With lung cancer screening identifying up to 1.6 million suspicious nodules annually in the United States, clinicians face a growing diagnostic challenge. While most pulmonary nodules are benign, the malignant cases remain the leading cause of cancer-related deaths worldwide. A five-year, multisite study by Mayo Clinic highlights how robotic bronchoscopy may offer a safer, faster and more accurate diagnostic pathway.
Published in Mayo Clinic Proceedings, the study evaluated 2,115 lung lesions in 1,904 patients between 2019 and 2024. The findings show an 85% sensitivity for detecting malignancy and a diagnostic accuracy of 76.9%, alongside a low complication rate of 2.8%. These results are based on updated, stricter national criteria, underscoring the robustness of the outcomes.
Earlier detection, better outcomes
A key impact of robotic bronchoscopy is its contribution to earlier cancer detection. At Mayo Clinic, the proportion of lung cancers diagnosed at an early stage rose from 46% in 2019 to nearly 69% by mid-2024. At the same time, advanced-stage diagnoses dropped from 54% to 31%.
“Lung cancer survival depends heavily on early detection,” said Sebastian Fernandez-Bussy. “Technologies that enable us to diagnose disease earlier and with fewer complications can significantly improve patient outcomes.” Given that five-year survival for localized lung cancer approaches 67%, compared to approximately 12% for metastatic disease, the clinical importance of early diagnosis cannot be overstated.
Integrated workflows
Robotic bronchoscopy uses shape-sensing technology to navigate deep into the lungs with high precision. Cleared by the U.S. Food and Drug Administration in 2019, the system allows clinicians to obtain multiple biopsies in a single procedure, ensuring sufficient tissue for both diagnosis and molecular analysis.
The integration of endobronchial ultrasound enables simultaneous staging of mediastinal lymph nodes, while real-time 3D imaging or cone beam CT helps confirm accurate tool placement before biopsy. This combination of technologies enhances both diagnostic confidence and procedural efficiency.
A ‘single anesthetic’ care pathway
Robotic bronchoscopy platforms are increasingly combined with minimally invasive therapies, such as pulsed electric field ablation. This enables clinicians to diagnose, stage and treat lung cancer within a single procedure. Co-author Janani Reisenauer describes this as a “single anesthetic lung surgery pathway,” reducing hospital visits, shortening recovery times and improving patient experience.
As lung cancer screening expands globally, demand for accurate, scalable and minimally invasive diagnostic solutions will continue to grow. The Mayo Clinic study demonstrates how robotic bronchoscopy can streamline care pathways, support earlier intervention and ultimately contribute to improved survival rates in lung cancer care.
AI navigation
In 2025, Erasmus MC (Netherlands) pulmonologists were using artificial intelligence to improve the precision and safety of bronchoscopy procedures. By integrating a convolutional neural network (CNN), the system enhances navigation inside the lungs by translating CT scan data into a real-time, internal view of airways and blood vessels.
This AI-driven approach functions like a “Google Maps” for the lungs, helping physicians select the safest and most efficient route to target areas. As a result, procedures are on average 30 minutes shorter and require fewer X-ray images, reducing radiation exposure for patients. According to pulmonologist Arnold Duinisveld, the technology also improves safety by clearly identifying major blood vessels, lowering the risk of complications such as bleeding or pneumothorax during biopsies.
