Learning curve, safety and diagnostic yield of the GalaxyTM, Noah Medical Group robotic bronchoscopy platform.

BACKGROUND

Noah Medical Group (Reseda, CA) obtained Food and Drug Administration (FDA) approval for the robotic-assisted bronchoscopy (RAB) GalaxyTM System in 2023. The platform utilizes electromagnetic navigation (EMN) and integrated digital tomosynthesis (DT) for precise nodule targeting. Real-world data on its performance remain limited. This study aimed to evaluate the diagnostic yield and safety of the GalaxyTM system in the first year of its integration in an academic center.

METHODS

We conducted a retrospective, single-center study at an academic interventional pulmonary program, reviewing RAB procedures performed with the GalaxyTM system between February 2024 and February 2025. The primary outcomes were strict diagnostic yield and safety. Secondary analyses evaluated the impact of operator learning curve, biopsy modality [1.1-mm cryoprobe, 21-gauge fine-needle aspiration (FNA), and forceps], and nodule characteristics.

RESULTS

Ninety-one patients with 94 nodules (median size 2.1 cm) were included. Overall diagnostic yield was 68%. Yield improved from 61% in the first six months to 75% in the latter half of the study [P=0.44, odds ratio (OR) =1.289]. The 1.1-mm cryoprobe achieved the highest yield (80.6%), outperforming FNA (42.9%, P=0.01, OR =5.543) and forceps (51.2%, P=0.046, OR =3.867). Pneumothorax occurred in 13% of cases (all requiring chest tubes), and one case of self-limited massive hemoptysis was reported.

CONCLUSIONS

In this real-world descriptive study, the GalaxyTM system demonstrated diagnostic performance comparable to the other EMN RAB. Outcomes were influenced by a learning curve and trainee participation. Routine use of the 1.1-mm cryoprobe may optimize yield.