Lung nodule biopsies performed with new robotic bronchoscopy technology may be safer and more effective than those done by traditional methods, a study by researchers at UT Southwestern suggests. UT Southwestern was the first medical center in Dallas-Fort Worth – and among the first in the country – to use robotic-assisted bronchoscopy (RAB) to biopsy pulmonary lesions. Paired with advanced imaging that provides real-time 3D visuals, the technology enables UTSW’s Interventional Pulmonology team to navigate an ultra-thin, ultra-flexible tube with light and camera capabilities into a patient’s lungs to pinpoint and test suspicious abnormalities. Now, with robotic-assisted bronchoscopy using the Ion Endoluminal System, pulmonologists can guide an ultra-thin, flexible catheter through the patient’s mouth and airway to the exact location of the smallest nodule anywhere in the lung, even if it’s in the tiny branches called bronchioles. An integrated vision probe allows them to see their movements on a screen and navigate their way to the nodule in real time based upon 3D ‘airway trees’ generated from CT scans of the patient’s lung that serve as a roadmap. Ion’s ‘shape-sensing’ technology provides precise location and shape information during the entire process. As the lungs are constantly moving because the patient is breathing, it also stabilizes the catheter in place. Currently, local expertise and shared decision-making are frequently utilized to guide management. The major hurdles in recommending evidenced based “best practices” guidelines for biopsy of a peripheral nodule lies in the inherent variability between studies. Bronchoscopic technologies are frequently used in tandem and biopsy techniques inevitably vary between operators. Additionally, there is significant variability in how diagnostic yield is calculated and reported. Large scale, prospective and randomized studies that utilize an agreed upon standard for calculating and reporting diagnostic yield would be of high clinical value and allow providers to achieve a more accurate understanding of which technologies may be superior in their safety profile and offering the highest diagnostic yield.
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