Added Value of a Robotic-assisted Bronchoscopy Platform in Cone Beam Computed Tomography-guided Bronchoscopy for the Diagnosis of Pulmonary Parenchymal Lesions

J Bronchology Interv Pulmonol. 2024 Jun 27;31(3):e0971. doi: 10.1097/LBR.0000000000000971. eCollection 2024 Jul 1.

Abstract

Background: Cone beam computed tomography (CBCT)-guided bronchoscopic sampling of peripheral pulmonary lesions (PPLs) is associated with superior diagnostic outcomes. However, the added value of a robotic-assisted bronchoscopy platform in CBCT-guided diagnostic procedures is unknown.

Methods: We performed a retrospective review of 100 consecutive PPLs sampled using conventional flexible bronchoscopy under CBCT guidance (FB-CBCT) and 100 consecutive PPLs sampled using an electromagnetic navigation-guided robotic-assisted bronchoscopy platform under CBCT guidance (RB-CBCT). Patient demographics, PPL features, procedural characteristics, and procedural outcomes were compared between the 2 cohorts.

Results: Patient and PPL characteristics were similar between the FB-CBCT and RB-CBCT cohorts, and there were no significant differences in diagnostic yield (88% vs. 90% for RB-CBCT, P=0.822) or incidence of complications between the 2 groups. As compared with FB-CBCT cases, RB-CBCT cases were significantly shorter (median 58 min vs. 92 min, P<0.0001) and used significantly less diagnostic radiation (median dose area product 5114 µGy•m2 vs. 8755 µGy•m2, P<0.0001).

Conclusion: CBCT-guided bronchoscopy with or without a robotic-assisted bronchoscopy platform is a safe and effective method for sampling PPLs, although the integration of a robotic-assisted platform was associated with significantly shorter procedure times and significantly less radiation exposure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchoscopy* / methods
  • Cone-Beam Computed Tomography* / methods
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / pathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Robotic Surgical Procedures / methods
  • Robotics / instrumentation