Photo Credit: Kolonko

The following is a summary of “Diagnostic performance of shape-sensing robotic-assisted bronchoscopy for pleural-based and fissure-based pulmonary lesions,” published in the January 2025 issue of Pulmonology by Fernandez-Bussy et al. 

Researchers conducted a retrospective study to evaluate the efficacy and safety of shape-sensing robotic-assisted bronchoscopy (ssRAB) in diagnosing peripheral pulmonary lesions (PPLs) abutting the pleura.  

They examined PPLs attached to the peripheral pleura (PP), including costal, diaphragmatic, mediastinal pleura (MP), and fissural pleura (FP), sampled using ssRAB from January 2020 to December 2023. Clinicodemographic data, PPL characteristics, and procedure-related details were collected. The primary outcome was diagnostic yield, defined as the proportion of conclusive diagnoses (malignant or benign) among total procedures and secondary outcomes included the safety profile, assessed by procedure-related complications, and diagnostic yield with the use of mobile cone-beam CT (mCBCT) and biopsy tools.  

The results showed 182 nodules were sampled from 178 patients, categorized into (PP, n=95), (MP, n=30), and (FP, n=57). The overall diagnostic yield was 80.2% (146/182), with a malignancy sensitivity of 83.2% (104/125). Diagnostic yield was linked to upper location (OR 2.86; 95% CI 1.35–6.03, P =0.006), mCBCT (OR 2.27; 95% CI 1.06–4.86, P =0.036), and cryobiopsy (OR 2.90; 95% CI 1.31–6.47, P =0.009). Pneumothorax requiring a chest tube occurred in 2.8% (5 patients), and grade 3 bleeding was observed in 0.6% (1 patient) as per the Nashville Scale.  

Investigators concluded that ssRAB demonstrated a high diagnostic yield with low complications for pleural-based and fissure-based nodules, and the addition of mCBCT and cryobiopsy further enhanced diagnostic performance for this subtype of lesions. 

Source: thorax.bmj.com/content/early/2025/01/20/thorax-2024-222502