
Methods:
This retrospective observational study included patients who underwent ENB-guided transbronchial biopsy or RP-EBUS-guided TBC with a GS for lung lesions suspected to be malignant on computed tomography between May 2021 and December 2025 in South Korea. Propensity score matching was applied using logistic regression with a caliper width of 0.2 standard deviation (SD) of the logit of the propensity score, adjusting for lesion size, axial distribution, lobe location, nodule characteristics, and bronchus sign.
Results:
Matching resulted in 201 pairs, although some baseline imbalances remained. The overall diagnostic yield was significantly higher for RP-EBUS-guided TBC than for ENB (91.1% vs. 73.4%, P<0.001). Sensitivity for malignancy was also higher with RP-EBUS-guided TBC (88.4% vs. 73.3%, P<0.001). In the matched cohort, RP-EBUS-guided TBC was significantly associated with higher diagnostic yield [odds ratio (OR) 2.715, P<0.001] and sensitivity (OR 3.897, P<0.001). Pneumothorax occurred more frequently in the RP-EBUS-guided TBC group; however, the difference was not statistically significant (OR 2.054, P=0.20).
Conclusions:
RP-EBUS-guided TBC with a GS was associated with a higher diagnostic yield than ENB-guided forceps biopsy, without a statistically significant increase in major complications in patients with peripheral lung lesions.
