Vnitr Lek 2025, 71(5):E6-E12

The role of bronchoscopy in the diagnosis of solitary pulmonary nodules in 2025

Jiří Votruba
Klinika TRN VFN a 1. LF UK Praha

Solitary pulmonary nodules (SPN) are an increasingly common clinical challenge and will continue to place a huge burden on healthcare systems for at least another 30 years. They are problematic due to their variable malignant potential and diverse etiology. The number of detected nodules is rapidly increasing and will certainly continue to do so in the future (1). This is due to the widespread use of computed tomography and the introduction of early detection programs for high-risk patients. The shift in the primary detection of bronchogenic carcinoma from the central to the peripheral airways is another reason for the increase in their incidence. It is estimated that more than 1 million pulmonary nodules are detected worldwide each year, with the majority (90-95%) being benign in etiology (2). However, traditional diagnostic methods often lack the accuracy needed to distinguish between benign and malignant nodules, which often leads to unnecessary invasive procedures or, conversely, delays in initiating appropriate treatment. Below we summarize current knowledge about solitary pulmonary nodules, particularly with regard to their diagnosis and, in the future, treatment using an endobronchial approach.

Keywords: bronchoscopy, navigational methods, solitary pulmonary nodules.

Accepted: August 25, 2025; Published: September 18, 2025  Show citation

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Votruba J. The role of bronchoscopy in the diagnosis of solitary pulmonary nodules in 2025. Vnitr Lek. 2025;71(5):E6-12.
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References

  1. Chen S, Lin W, Liu W, et al. Pulmonary nodule malignancy probability. Clin Radiol. 2025;82:106788. Go to original source... Go to PubMed...
  2. Chen D, Li W, Liu S, et al. Prevalence and management of pulmonary nodules: a systematic review and meta‑analysis. J Thorac Dis. 2024;16(7):4619‑4632. Go to original source... Go to PubMed...
  3. Brunelli A, Dinesh P, Woodcock‑Shaw J, et al. Ninety‑day mortality after video‑assisted thoracoscopic lobectomy: incidence and risk factors. Ann Thorac Surg. 2017;104(3):1020‑1026. Go to original source... Go to PubMed...
  4. Morris M, Habib S, Do Valle M, et al. Economic evaluation of a novel lung cancer diagnostic. J Health Econ Outcomes Res. 2024;11(2):74‑79. Go to original source...
  5. Constantinescu A, Stoicescu E, Iacob R, et al. CT‑guided transthoracic core‑needle biopsy. J Clin Med. 2024;13(23):7330. Go to original source... Go to PubMed...
  6. Kim S, Mok J, Jo E, et al. The additive impact of transbronchial cryobiopsy using a 1.1‑mm diameter cryoprobe on conventional biopsy for peripheral lung nodules. Cancer Res Treat. 2023;55(2):506‑512. Go to original source... Go to PubMed...
  7. Kho S, Lee J, Santorini T, et al. Performance of radial EBUS in tuberculosis‑endemic regions. J Thorac Dis. 2023;15(11):6072‑6083. Go to original source... Go to PubMed...
  8. Hiddinga B, Slebos D, Koster T, et al. Additional diagnostic value of virtual bronchoscopy navigation. Lung Cancer. 2023;177:37‑43. Go to original source... Go to PubMed...
  9. Hao M, Fang Z, Ding J, et al. Effects of preoperative needle biopsy for lung cancer on survival and recurrence: a systematic review and meta‑analysis. Surg Today. 2022;52(11):1832‑1840.
  10. Karnatapu S, Ekechukwu K, Doke S, et al. Application of radiology in management of incidental lung nodule. Ann Case Rep. 2022;7(3):1‑8. Go to original source...
  11. Vachani A, Zheng C, Liu I, et al. The probability of lung cancer in incidentally detected pulmonary nodules. Chest. 2022;161(2):562‑571. Go to original source... Go to PubMed...
  12. Mazzone P, Lam L. Evaluating the patient with a pulmonary nodule. JAMA. 2022;327(3):264‑273. Go to original source... Go to PubMed...
  13. Thandra K, Barsouk A, Saginala K, et al. Epidemiology of lung cancer. Contemp Oncol (Pozn). 2021;25(1):45‑52. Go to original source... Go to PubMed...
  14. Fiorelli A, Santini M, Vicidomini G, et al. Pulmonary hamartoma associated with lung cancer. Lung. 2021;199(4):369‑378. Go to original source... Go to PubMed...
  15. Toyoda T. Is needle biopsy a risk factor of pleural recurrence after surgery for non‑small cell lung cancer? J Thorac Dis. 2020;12(5):2635‑2643. Go to original source... Go to PubMed...
  16. Zhang R, Tian P, Qiu Z, et al. Growth features of pulmonary nodules. J Thorac Dis. 2020;12(5):2019‑2030. Go to original source... Go to PubMed...
  17. MacMahon H, Naidich D, Goo J, et al. Guidelines for management of incidental pulmonary nodules detected on CT images. Radiology. 2017;284(1):228‑243. Go to original source... Go to PubMed...
  18. Choi H, Ghobrial M, Mazzone P. Models to estimate malignancy probability in pulmonary nodules. Ann Am Thorac Soc. 2018;15(10):1117‑1126. Go to original source... Go to PubMed...
  19. Callister M, Baldwin D, Akram A, et al. British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax. 2015;70(Suppl 2):ii1‑ii54. Go to original source... Go to PubMed...
  20. Gould M, Donington J, Lynch W, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Chest. 2013;143(5 Suppl):e93S‑e120S. Go to original source... Go to PubMed...




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