Robotic bronchoscopy: potential in diagnosing and treating lung cancer

ABSTRACT

Introduction

Lung cancer remains the deadliest form of cancer in the world. Screening through low-dose CT scans has shown improved detection of pulmonary nodules; however, with the introduction of robotic bronchoscopy, accessing and biopsying peripheral pulmonary nodules from the airway has expanded. Improved diagnostic yield through enhanced navigation has made robotic bronchoscopy an ideal diagnostic technology for many proceduralists. Studies have demonstrated that robotic bronchoscopes can reach further with improved maneuverability into the distal airways compared to conventional bronchoscopes.

Areas covered

This review paper highlights the literature on the technological advancements associated with robotic bronchoscopy and the future directions the field of interventional pulmonary may utilize this modality for in the treatment of lung cancer. Referenced articles were included at the discretion of the authors after a database search of the particular technology discussed.

Expert opinion

As the localization of target lesions continues to improve, robotic platforms that provide reach, stability, and accuracy paves the way for future research in endoluminal treatment for lung cancer. Future studies with intratumoral injection of chemotherapy and immunotherapy and ablation modalities are likely to come in the coming years.

KEYWORDS:

• Lung cancer
• navigational bronchoscopy
• pulmonary nodule
• robotic bronchoscopy

Article highlights

• One of every four deaths in the United States is due to cancer; of those, lung cancer is the deadliest cancer worldwide

• Screening CT scans have increased the demand of minimally invasive bronchoscopic biopsy but optimizing diagnostic yield remains a priority

• Robotic bronchoscopy platforms combine the three fundamental components of successful biopsy of a target lesion including accurate navigation to the lesion, confirmation that the biopsy tool is within the intended target, and subsequent tissue acquisition

• Combination with other technologies, like cone-beam computed tomography, is possible with robotic bronchoscopy and can overcome CT-to-body divergence to optimize biopsy tool-in-lesion

• As navigational reach and diagnostic yield of peripheral pulmonary nodules improves, the future of bronchoscopy therapeutics for lung cancer expands and could include ablation and intratumoral injection of chemotherapy and immunotherapy.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.