Kim, Yeon Wook; Kim, Hyung-Jun; Kwon, Byoung Soo; Lee, Ye Jin; Song, Myung Jin; Yoon, Sung Hyun; Lim, Sung Yoon; Lee, Yeon Joo; Park, Jong Sun; Cho, Young-Jae; Lee, Kyung Hee; Chung, Jin-Haeng; Han, Yeon Bi; Maldonado, Fabien; Ahn, So Yeon; Park, Youngmi; Joo, Dong-Hyun; Lee, Jae Ho; Lee, Choon-Taek. “Diagnostic yield and synergistic impact of needle aspiration and forceps biopsy with electromagnetic navigation bronchoscopy for peripheral pulmonary lesions: A randomized controlled trial.” Chest (2025). https://doi.org/10.1016/j.chest.2025.02.015.
Electromagnetic navigation bronchoscopy (ENB) is a specialized imaging technique used to help doctors take samples from small, hard-to-reach areas in the lungs. One of the ongoing questions is how best to collect tissue during the procedure: should a needle, forceps (small pincers), or both be used?
This study tested whether combining both needle aspiration and forceps biopsy provides better results than using either tool alone. It involved 142 patients who needed ENB to evaluate lung spots. Each patient had both types of biopsies done in a random order, and the main goal was to see which method (or combination) led to a clear diagnosis that could help guide treatment.
The results showed that the combination of needle and forceps gave a diagnosis in nearly 67% of cases, which was significantly better than using only the needle (51%) or only the forceps (44%). The combined method also detected lung cancer more reliably than either tool on its own.
The procedure was generally safe. Only a small number of patients (about 3.5%) experienced a collapsed lung (pneumothorax), and just two required treatment with a chest tube.
In summary, using both biopsy tools together during ENB improves the chances of getting an accurate diagnosis—especially for lung cancer—without adding significant risk. This supports a dual-tool approach as an effective strategy for diagnosing lung problems using ENB.
Figure 1. Flow diagram of the study population. ENB = electromagnetic navigation bronchoscopy.
