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Advanced flexible bronchoscopy techniques in its current form mainly target for pulmonary nodules >20 mm. These advanced bronchoscopy techniques consist of (ultra)thin bronchoscopes with or without virtual planning for navigation and radial EBUS miniprobes for real-time target verification.1 2 This has led to improved detection capabilities and diagnostic ability for peripheral pulmonary nodule(s) in daily clinical practice compared with classical flexible bronchoscopy. Detection rates around 85% and a diagnostic yields 70%–75% have been reported for pulmonary nodules >20 mm within experienced interventional pulmonology centres.
More recently, innovative bronchoscopy techniques leverage current advanced techniques for peripheral pulmonary nodules as small as 15–20 mm. In prospective studies, bronchoscopy guided by cone beam CT and augmented fluoroscopy or robot-assisted bronchoscopy techniques improved the access to target lesions with tool-in-lesion navigation reporting success rates from 90% to 97%.3–6 A diagnostic yield (considering inflammation as non-diagnostic) ranging from 52% to 78% has been reported in these studies with high cancer probability. The discordance between a high tool-in-lesion navigation success rate and a moderate diagnostic yield remains a matter of …
Contributors Writing of editorial was done by both authors.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.