The Role of Bronchoscopy in the Management of Lung Nodules. Is it too Early to Retire Transthoracic Needle Aspiration?

Transthoracic Needle Aspiration (TTNA) is a medical procedure that involves the percutaneous insertion of a needle, typically guided by computed tomography, to aspirate lung tissue. During TTNA, the needle is often directed through the pleura and lung to reach and aspirate target tissues, such as the lung or lymph nodes. This procedure is commonly used to obtain tissue samples for diagnostic purposes. Over the past decade, invasive bronchoscopy, including endobronchial ultrasound biopsy (EBUS), radial probe, navigational, and robotic bronchoscopy, has improved the yield and safety profile of lung nodule biopsies while ensuring adequate lung tissue sampling. In this review article, we aim to compare the differences in efficacy, safety, and diagnostic yield among various diagnostic modalities in pulmonary medicine.