Electromagnetic bronchoscopy versus computed tomography for pulmonary nodule localization

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ID: 334183
2026
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Ranked #132 of 147 articles by views in Interdisciplinary CardioVascular and Thoracic Surgery

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Abstract
OBJECTIVE: Electromagnetic navigational bronchoscopy (NAVIB) and CT-guided transthoracic marking (CTI) are two possible methods for preoperative marking. We have conducted a study to determine whether one technique performs better in a selected patient population. METHODS: In a single-center, 1:1 randomized controlled trial we compared NAVIB using indocyanine green and CTI with Technetium-99m during uniportal wedge resections of lung nodules. Primary endpoint was the duration of surgery. Secondary endpoints included wedge resection time, complication rates, surgical margin, and surgeon satisfaction questionnaires. RESULTS: 63 patients were randomized, with 32 assigned to the NAVIB and 31 to the CTI group. Surgeries' duration was similar, with a median of 52.5 minutes (IQR:40-70) for NAVIB and 45 minutes for CTI (IQR:30-60;p= 0.664). The median wedge time for NAVIB was 15.5 minutes (IQR: 13-20), while for CTI it was 12 minutes (IQR: 9-15;p=0.0007). Grade II or higher complication rates were 9.4% for NAVIB vs 12.9% for CTI; (p = 0.144) and lesion's distance to staple line was 5.7mm (CI:4.2-7.2) vs. 7.0mm (CI:4.3-9.9) respectively (p = 0.355). In the questionnaire from 0 (not helpful) to 3 (very helpful), CTI received a median score of 3 (IQR;3-3), while NAVIB's was 2.5 (IQR;2-3;p = 0.045). After Bonferroni correction, questionnaire differences were not significant. CONCLUSIONS: The randomized trial failed to demonstrate a significant difference in overall surgery duration between electromagnetic navigational bronchoscopy and computed tomography-guided transthoracic marking.
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Authors Márton Csaba, Zsolt Megyesfalvi, Anita Salamon, Judit Andi, Mirella Olajos, Hanna Tihanyi, Ákos Kocsis, László Agócs, Dávid László Tárnoki, Ádám Domonkos Tárnoki, Balázs Döme, Ferenc Renyi-Vamos, Péter Radeczky, Áron Ghimessy
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Journal Interdisciplinary CardioVascular and Thoracic Surgery
Year 2026
DOI
10.1093/icvts/ivag283
URL
https://doi.org/10.1093/icvts/ivag283
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