{
  "abstract": "Background Lung cancer screening programmes have significantly reduced mortality through earlier detection of malignancy. However, they have also increased the identification of small pulmonary nodules, which poses a challenge for traditional sampling techniques. CT-guided transthoracic needle biopsy (CT-TTNB) is the gold standard for sampling peripheral lesions, achieving high diagnostic yields (~90%) overall. However, this yield decreases for smaller nodules, with yields as low as 66% reported in nodules smaller than 15 mm. 1 Shape-sensing robotic-assisted bronchoscopy (ssRAB) offers precise navigation to peripheral lung nodules and may improve diagnostic performance, particularly for smaller lesions.Methods We conducted a retrospective analysis of prospectively collected data at a tertiary referral centre. Consecutive patients who underwent ssRAB between 3rd September 2023 and 20th February 2024 were included. All procedures were performed under general anesthesia using the ION shape-sensing robotic endoluminal system (Intuitive Surgical) supported by cone-beam CT, fluoroscopy and radial endobronchial ultrasound. Nodules were sampled using transbronchial needle aspiration (TBNA), cryobiopsies and/or forceps biopsies. Lesions were stratified by size into three groups: <15 mm, 15–30 mm and >30 mm. Diagnostic yield was calculated per nodule using the strict definition outlined in the American Thoracic Society (ATS) Delphi consensus.Results A total of 251 nodules from 204 procedures were analysed. The mean age was 70.3 years, and 60% were female. Of the nodules, 124 measured < 15 mm, 108 were 15–30 mm and 17 were > 30 mm. The strict diagnostic yields were 86.3%, 87% and 89.5% for the respective sizes.Conclusion SsRAB achieved a high strict diagnostic yield across all nodule sizes, including those <15 mm. These findings highlight the potential of ssRAB as an effective tool for the sampling of small pulmonary nodules, a growing need as the screening programme expands. Prospective randomised control studies are warranted to directly compare different sampling modalities and determine the optimal approach.Reference Lentz RJ, Frederick-Dyer K, Planz VB, Koyama T, Aboudara MC, Avasarala SK, et al. Navigational bronchoscopy or transthoracic needle biopsy for lung nodules. N Engl J Med. 2025;392(21):2100–12.",
  "authors": [
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "A Tana"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "LT Chan"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "H Trainer"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "O Volhina"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "A Karir"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "ES Agaoglu"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital, London, UK"
      ],
      "name": "I Meireles"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "JL Garner"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "J Tonkin"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "CM Orton"
    },
    {
      "affiliations": [
        "Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK"
      ],
      "name": "PL Shah"
    }
  ],
  "title": "P213 Impact of nodule size on diagnostic yield in shape-sensing robotic-assisted bronchoscopy",
  "uid": "aac0b9cd-3e6c-5012-a158-93ab1cc587bd"
}