DIAGNOSIS OF PERIPHERAL LUNG TUMORS: FROM ULTRASOUND TO ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY

Abstract

Peripheral lung lesions cannot be visualized during conventional bronchoscopy, making their diagnosis challenging and necessitating advanced ancillary radiological technologies. Over the past several decades, bronchoscopic diagnostic methods have evolved substantially, progressing from early transbronchial biopsies performed without supplemental imaging to sophisticated technologies such as radial endobronchial ultrasound, electromagnetic navigation bronchoscopy, and cone beam computed tomography. While the highest diagnostic yield of transbronchial biopsy is achieved through a multimodal approach combining these modalities, the overall outcome remains influenced by factors such as lesion localization, patient habitus, respiratory excursions during the procedure, and the orientation of the guiding probe. Bronchoscopic diagnostic methods demonstrate high diagnostic accuracy for peripheral lung lesions and maintain a favorable safety profile with a low risk of complications; consequently, they should be prioritized as first-line interventions over more invasive methods, such as transthoracic needle biopsy or surgical verification.