What is the key question?

• CT screening is identifying increasing numbers of peripheral pulmonary lesions (PPLs) which require investigation. Electromagnetic Navigation Bronchoscopy (ENB) has been suggested to have higher diagnostic accuracy then Radial EBUS (R-EBUS) though at higher cost. This study performed a systematic review and meta-analysis of the diagnostic accuracy, sensitivity and NPV of R-EBUS and ENB in sampling PPLs.

What is the bottom line?

• 41 studies were analysed for heterogeneity and pooled estimate of diagnostic accuracy and sensitivity for malignancy.
• Overall sensitivity to detect cancer was 70.7% (R-EBUS 70.5% and ENB 70.7%). Pooled overall diagnostic accuracy was 74.2% (R-EBUS 72.4% and ENB 76.4%). There was <2% complication rate.
• Both modalities have similar sensitivity and diagnostic accuracy for malignancy in PPLs. Given the cost of establishing ENB, these results suggest R-EBUS remains an important and reliable tool, particularly for centres without ENB.

Why read on?

• Considering the cost of establishing ENB, centres continuing to perform R-EBUS can expect comparable accuracy and sensitivity and both options remain reasonable.