Imaging-confirmed TIL or tool-touching-lesion (TTL) positioning was achieved in 97.4% of procedures.\u00b9 With more than 1 year of ongoing follow-up, diagnostic accuracy was 93.2%.\u00b9<\/p>\n
\u201cOnce you have a robot, and you have an integrated imaging workflow … then adding the breath hold really doesn\u2019t make much of a difference,\u201d Mathew said. \u201cOnce you achieve tool-in-lesion confirmation with integrated imaging, and also with augmented fluoro, which actually helps you make sure your tool is actually in 3 planes aligned always, then there is really no difference when you do breath hold.\u201d<\/p>\n
Tool-Lesion Relationship and Safety OutcomesKey TakeawaysBreath-hold ventilation did not improve strict diagnostic yield versus conventional ventilation during AF\/CABT-guided robotic bronchoscopy.Diagnostic yield rose with tool position, from 0% with no tool-lesion relationship to 95.9% with tool-in-lesion positioning.Lesion localization, radiation exposure, and complication rates were comparable between groups.<\/p>\n
Independent of ventilation strategy, diagnostic yield showed a graded relationship with tool position. Yield was 0% with no tool-lesion relationship (NTL), 85.0% with TTL, and 95.9% with TIL.\u00b9 TIL showed a trend toward greater diagnostic yield than TTL (OR, 4.18; 95% CI, 0.98-17.7; P =.064), and both TIL and TTL were significantly associated with greater yield than NTL (P <.001 and P =.007, respectively).\u00b9<\/p>\n
Radiation exposure, procedural characteristics, and complication rates were comparable between groups.\u00b9 Pneumothorax requiring chest tube placement occurred in 0 of 53 patients (0%) in the breath-hold group and 2 of 64 (3.1%) in the conventional ventilation group (P =.50).\u00b9<\/p>\n
Mathew noted robotic platforms have improved diagnostic yield in prior studies, though the addition of static cone-beam imaging did not raise yield as much as expected. STABLE sought to identify which remaining procedural variables could further improve outcomes once a robotic platform and integrated imaging are in place.<\/p>\n
The investigators concluded routine breath-hold ventilation may not be necessary during AF\/CABT-guided robotic bronchoscopy, and strategies optimizing real-time TIL positioning appear to have a greater influence on yield.\u00b9 Mathew acknowledged the trial\u2019s limitations, including its single-center design.<\/p>\n
\u201cYou probably need larger numbers to verify it,\u201d Mathew said. \u201cI think the signal we got is breath-hold ventilation probably is not the way to go.\u201d<\/p>\n
Editors note: Reported disclosures for Matthew include Noah Medical Corporation & Ethicon.<\/p>\n
References<\/p>\n
Mathew R, Danilevskaya O, Meena NK. The STABLE trial: a prospective randomized trial of breath-hold versus conventional ventilation during robotic bronchoscopy. Presented at: CHEST 2026; October 20, 2026; Phoenix, AZ.Gonzalez AV, Silvestri GA, Korevaar DA, et al. Assessment of advanced diagnostic bronchoscopy outcomes for peripheral lung lesions: a Delphi consensus definition of diagnostic yield and recommendations for patient-centered study designs. An official American Thoracic Society\/American College of Chest Physicians research statement. Am J Respir Crit Care Med. 2024. https:\/\/pubmed.ncbi.nlm.nih.gov\/38394646\/<\/a> <\/p>\n","protected":false},"excerpt":{"rendered":"Imaging-confirmed TIL or tool-touching-lesion (TTL) positioning was achieved in 97.4% of procedures.\u00b9 With more than 1 year of…\n","protected":false},"author":2,"featured_media":655094,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[85,46,125],"class_list":["post-655093","post","type-post","status-publish","format-standard","has-post-thumbnail","category-technology","tag-il","tag-israel","tag-technology"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/655093","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=655093"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/655093\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/655094"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=655093"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=655093"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=655093"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}