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Robotic-assisted CT-guided transthoracic needle biopsy reduces radiation exposure and complication rates for pulmonary nodulesRobotic-assisted biopsy shows lower radiation and fewer complications

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Key Takeaway
Note that robotic-assisted CT-guided biopsy reduces radiation and complications while maintaining similar diagnostic yields.

This meta-analysis evaluates the procedural efficiency, diagnostic performance, and safety of robotic-assisted CT-guided transthoracic needle biopsy compared to conventional manual techniques for patients with pulmonary nodules. The analysis synthesizes data on several outcomes including procedure time, radiation exposure (DLP), complication rates, and technical success.

Key findings indicate that robotic-assisted procedures are associated with significantly shorter procedure times (MD = -4.94; 95% CI [-9.56, -0.32]) and lower radiation exposure (MD = -211.55; 95% CI [-305.07, -118.03]). Furthermore, the robotic technique was associated with a reduced overall complication incidence (RR = 0.460; 95% CI [0.290, 0.720]). Other metrics, including technical success, diagnostic yield, and pulmonary hemorrhage rates, were reported as similar between both techniques.

The authors note several limitations, including a limited number of included studies and substantial heterogeneity among the data. Additionally, much of the evidence is observational in nature. While robotic-assisted biopsy shows promise for reducing procedural complexity and radiation exposure while maintaining comparable diagnostic yield, these results should be interpreted with caution due to the underlying study limitations.

When doctors need to sample a suspicious spot on the lung, known as a pulmonary nodule, they often use a needle guided by CT scans. This procedure is vital for getting answers, but it carries risks like radiation exposure and potential complications. Recent data suggests that using a robotic system to guide the needle might make this process safer and more efficient.

The analysis compared robotic-assisted biopsies to traditional manual methods. The results showed that patients undergoing the robotic procedure received significantly less radiation and experienced fewer overall complications. The procedure also took less time on average, and doctors had to make fewer adjustments with the needle during the process.

While the robot made the procedure faster and safer in several ways, it did not change the final diagnostic results. Both methods were equally successful at getting a clear diagnosis and reaching the target. Because much of the current evidence comes from observational data and a small number of studies, these findings should be viewed as promising but still early.

What this means for you:
Robotic-assisted lung biopsies can lower radiation exposure and complications while providing similar diagnostic results.

Common questions

Is a robotic-assisted biopsy safer than a traditional one?

The data shows that the robotic method is associated with a lower rate of overall complications. It also resulted in fewer needle adjustments during the procedure. While both methods are equally successful at providing a diagnosis, the robotic approach appears to offer a safer experience for the patient.

Does using a robot change the accuracy of the results?

No, the accuracy remains the same regardless of the method. The study found that both the robotic-assisted and conventional manual techniques had similar technical success and diagnostic yield. This means the robot helps with safety and speed without changing the quality of the final diagnosis.

How does radiation exposure differ between the two methods?

Patients who underwent the robotic-assisted procedure received significantly lower radiation exposure compared to those who had the conventional manual biopsy. This is a major benefit for patients undergoing CT-guided procedures, as it reduces their total exposure during the needle placement process.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
Pulmonary nodules are commonly evaluated using the CT-guided transthoracic biopsy; however, it is highly dependent on operator skill and can be associated with extended procedure duration and increased radiation exposure. Although robotic-assisted systems are intended to enhance procedural precision, there is limited comparative evidence against conventional techniques. Accordingly, this systematic review and meta‑analysis was conducted to compare robotic-assisted biopsy with conventional CT-guided transthoracic biopsy. We systematically searched Scopus, Web of Science, PubMed, CNKI, and the Cochrane Library until February 2026. Both randomized trials and cohort studies comparing robotic and conventional (manual) CT-guided transthoracic needle biopsy in adults were included in this review. The outcomes included procedural efficiency, diagnostic performance, radiation exposure, and safety. Meta-analysis was conducted using RevMan 5.4.1, presenting MD, RR, or OR with 95% CIs. Heterogeneity and publication bias were assessed. Nine studies were included. Compared with conventional (manual) CT-guided biopsy, the robotic approach was associated with shorter procedure time (MD = -4.94, 95% CI [-9.56, -0.32], P = 0.04) and lower radiation exposure (DLP) (MD = -211.55, 95% CI [-305.07, -118.03], P < 0.00001). Additionally, the robotic approach reduced the number of needle adjustments required, pneumothorax incidence, and overall complication incidence (RR = 0.460, 95% CI [0.290, 0.720], P = 0.0008). A reduction in the number of CT scans was observed only in the sensitivity analysis. Technical success, diagnostic yield, pulmonary hemorrhage, and chest tube placement were similar between the robotic-assisted and conventional techniques. Robot-assisted CT-guided biopsy was associated with lower radiation exposure, reduced procedural complexity, and fewer complications while maintaining comparable technical success and diagnostic yield. However, these findings should be interpreted cautiously, given the limited number of included studies, substantial heterogeneity, and observational nature of much of the available evidence. Further large prospective studies are required to validate these findings.
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