How does one decide whether to use a percutaneous approach or a bronchoscopic approach to biopsy a lung nodule?
Lung nodules and masses may be biopsied by bronchoscopy or by IPNB. Generally, lesions close to the hilum (central lesions) are accessed by bronchoscopy, whereas peripheral lesions are accessed percutaneously.
With the new use of navigational endobronchial ultrasonography (EBUS), bronchoscopy may allow access to more peripheral lesions, as long as there is a visible bronchus leading to the lesion. However, bronchoscopy requires anesthesia, which carries a higher risk in patients with compromised respiratory status.