Guided Bronchoscopy for Peripheral Pulmonary Lesion Sampling: The Pros and Cons of Electromagnetic Navigation Bronchoscopy and Robotic-Assisted Bronchoscopy

This review compares the advantages and limitations of two guided bronchoscopy platforms—electromagnetic navigation bronchoscopy and robotic-assisted bronchoscopy—in sampling peripheral pulmonary lesions.

Diagnostic outcomes for electromagnetic navigation bronchoscopy fall short of CT-guided transthoracic needle aspiration. Robotic-assisted bronchoscopy has improved the accuracy of sampling peripheral pulmonary lesions due to advancements in technology. However, major limitations remain with both guided bronchoscopy platforms specifically the presence of CT to body divergence and lack of real-time imaging which negatively affect diagnostic outcomes. Advanced imaging, such as cone beam CT, should be considered as an adjunct to either platform.

Robotic-assisted bronchoscopy combined with advanced imaging appears to be the most optimal and technologically advanced bronchoscopic approach to biopsy peripheral pulmonary lesions. However, the cost of this technology is prohibitively high for many hospitals. Further studies are warranted to evaluate cost effectiveness and diagnostic outcomes.