{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:36:11Z","timestamp":1784025371097,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Transbronchial sampling of peripheral pulmonary lesions (PPLs) is routinely performed under fluoroscopy. However, advanced ancillary techniques have become available, such as virtual bronchoscopic navigation (VBN) and radial endobronchial ultrasound with a guide sheath (rEBUS\u2010GS). This study was performed to determine whether the diagnostic utility of VBN and rEBUS with a GS is similar with or without fluoroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter non\u2010inferiority trial randomized patients to a VBN\u2010rEBUS\u2010GS with or without fluoroscopy group at three centres. The primary endpoint was the diagnostic yield. The secondary endpoints were the time for rEBUS, GS, and the total operation. Complications were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred and ninety\u2010six subjects were assessed and 426 subjects were included in the analysis (212 in non\u2010fluoroscopy\u2010guided\u2010group and 214 in fluoroscopy\u2010guided\u2010group). The diagnostic yield in the non\u2010fluoroscopy\u2010guided\u2010group (84.0%) was not inferior to that in the fluoroscopy\u2010guided\u2010group (84.6%), with a diagnostic difference of \u22120.6% (95% CI: \u22126.4%, 5.2%). Multivariable analysis confirmed that bronchus sign and lesion nature were valuable diagnostic predictors in non\u2010fluoroscopy\u2010guided\u2010group. The non\u2010fluoroscopy\u2010guided\u2010group had shorter rEBUS, GS, and total operation time. No severe complications occurred in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transbronchial diagnosis of PPLs suspicious of malignancy and presence of a bronchus leading to or adjacent to lesions using VBN\u2010rEBUS\u2010GS without fluoroscopy is a safe and effective method that is non\u2010inferior to VBN\u2010rEBUS\u2010GS with fluoroscopy. Bronchus leading to lesions and malignant nature are associated with high diagnostic yield in VBN\u2010rEBUS\u2010GS without fluoroscopy for the diagnosis of PPLs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.14405","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T23:59:30Z","timestamp":1668124770000},"page":"389-398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Virtual bronchoscopic navigation and endobronchial ultrasound with a guide sheath without fluoroscopy for diagnosing peripheral pulmonary lesions with a bronchus leading to or adjacent to the lesion: A randomized non\u2010inferiority trial"],"prefix":"10.1111","volume":"28","author":[{"given":"Xiaoxuan","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Respiratory Endoscopy and Department of Respiratory and Critical Care Medicine Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai Engineering Research Center of Respiratory Endoscopy  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhao","family":"Zhong","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health The First Affiliated Hospital of Guangzhou Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Respiratory Endoscopy and Department of Respiratory and Critical Care Medicine Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai Engineering Research Center of Respiratory Endoscopy  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyue","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Respiratory Disease, 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