ArticleThe New England journal of medicine2025
Navigational Bronchoscopy or Transthoracic Needle Biopsy for Lung Nodules.
Article in The New England journal of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 61 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Navigation Endoscopy to Reach Indeterminate Lung Nodules Versus Trans-Thoracic Needle Aspiration, a Randomized Controlled Study (VERITAS)
Advanced Robotic Techniques and Rapid Onsite Evaluation for Minimally Invasive Diagnosis and Next-Generation Sequencing: the ARTEMIS Trial.
Who cites it
61 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robotic-assisted transbronchial biopsy versus computed tomography-guided transthoracic needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis of direct comparative studies.Journal of robotic surgery · 2026Pooled it
- Artificial intelligence and digital health in bronchoscopy: advances in diagnostic accuracy, real-time navigation and procedural skills training.Breathe (Sheffield, England) · 2026Review
- Electromagnetic navigation bronchoscopy-guided three-dimensional conformal microwave ablation for unresectable peripheral high-risk pulmonary nodules: a mid-term assessment with no real-time intraoperative CT/cone-beam computed tomography guidance.Translational lung cancer research · 2026Article
- Diagnostic yield and predictors of complications in CT-guided percutaneous lung biopsy: an analysis based on ATS/ACCP criteria.La Radiologia medica · 2026Article
- Robotic-Assisted Bronchoscopy for Peripheral Pulmonary Lesions: Current Evidence, Clinical Applications, and Future Directions.Diagnostics (Basel, Switzerland) · 2026Review
- Sensitivity for Malignancy with Navigation Bronchoscopy in Small Lung Nodules.Advances in respiratory medicine · 2026Article
- Review
- Advanced Bronchoscopic Approaches to Peripheral Pulmonary Lesions: a Narrative Review of Current and Emerging Techniques.Pulmonary therapy · 2026Review
- Performance Characteristics and 2-Year Outcomes of Digital Tomosynthesis-Assisted Electromagnetic Navigation Bronchoscopy in a Community Hospital.CHEST pulmonary · 2026Article
- Robotic-Assisted Bronchoscopy and Pulmonary Nodules Due to Atypical Infections in Coccidioidomycosis Endemic Area.CHEST pulmonary · 2026Article
- The PRECIsE study: a prospective, multicenter study of shape-sensing robotic-assisted bronchoscopy with 2 years of follow-up.Annals of the American Thoracic Society · 2026Observational
- Minimally Invasive Sampling Techniques for Pancreatic and Pulmonary Nodules: A Review of the Evolution of Guidance and Sampling Methods.Diagnostic cytopathology · 2026Review
- Real-world diagnostic pathways and treatment patterns for suspected lung cancer in Japan: a nationwide claims database analysis.ESMO real world data and digital oncology · 2026Article
- Local Recurrence After Lung Segmentectomy-Risk Factors and Future Directions: A Contemporary Review.Cancers · 2026Review
- Diagnostic Outcomes of Robotic Bronchoscopy in a Multidisciplinary, Multi-hospital Lung Nodule Program.The Journal of surgical research · 2026Observational
- The role of navigation bronchoscopy in the workup of lung lesions in lung transplant-eligible patients: A single-center case series.JHLT open · 2026Article
- Article
- Review
- Predictive factors for prolonged hospitalization related to pneumothorax after CT-guided transthoracic needle biopsy.BMC pulmonary medicine · 2026Article
- Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors.
Funding
Abstract
backgroundEach year, millions of pulmonary nodules are identified incidentally or through lung cancer screening, and many involve biopsy to distinguish cancer from benign processes. Both navigational bronchoscopy and computed tomography-guided transthoracic needle biopsy are commonly used in patients undergoing biopsies of peripheral pulmonary nodules, but the relative diagnostic accuracy of these two approaches is unclear.
methodsIn this multicenter, randomized, parallel-group, noninferiority trial, we assigned patients with an intermediate-risk or high-risk peripheral pulmonary nodule measuring 10 to 30 mm in diameter to undergo navigational bronchoscopy or transthoracic needle biopsy at seven centers across the United States. The primary outcome was diagnostic accuracy, which was defined as the percentage of patients with biopsies that showed a specific diagnosis (cancer or a specific benign condition) that was confirmed to be accurate through 12 months of clinical follow-up (nonferiority margin, 10 percentage points). Secondary outcomes included procedural complications such as the occurrence of pneumothorax.
resultsAmong the 234 patients included in the primary-outcome analysis (5 of whom were lost to follow-up), biopsy resulted in a specific diagnosis that was confirmed to be accurate through month 12 in 94 of 119 patients (79.0%) in the navigational bronchoscopy group and in 81 of 110 patients (73.6%) in the transthoracic needle biopsy group (absolute difference, 5.4 percentage points; 95% confidence interval, -6.5 to 17.2; P = 0.003 for noninferiority; P = 0.17 for superiority). Pneumothorax occurred in 4 of 121 patients (3.3%) in the navigational bronchoscopy group and in 32 of 113 patients (28.3%) in the transthoracic needle biopsy group and led to the placement of a chest tube, hospital admission, or both in 1 patient (0.8%) and 13 patients (11.5%), respectively.
conclusionsThe diagnostic accuracy of navigational bronchoscopy was noninferior to that of transthoracic needle biopsy among patients with peripheral pulmonary nodules measuring 10 to 30 mm. (Funded by Medtronic and others; VERITAS ClinicalTrials.gov number, NCT04250194.).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.