This randomized crossover study aimed to evaluate whether combining electromagnetic navigation bronchoscopy (ENB)-guided needle aspiration and forceps biopsy provides synergistic benefits, and compare the diagnostic performance of needle aspiration biopsy and forceps biopsy for diagnosis of pulmonary lesions.~The investigators designed this study to prospectively enroll patients with lung lesions suspicious for lung cancer with positive bronchus sign and feasible for undergoing electromagnetic bronchoscopy under moderate sedation. Participants will be randomized to two groups. One group will receive ENB-guided biopsy with lung lesion with needle aspiration followed by forceps biopsy (needle-centered group), while the other groups will receive the same procedure with forceps biopsy followed by needle aspiration biopsy (forceps-centered group). All participants will undergo ENB under moderate sedation without the concurrent use of other guiding techniques such as fluoroscopy, radial endobronchial sonography. All participants will be followed up for 1 year to confirm the final diagnosis.~The primary endpoint is the diagnostic performance of ENB-guided needle biopsy and forceps biopsy and the yield achieved by combining the modalities based on the 12-month clinical follow-up. Secondary endpoints include a comparison of successful approach to the lesion, duration of sampling time, number of attempts, and successful acquisition of core tissue between the needle and forceps biopsy techniques.
This randomized crossover study aimed to compare the diagnostic performance of needle aspiration biopsy and forceps biopsy for diagnosis of pulmonary lesions with electromagnetic navigation bronchoscopy, and whether combination of the two methods (needle and forceps) can provide additive benefit for diagnosis.