Table 1.
A comparison of the multiple modalities available for peripheral pulmonary nodule biopsy
| Characteristics | CT-TTNA | Standard bronchoscopy | EBUS-TBNA | Radial probe EBUS | VB | EMN | BTPNA |
|---|---|---|---|---|---|---|---|
| Image guidance | CT | Fluoroscopy | Endoscopic ultrasound | Endoscopic ultrasound | Virtual pathway | Electromagnetic navigation | Virtual pathway |
| Lung nodules | Yes | Rarely | Peribronchial mass | Lung nodules | Yes | Yes | Yes |
| Mediastinal lymph nodes | Noa | TBNA | Yes | Nob | No | Yes | No |
| Sensitivity for malignant lung nodule | 65–90% | 20–84% | Unknown | 70% | 44–79% | 70% | Unknown |
| Pneumothorax | 15–43% | Rare | Rare | 1% | 1.5% | 1.5–3.5% | Unknown |
| Cost | +c | + | ++c | ++ | ++ | +++c | Unknown |
BTPNA bronchoscopic, CT-TTNA computerized tomography-guided transthoracic needle aspiration, EBUS endobronchial ultrasound, ENB electromagnetic navigation, TBNA transbronchial needle aspiration, VB virtual bronchoscopy, TPNA transparenchymal nodule access
aCT-TTNA is used to access the anterior mediastinal nodes
bA larger radial probe EBUS device is used rarely to guide TBNA of mediastinal nodes; however, it has been replaced by the dedicated EBUS-TBNA scope
cCT-TTNA and standard bronchoscopy are common practice. +, ++ and +++ are based on initial outlay and cost of consumables. + is an indicative sign and reflects basic cost, ++ is higher and +++ reflects expensive and additional cost