VITAL Study: Real-World Comparison of Robotic and Imaging-Guided Bronchoscopy : Impact of Real-Time Imaging and Tool-Lesion Alignment on Diagnostic Yield.

Authors

Roshen Mathew, Winnie Elma Roy

Published in

Respiratory medicine. Pages 109123. Aug 25, 2026. Epub Aug 25, 2026.

Abstract

Accurate bronchoscopic diagnosis of peripheral pulmonary lesions remains limited by navigation challenges and CT-to-body divergence. Integrated imaging techniques, including augmented fluoroscopy (AF) and C-arm-based tomography (CABT), have improved lesion localization across both robotic and non-robotic platforms. However, real-world comparative data in community settings remain limited.
We conducted a retrospective, single-operator study comparing LungVision (LV) bronchoscopy (2022-2023, n=75) and Galaxy robotic bronchoscopy (Galaxy RB) (2024-2025, n=105) in a community hospital. Both platforms utilized integrated AF and CABT with a standard C-arm. Primary endpoints were strict diagnostic yield (DY) at index bronchoscopy (ATS/ACCP criteria) and diagnostic accuracy at 1.5 years. Secondary analyses evaluated determinants of diagnostic success and an exploratory randomized breath-hold subgroup.
Strict DY was higher with Galaxy RB compared to LV (87.6% vs 74.7%; OR 2.40, 95% CI 1.10-5.24; p=0.03). Diagnostic accuracy at 1.5 years was also greater (97.1% vs 89%). Non-diagnostic rates were lower with Galaxy RB (12.4% vs 25.3%), with all cases resolved on follow-up. Within the Galaxy RB cohort, diagnostic success was strongly associated with AF localization (OR 8.30, p=0.0026), visual tool adjustment (OR 7.45, p=0.0039), and tool-lesion alignment (TIL/TTL vs NTL; OR 20.67, p=0.035). Breath-hold was not associated with improved yield (81.4% vs 86.5%; OR 0.68, p=0.57).
In a real-world community setting using integrated imaging, robotic bronchoscopy demonstrated higher diagnostic yield and accuracy compared to a non-robotic platform. However, diagnostic success was primarily driven by effective tool-lesion alignment and real-time imaging rather than platform type or breath-hold utilization.

PMID:
42641995
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.