Bronchoscopic Biopsy Techniques as Effective and Safer Alternatives to Percutaneous Methods for Lung Biomarker Testing

Recent guidelines developed through a collaboration between the American Association of Bronchology and Interventional Pulmonology (AABIP) and the International Association for the Study of Lung Cancer (IASLC) highlight significant advances in lung biopsy procedures. Specifically, they confirm that guided-bronchoscopy sampling provides tissue of comparable adequacy for comprehensive biomarker testing as traditional percutaneous, CT-guided biopsies. Additionally, bronchoscopic methods using modern navigational technologies demonstrate a superior safety profile, with fewer complications such as pneumothorax and bleeding.

Typically, linear endobronchial guided sampling is the preferred approach for mediastinal staging in lung cancer. Parenchymal lung lesions, on the other hand, are accessed via either percutaneous or bronchoscopic approaches. Despite the widespread use of these techniques, there has been limited direct comparison of their diagnostic accuracy and safety.

Published in the Journal of Thoracic Oncology, the new guidelines evaluate evidence demonstrating that bronchoscopic biopsies are not only sufficient for detailed molecular and biomarker testing but also offer fewer risks to patients. Endobronchial ultrasound (EBUS), in particular, still holds up well against mediastinoscopy for lymph node evaluation, presenting a lower morbidity option.

Key findings from the review include that bronchoscopy-guided sampling yields tissue samples of similar molecular quality to percutaneous biopsies, with a consistently better safety profile. These minimally invasive techniques, especially when utilizing advanced navigation systems, reduce the incidence of serious adverse events like pneumothorax and bleeding.

Dr. Abhinav Agrawal, an expert in interventional pulmonology, emphasizes that these recommendations should influence clinical practice by guiding physicians towards safer, equally effective tissue sampling methods. Furthermore, they are instrumental in designing future clinical trials focused on lung cancer biomarkers, promoting safer and more efficient lung cancer diagnosis and management.

For more detailed information, consult the full guideline published in the Journal of Thoracic Oncology.

Source: https://medicalxpress.com/news/2025-07-bronchoscopic-lung-biopsy-techniques-percutaneous.html