{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:44:17Z","timestamp":1793137457806,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Bronchoscopic thermal ablation has emerged as a minimally invasive therapeutic option for managing pulmonary nodules in patients unsuitable for surgery or radiotherapy. Robotic-assisted bronchoscopy (RAB) offers enhanced stability and precise navigation, potentially improving the safety and accuracy of bronchoscopic ablation. However, clinical data on RAB-guided microwave ablation (MWA) remains limited. Therefore, further evidence is needed to evaluate its feasibility, safety, and early therapeutic performance. Methods: We conducted a single-center retrospective feasibility study of shape-sensing RAB-guided MWA (ssRAB-MWA) for pulmonary nodules between October 2024 and September 2025. Eligible lesions (\u22643.0 cm) included both primary lung cancers and metastatic nodules. All procedures were performed under general anesthesia using the ssRAB system integrated with cone-beam CT for intra-procedural confirmation. Technical success, safety outcomes, and short-term efficacy were assessed. Results: Nine patients (with 11 lesions: 3 primary, 8 metastatic) underwent ssRAB-MWA with 100% technical success. The median ablation time per nodule was 10 min (range, 1\u201326). One patient developed post-ablation pneumonia requiring hospitalization; no pneumothorax, major bleeding, or airway injury occurred. All lesions exhibited a transient increase in size immediately following MWA, followed by gradual reduction or stabilization over time. PET-CT evaluation demonstrated metabolic remission in primary lesions, with one patient achieving pathologic complete response after surgery. Conclusions: ssRAB-MWA appears to be a feasible and safe navigation-guided technique for small pulmonary lesions, offering encouraging early local control in both primary and metastatic lung cancers. This platform may expand the therapeutic spectrum of interventional pulmonology, bridging diagnosis and local therapy. Larger multicenter studies are warranted to validate long-term outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics15243248","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T16:42:05Z","timestamp":1766076125000},"page":"3248","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Shape-Sensing Robotic-Assisted Bronchoscopic Microwave Ablation for Primary and Metastatic Pulmonary Nodules: Retrospective Case Series"],"prefix":"10.3390","volume":"15","author":[{"given":"Liqin","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"},{"name":"Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Nantong University, Nantong 226001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-4748","authenticated-orcid":false,"given":"Russell","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"},{"name":"Department of Pulmonary Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-3318","authenticated-orcid":false,"given":"Mitchell","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of California, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8018-5604","authenticated-orcid":false,"given":"Grace","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of California, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3859-3150","authenticated-orcid":false,"given":"Wenduo","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1360-2767","authenticated-orcid":false,"given":"Niral","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keriann","family":"Van Nostrand","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Munoz Pineda","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-0175","authenticated-orcid":false,"given":"Bryce","family":"Duchman","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-8705","authenticated-orcid":false,"given":"George","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Interventional Pulmonology, Bronchoscopy, and Pleural Diseases, Division of Pulmonary, Critical Care & Sleep Medicine, UC San Diego Health, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1038\/s41571-023-00798-3","article-title":"The global burden of lung cancer: Current status and future trends","volume":"20","author":"Leiter","year":"2023","journal-title":"Nat. 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