Shape-Sensing Robotic-Assisted Bronchoscopy in the Diagnosis of Pulmonary Parenchymal Lesions

Kalchiem-Dekel O, Connolly J, Lin I-H et al

CHEST 2022;161(2):572-582. 10.1016/j.chest.2021.07.2169

What is the key question?

  • Biopsy techniques for peripheral pulmonary lesions have developed rapidly with progress in technology. Part of that development has been the introduction of shape-sensing robotic technologies (ssRAB). This study aimed to investigate the feasibility and diagnostic yield of ssRAB in the diagnosis of peripheral lung lesions. 159 peripheral pulmonary lesions were investigated. ssRAB successfully navigated to the lesion in 98.7% of cases and 81.7% of those were sampled successfully using either TBNA needle, forceps biopsy or brushings. Sensitivity and specificity were similar to other radial probe techniques. Even with the use of ssRAB, lesions under 20mm remain difficult to diagnose consistently.

What is the bottom line?

  • The ssRAB technology shows some promise although the major determinant of success in diagnosis remains lesion size and position of the probe in relation to the lesion. The two currently available technologies remain expensive but this will decrease as technology advances.

Why read on?

  • The authors offer some interesting observations into a rapidly emerging technology. Robotic technologies are rapidly becoming a routine part of diagnostic practice. More study is required to determine the place of ssRAB in the future.