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Peripheral Pulmonary NodulesNCT04758403

CBCT-Guided Navigational Bronchoscopy For Lung Nodules

A study testing Navigation Bronchoscopy and Cone beam computed tomography (CBCT) in people with Peripheral Pulmonary Nodules and Lung; Node, run by Beth Israel Deaconess Medical Center at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to determine if the cone beam computed tomography (CBCT)-guided navigation bronchoscopy is better in diagnosing lung nodules compared to navigation bronchoscopy alone. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Navigation Bronchoscopy and Cone beam computed tomography (CBCT)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
5 Mar 2021to 12 Apr 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Participants ≥18 years old.
  • Participants with lesions having an intermediate pre-test probability of malignancy (pCA, 0.05 to 0.65) as determined by Swensen-Mayo nodule risk calculator and in whom bronchoscopic biopsy was determined to be the next best treatment step by the treating pulmonologist.
  • Participants with higher risk lesions (pCA > 0.65) in need of a diagnosis for nonsurgical treatment or prior to surgery.
  • Participants are willing and able to provide informed consent.

Who cannot join

  • The participant is pregnant as confirmed by urine or serum pregnancy testing.
  • There is a predetermined plan to pursue stereotactic body radiation therapy (SBRT) in the event of a nondiagnostic study procedure in participant's with a nodule in the outer 1/3 lung zone (i.e. The participant would not go on for a CT guided TTNA).
  • Lacked fitness according to physician judgement to undergo bronchoscopy.
  • Contraindication for temporary interruption of the use of anticoagulant therapy.
  • Uncontrolled or irreversible coagulopathy.
  • Known allergy for lidocaine.
Show all 11Show fewer
  • Uncontrolled pulmonary hypertension.
  • Recent (< 4 weeks) and/or uncontrolled cardiac disease.
  • Compromised upper airway (eg concomitant head and neck cancer or central airway stenosis such that endobronchial access is considered unsafe).
  • ASA classification ≥ 4.
  • COVID-19 positive participant at the time of procedure.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Beth Israel Deaconness Medical Center

    Boston, Massachusetts, 02215

Other trials in United States

About this study

Official title: Cone Beam Computed Tomography - Guided Navigation Bronchoscopy for Peripheral Pulmonary Nodules: A Randomized Trial

The purpose of this study is to determine if the cone beam computed tomography (CBCT)-guided navigation bronchoscopy is better in diagnosing lung nodules compared to navigation bronchoscopy alone.

Read the detailed description

This clinical trial examines the effectiveness of a treatment comparing it to another known treatment.

The U.S. Food and Drug Administration (FDA) has approved the navigation bronchoscopy as a treatment option for this disease.

The U.S. Food and Drug Administration (FDA) has approved the Cone-Beam CT scan as a treatment option for this disease.

This research study involves a screening period, a procedure and follow up visits.

The names of the study interventions involved in this study are:

  • Computed tomography (CBCT)-guided navigation bronchoscopy (CBCT-guided NB)
  • Navigation bronchoscopy alone

Participants will receive the study procedure and will be followed for up to 6 months.

It is expected that about 136 people will take part in this research study.

Being tested
Navigation Bronchoscopy, Cone beam computed tomography (CBCT)
Keywords
Peripheral Pulmonary Nodules, Lung; Node, Cone Beam Computed Tomography, Guided Navigation Bronchoscopy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Navigation BronchoscopyRadiation

    Also called NB

    Navigation Bronchoscopy procedure will be performed per product instructions and the institution's standard practice.

  • Cone beam computed tomography (CBCT)Radiation

    Per Protocol

Study groups in NCT04758403
Study groupRoleWhat they receive
Navigation Bronchoscopy ALONEExperimentalThis research study involves a screening period, a procedure and follow up visits * Procedure Visit Navigation Bronchoscopy Alone * Follow-Up Visits at Week 1, 4 and 12
Receives: Radiation: Navigation Bronchoscopy
CBCT-GUIDED Navigation BronchoscopyExperimentalThis research study involves a screening period, a procedure and follow up visits Procedure Visit- Cone Beam Computed Tomography - Guided Navigation Bronchoscopy for Peripheral Pulmonary Nodules -Follow-Up Visits at Week 1, 4 and 12
Receives: Radiation: Navigation Bronchoscopy; Radiation: Cone beam computed tomography (CBCT)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Diagnostic Yield

    The overall diagnostic yield will be calculated by adding the number of true positives (TP) for both malignancy and benign disease in the numerator and dividing by the total number of procedures performed for each arm of the study.

    Proportions will be compared with the Chi-Square Test as this test is equivalent to the z-test of two proportions (26). A p-value <0.05 will be considered as statistically significant.

    Measured: 6 months

Secondary outcomes (3)
  1. Overall Incidence of Procedure-related Complications

    To compare complications between navigational bronchoscopy alone and CBCT guided bronchoscopy.

    Measured: 6 months

  2. Additional Diagnostic Procedures in Navigational Bronchoscopy Alone and CBCT Guided Bronchoscopy.

    To compare the need of additional diagnostic procedures in navigational bronchoscopy alone and CBCT guided bronchoscopy.

    Measured: 6 Months

  3. Navigational Time in Bronchoscopy Alone and CBCT Guided Bronchoscopy.

    To compare the navigational time defined as the time between the start of catheter driving after registration until catheter is parked for biopsy.

    Measured: 6 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Feb 2021
  2. Study start5 Mar 2021
  3. Primary completion12 Apr 2023
  4. Study completion12 Apr 2023

Why it stopped: Due to changes in technology (EMN technology replaced by robotic platform) the study was terminated

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04758403
Sponsor's protocol ID
20-580
Status last verified
Aug 2026
First submitted
14 Feb 2021
Last updated
22 Sep 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Yes: The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to Sponsor Investigator or designee. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

Publications

  • Choi JW, Park CM, Goo JM, Park YK, Sung W, Lee HJ, Lee SM, Ko JY, Shim MS. C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of small (</= 20 mm) lung nodules: diagnostic accuracy and complications in 161 patients. AJR Am J Roentgenol. 2012 Sep;199(3):W322-30. doi: 10.2214/AJR.11.7576.

    PubMed 22915422
  • Hur J, Lee HJ, Nam JE, Kim YJ, Kim TH, Choe KO, Choi BW. Diagnostic accuracy of CT fluoroscopy-guided needle aspiration biopsy of ground-glass opacity pulmonary lesions. AJR Am J Roentgenol. 2009 Mar;192(3):629-34. doi: 10.2214/AJR.08.1366.

    PubMed 19234257
  • Ohno Y, Hatabu H, Takenaka D, Higashino T, Watanabe H, Ohbayashi C, Sugimura K. CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 2003 Jun;180(6):1665-9. doi: 10.2214/ajr.180.6.1801665.

    PubMed 12760939
  • Laspas F, Roussakis A, Efthimiadou R, Papaioannou D, Papadopoulos S, Andreou J. Percutaneous CT-guided fine-needle aspiration of pulmonary lesions: Results and complications in 409 patients. J Med Imaging Radiat Oncol. 2008 Oct;52(5):458-62. doi: 10.1111/j.1440-1673.2008.01990.x.

    PubMed 19032391
  • DiBardino DM, Yarmus LB, Semaan RW. Transthoracic needle biopsy of the lung. J Thorac Dis. 2015 Dec;7(Suppl 4):S304-16. doi: 10.3978/j.issn.2072-1439.2015.12.16.

    PubMed 26807279
  • Wiener RS, Schwartz LM, Woloshin S, Welch HG. Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records. Ann Intern Med. 2011 Aug 2;155(3):137-44. doi: 10.7326/0003-4819-155-3-201108020-00003.

    PubMed 21810706
  • Ost DE, Ernst A, Lei X, Kovitz KL, Benzaquen S, Diaz-Mendoza J, Greenhill S, Toth J, Feller-Kopman D, Puchalski J, Baram D, Karunakara R, Jimenez CA, Filner JJ, Morice RC, Eapen GA, Michaud GC, Estrada-Y-Martin RM, Rafeq S, Grosu HB, Ray C, Gilbert CR, Yarmus LB, Simoff M; AQuIRE Bronchoscopy Registry. Diagnostic Yield and Complications of Bronchoscopy for Peripheral Lung Lesions. Results of the AQuIRE Registry. Am J Respir Crit Care Med. 2016 Jan 1;193(1):68-77. doi: 10.1164/rccm.201507-1332OC.

    PubMed 26367186
  • Ernst A, Simoff M, Ost D, Michaud G, Chandra D, Herth FJ. A multicenter, prospective, advanced diagnostic bronchoscopy outcomes registry. Chest. 2010 Jul;138(1):165-70. doi: 10.1378/chest.09-2457. Epub 2010 Apr 2.

    PubMed 20363846
  • Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S, Sato S, Suzuki E, Senba H, Fujino S, Ohmori K. Deaths and complications associated with respiratory endoscopy: a survey by the Japan Society for Respiratory Endoscopy in 2010. Respirology. 2012 Apr;17(3):478-85. doi: 10.1111/j.1440-1843.2011.02123.x.

    PubMed 22222022
  • Khandhar SJ, Bowling MR, Flandes J, Gildea TR, Hood KL, Krimsky WS, Minnich DJ, Murgu SD, Pritchett M, Toloza EM, Wahidi MM, Wolvers JJ, Folch EE; NAVIGATE Study Investigators. Electromagnetic navigation bronchoscopy to access lung lesions in 1,000 subjects: first results of the prospective, multicenter NAVIGATE study. BMC Pulm Med. 2017 Apr 11;17(1):59. doi: 10.1186/s12890-017-0403-9.

    PubMed 28399830
  • Ali EAA, Takizawa H, Kawakita N, Sawada T, Tsuboi M, Toba H, Takashima M, Matsumoto D, Yoshida M, Kawakami Y, Kondo K, Khairy El-Badrawy M, Tangoku A. Transbronchial Biopsy Using an Ultrathin Bronchoscope Guided by Cone-Beam Computed Tomography and Virtual Bronchoscopic Navigation in the Diagnosis of Pulmonary Nodules. Respiration. 2019;98(4):321-328. doi: 10.1159/000500228. Epub 2019 May 23.

    PubMed 31121593
  • Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e142S-e165S. doi: 10.1378/chest.12-2353.

    PubMed 23649436
  • Mondoni M, Sotgiu G, Bonifazi M, Dore S, Parazzini EM, Carlucci P, Gasparini S, Centanni S. Transbronchial needle aspiration in peripheral pulmonary lesions: a systematic review and meta-analysis. Eur Respir J. 2016 Jul;48(1):196-204. doi: 10.1183/13993003.00051-2016. Epub 2016 May 12.

    PubMed 27174878
  • Pritchett MA, Schampaert S, de Groot JAH, Schirmer CC, van der Bom I. Cone-Beam CT With Augmented Fluoroscopy Combined With Electromagnetic Navigation Bronchoscopy for Biopsy of Pulmonary Nodules. J Bronchology Interv Pulmonol. 2018 Oct;25(4):274-282. doi: 10.1097/LBR.0000000000000536.

    PubMed 30179922
  • Gould MK, Donington J, Lynch WR, Mazzone PJ, Midthun DE, Naidich DP, Wiener RS. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e93S-e120S. doi: 10.1378/chest.12-2351.

    PubMed 23649456

Questions about this trial

What is this clinical trial studying?

A study testing Navigation Bronchoscopy and Cone beam computed tomography (CBCT) in people with Peripheral Pulmonary Nodules and Lung; Node, run by Beth Israel Deaconess Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 22 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Nov 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Diagnostic Yield (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04758403, which also lists 25 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2026; AzTrials last refreshed its copy on 27 Oct 2026.

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