Invasive diagnostic procedures for early-stage lung cancer – the clinical significance of novel navigational techniques in interventional bronchoscopy

Abstract

Long-term statistical data worldwide on lung cancer (LC) show an overall 34% reduction in mortality compared to 1991. The primary reasons for this decline include a reduced smoking rate, earlier diagnosis, advancements in invasive diagnostic methods, and the introduction of low-dose computed tomography screening. These factors have contributed to detecting LC at earlier stages of the disease and improving timely treatment. The diagnostic sensitivity of conventional bronchoscopy for peripheral pulmonary lesions (PPL), representing early-stage LC, has historically been relatively low, ranging 30–60%. Over the past two decades, diagnostic sensitivity for PPL has improved with the development of advanced navigational techniques, such as virtual bronchoscopic navigation, electromagnetic navigation bronchoscopy, radial endobronchial ultrasound, cone-beam computed tomography, and ultrathin bronchoscopy. In the past two to three years, robotic-assisted bronchoscopy has further enhanced diagnostic navigation capabilities to their current maximum potential.

Keywords: bronchoscopy; early detection of cancer; lung neoplasms; smoking; video-assisted techniques and procedures