{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T06:50:22Z","timestamp":1776840622933,"version":"3.51.2"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study compared the diagnostic performance and safety of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and virtual bronchoscopic navigation (VBN)-guided transbronchial lung biopsy (TBLB) in patients with solitary pulmonary nodules (SPNs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 204 SPN patients, divided into CT-guided (n = 102) and VBN-guided (n = 102) groups. Parameters, including diagnostic yield, procedure time, and complication rates, were compared between the two methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After applying rigorous diagnostic criteria per ATS\/ACCP guidelines, the overall diagnostic yield was higher in the VBN group (64.7%, 66\/102) than in the CT group (59.8%, 61\/102), though the difference was not statistically significant (P = 0.472). In exploratory subgroup analyses, VBN demonstrated higher diagnostic yield for smaller nodules (8\u201320\u00a0mm) and those located closer to the pleura (2\u20133\u00a0cm) (both P &amp;lt; 0.05). For larger nodules (20\u201330\u00a0mm) or those further from the pleura (3\u20135\u00a0cm), diagnostic rates were comparable between groups. The VBN group had significantly shorter procedure times, including lesion localization (6.62 \u00b1 0.93 vs. 9.27 \u00b1 1.05\u00a0min) and total procedure duration (22.04 \u00b1 2.36 vs. 38.16 \u00b1 4.29\u00a0min) (P &amp;lt; 0.01). The complication rate was significantly lower in the VBN group (9.80% vs. 29.41%, P &amp;lt; 0.01), with the CT group showing higher incidences of pneumothorax, hemoptysis, and chest pain in nodules 2-3\u00a0cm from the pleura. Multivariate analysis identified several factors significantly associated with diagnostic outcomes. Additionally, the VBN group incurred lower medical costs and shorter hospital stays (P &amp;lt; 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VBN-guided biopsy was associated with higher diagnostic yield, fewer complications, shorter procedure times, and lower costs compared to CT-guided biopsy. These findings warrant confirmation in prospective randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1743070","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:51:38Z","timestamp":1776837098000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the efficacy of different lung biopsy modalities in solitary pulmonary nodules"],"prefix":"10.3389","volume":"14","author":[{"given":"Wei","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, The First People\u2019s Hospital of Yunnan Province","place":["Kunming, China"]},{"name":"The Affiliated Hospital of Kunming University of Science and Technology","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First People\u2019s Hospital of Yunnan Province","place":["Kunming, China"]},{"name":"The Affiliated Hospital of Kunming University of Science and Technology","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yajie","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First People\u2019s Hospital of Yunnan Province","place":["Kunming, China"]},{"name":"The Affiliated Hospital of Kunming University of Science and Technology","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhong","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First People\u2019s Hospital of Yunnan Province","place":["Kunming, China"]},{"name":"The Affiliated Hospital of Kunming University of Science and Technology","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First People\u2019s Hospital of Yunnan Province","place":["Kunming, China"]},{"name":"The Affiliated Hospital of Kunming University of Science and Technology","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2968","DOI":"10.3390\/nu12102968","article-title":"Effect of supplemental parenteral nutrition versus enteral nutrition alone on clinical outcomes in critically ill adult patients: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Alsharif","year":"2020","journal-title":"Nutrients"},{"key":"B2","doi-asserted-by":"publisher","first-page":"33","DOI":"10.25259\/JCIS_53_2020","article-title":"Role of computed tomography-guided biopsies in the era of electromagnetic navigational bronchoscopy: a retrospective study of factors predicting diagnostic yield in electromagnetic navigational bronchoscopy and computed tomography biopsies","volume":"10","author":"Atkins","year":"2020","journal-title":"J. Clin. Imaging Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ccm.2019.10.001","article-title":"Lung cancer 2020: epidemiology, etiology, and prevention","volume":"41","author":"Bade","year":"2020","journal-title":"Clin. Chest Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.3390\/tomography9030095","article-title":"Tips and tricks in thoracic radiology for beginners: a findings-based approach","volume":"9","author":"Borgheresi","year":"2023","journal-title":"Tomography"},{"key":"B5","doi-asserted-by":"publisher","first-page":"20220366","DOI":"10.1259\/bjr.20220366","article-title":"Manual aspiration of a pneumothorax after CT-guided lung biopsy: outcomes and risk factors","volume":"96","author":"Chan","year":"2023","journal-title":"Br. J. Radiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s13019-022-01859-x","article-title":"Predictive model for the probability of malignancy in solitary pulmonary nodules: a meta-analysis","volume":"17","author":"Chen","year":"2022","journal-title":"J. Cardiothorac. Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/crj.12200","article-title":"Characteristics of benign solitary pulmonary nodules confirmed by diagnostic video-assisted thoracoscopic surgery","volume":"10","author":"Choi","year":"2016","journal-title":"Clin. Respir. J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/MCP.0000000000000847","article-title":"Transbronchial biopsy vs. bronchoalveolar lavage in interstitial lung disease","volume":"28","author":"Chugh","year":"2022","journal-title":"Curr. Opin. Pulm. Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1159\/000533197","article-title":"Transbronchial cryobiopsy is superior to forceps biopsy for diagnosing both fibrotic and non-fibrotic interstitial lung diseases","volume":"102","author":"Freund","year":"2023","journal-title":"Respiration"},{"key":"B10","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1001\/jamasurg.2022.0269","article-title":"Effect of early vs late supplemental parenteral nutrition in patients undergoing abdominal surgery: a randomized clinical trial","volume":"157","author":"Gao","year":"2022","journal-title":"JAMA Surg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1111\/imj.13576","article-title":"Risk stratification in the investigation of pulmonary nodules in a high-risk cohort: positron emission tomography\/computed tomography outperforms clinical risk prediction algorithms","volume":"47","author":"Gibson","year":"2017","journal-title":"Intern Med. J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1148\/rg.220073","article-title":"Interstitial lung abnormalities at CT: subtypes, clinical significance, and associations with lung cancer","volume":"42","author":"Hata","year":"2022","journal-title":"Radiographics"},{"key":"B13","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s00408-023-00596-9","article-title":"Solitary lung nodule: CT-guided transthoracic biopsy vs transbronchial biopsy with endobronchial ultrasound and flexible bronchoscope, a meta-analysis of randomized controlled trials","volume":"201","author":"Ho","year":"2023","journal-title":"Lung"},{"key":"B14","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1080\/15563650.2022.2028803","article-title":"Lung injury caused by aspiration of organophosphorus insecticide and gastric contents in pigs","volume":"60","author":"Hulse","year":"2022","journal-title":"Clin. Toxicol. (Phila)."},{"key":"B15","doi-asserted-by":"publisher","first-page":"526","DOI":"10.3348\/kjr.2019.0492","article-title":"Usefulness of CT-Guided percutaneous transthoracic needle lung biopsies in patients with suspected pulmonary infection","volume":"21","author":"Kim","year":"2020","journal-title":"Korean J. Radiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1186\/s12890-022-02071-2","article-title":"Findings of virtual bronchoscopic navigation can predict the diagnostic rate of primary lung cancer by bronchoscopy in patients with peripheral lung lesions","volume":"22","author":"Kitamura","year":"2022","journal-title":"BMC Pulm. Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.1007\/s00270-015-1098-z","article-title":"CT-Guided percutaneous transthoracic needle biopsies using 10G large-core needles: initial experience","volume":"38","author":"Lalji","year":"2015","journal-title":"Cardiovasc Interv. Radiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"3450","DOI":"10.12998\/wjcc.v8.i16.3450","article-title":"Value of virtual bronchoscopic navigation and transbronchial ultrasound-guided sheath-guided exploration in diagnosis of peripheral lung cancer","volume":"8","author":"Liu","year":"2020","journal-title":"World J. Clin. Cases"},{"key":"B19","doi-asserted-by":"publisher","first-page":"443","DOI":"10.21037\/atm-22-1231","article-title":"Diagnostic yield of virtual bronchoscope navigation combined with radial endobronchial ultrasound guided transbronchial cryo-biopsy for peripheral pulmonary nodules: a prospective, randomized, controlled trial","volume":"10","author":"Liu","year":"2022","journal-title":"Ann. Transl. Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1016\/j.ccell.2023.08.012","article-title":"The intratumor mycobiome promotes lung cancer progression via myeloid-derived suppressor cells","volume":"41","author":"Liu","year":"2023","journal-title":"Cancer Cell"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2166","DOI":"10.1158\/2159-8290.CD-21-1252","article-title":"The origin of highly elevated cell-free DNA in healthy individuals and patients with pancreatic, colorectal, lung, or ovarian cancer","volume":"13","author":"Mattox","year":"2023","journal-title":"Cancer Discov."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e2022543","DOI":"10.1590\/1516-3180.2022.0543.R1.01022023","article-title":"Minimally invasive interventions for biopsy of malignancy-suspected pulmonary nodules: a systematic review and meta-analysis","volume":"141","author":"Miotto","year":"2023","journal-title":"Sao Paulo Med. J."},{"key":"B23","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.suc.2021.12.001","article-title":"Lung cancer: epidemiology and screening","volume":"102","author":"Oliver","year":"2022","journal-title":"Surg. Clin. North Am."},{"key":"B24","doi-asserted-by":"publisher","first-page":"00421-2024","DOI":"10.1183\/23120541.00421-2024","article-title":"Laryngeal mask airway or high-flow nasal cannula versus nasal cannula for advanced bronchoscopy: a randomised controlled trial","volume":"11","author":"Pikman Gavriely","year":"2025","journal-title":"ERJ Open Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1097\/RTI.0000000000000427","article-title":"Imaging-guided percutaneous biopsy of nodules \u22641 cm: study of diagnostic performance and risk factors associated with biopsy failure","volume":"35","author":"Portela de Oliveira","year":"2020","journal-title":"J. Thorac. Imaging"},{"key":"B26","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s00408-021-00445-7","article-title":"A retrospective multi-site academic center analysis of pneumothorax and associated risk factors after CT-Guided percutaneous lung biopsy","volume":"199","author":"Rong","year":"2021","journal-title":"Lung"},{"key":"B27","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s12194-019-00546-2","article-title":"Transbronchial biopsy of peripheral lung lesions using fluoroscopic guidance combined with an enhanced ray-summation display","volume":"13","author":"Suzuki","year":"2020","journal-title":"Radiol. Phys. Technol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.3348\/kjr.2019.0014","article-title":"Non-diagnostic CT-guided percutaneous needle biopsy of the lung: predictive factors and final diagnoses","volume":"20","author":"Tongbai","year":"2019","journal-title":"Korean J. Radiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"94s","DOI":"10.1378\/chest.07-1352","article-title":"Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer? ACCP evidence-based clinical practice guidelines (2nd edition)","volume":"132","author":"Wahidi","year":"2007","journal-title":"Chest"},{"key":"B30","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1038\/s41598-020-79690-4","article-title":"A comparative study to evaluate CT-based semantic and radiomic features in preoperative diagnosis of invasive pulmonary adenocarcinomas manifesting as subsolid nodules","volume":"11","author":"Wu","year":"2021","journal-title":"Sci. Rep."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1533033821989992","DOI":"10.1177\/1533033821989992","article-title":"Diagnostic value of virtual bronchoscopic navigation combined with endobronchial ultrasound guided transbronchial lung biopsy for peripheral pulmonary lesions","volume":"20","author":"Xu","year":"2021","journal-title":"Technol. Cancer Res. Treat."},{"key":"B32","doi-asserted-by":"publisher","first-page":"152","DOI":"10.12659\/PJR.899626","article-title":"A systematic review and meta-analysis of C-Arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung nodules","volume":"82","author":"Yan","year":"2017","journal-title":"Pol. J. Radiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1038\/s41593-023-01390-9","article-title":"Antipsychotic drug efficacy correlates with the modulation of D1 rather than D2 receptor-expressing striatal projection neurons","volume":"26","author":"Yun","year":"2023","journal-title":"Nat. Neurosci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e70012","DOI":"10.1111\/crj.70012","article-title":"Comparison of efficacy and safety of different guided technologies combined with ultrathin bronchoscopic biopsy for peripheral pulmonary lesions","volume":"18","author":"Zhang","year":"2024","journal-title":"Clin. Respir. J."},{"key":"B35","doi-asserted-by":"publisher","first-page":"3074","DOI":"10.1177\/02841851231205737","article-title":"The classification of benign and malignant lung nodules based on CT radiomics: a systematic review, quality score assessment, and meta-analysis","volume":"64","author":"Zhu","year":"2023","journal-title":"Acta Radiol."}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1743070\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:51:40Z","timestamp":1776837100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1743070\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":35,"alternative-id":["10.3389\/fbioe.2026.1743070"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2026.1743070","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"1743070"}}