Early detection, diagnosis, and intervention of pulmonary nodules are crucial for reducing the risk of lung cancer incidence and mortality and improving long-term survival rates. However, complex lesions and small lesions in the peripheral lung regions often present challenges in clinical practice due to their deep location, small size, and complex adjacent structures, making localization, sampling, and diagnosis difficult. This poses a significant challenge to high-precision diagnosis and standardized treatment.

Today, we'll introduce you to an innovative lung diagnosis and treatment solution—the '3D Imaging DT Technology' in the Galaxy Bronchoscope Robot—and see how it precisely solves the problem of lesion localization, building a strong defense for early diagnosis and treatment and protecting lung health.

What is 3D Imaging (DT) technology?

Before answering this question, let me explain what 'CT to Body Divergence' is. Simply put, it's a significant discrepancy between the location of the lesion on a pre-operative static CT scan and its actual location within the patient's body during surgery. A CT scan only provides a static image of the lungs at a specific moment while the patient is awake. During surgery, the patient is under anesthesia and mechanical ventilation, resulting in different body positions, breathing depths, and lung expansion compared to the scan. Combined with the time interval between the CT scan and surgery, changes in lung structure, and atelectasis caused by anesthesia, the lesion location deviates from the marked points on the CT scan, creating this discrepancy. This directly leads to mislocalization by biopsy tools, reducing diagnostic accuracy.

What makes '3D Imaging DT technology' so amazing?

✅  3D Imaging (DT) technology boasts high reliability.

In a clinical study involving 31 subjects (Match 2 Study), the bronchial navigation system (Galaxy system) equipped with this cutting-edge technology achieved a 100% navigation and biopsy success rate, with a 93.5% confirmation rate of the biopsy tool in the lesion (TIL), and a consistency of 96.7% with the CBCT confirmation results. It avoids the sampling error of 'a slight difference can lead to a huge error', fully verifying the reliability of the real-time lesion localization of 3D imaging DT technology, and supporting the system as an effective tool for clinical real-time navigation and puncture confirmation [1].

✅Enhanced  perspective function

Enhanced fluoroscopy technology enables the real-time overlay display of lesion locations on two-dimensional fluoroscopic images. Even lesions that cannot be visualized under conventional two-dimensional fluoroscopy can be located by users through this technology, thereby helping doctors to perform high-precision diagnosis and treatment of lesions with the help of visualization tools.

✅Distance  quantization function

C-arm view in AP position (displaying the instrument within the lesion); C-arm view in anteroposterior and lateral positions (displaying the instrument outside the lesion). 

As shown in the left image, the doctor has completed the placement of the biopsy tool and confirmed it using imaging equipment. Under the AP (apical) view, the biopsy tool is visible inside the lesion. However, when the imaging equipment is rotated to the anteroposterior view, the tool appears outside the lesion (as shown in the middle image above). This indicates that achieving high-precision targeted localization in three-dimensional space using only two-dimensional images presents significant technical challenges. As shown in the right image, by utilizing the distance quantification function of the Pribaichuan system, the distance between the tool and the lesion center in the anterior-posterior orientation can be quantitatively measured. High-precision numerical values can then be used to determine whether the biopsy tool is truly located within the lesion, thus achieving more reliable localization confirmation.

Why is 3D Imaging (DT) technology considered an innovative solution for lung diagnosis and treatment?

With the increase in the detection rate of pulmonary nodules, the clinical demand for 'high precision, minimally invasive and efficient' diagnosis is becoming increasingly urgent. Although the first generation of bronchoscopic robots has solved the navigation accessibility problem, it has obvious shortcomings in terms of real-time lesion localization and updating during the operation, and lacks the ability to fuse and calibrate real-time images of lesion location and morphological changes. As a new generation of bronchoscopic robots equipped with 3D Imaging DT technology, the Galaxy bronchoscopic robot combines digital tomography synthesis three-dimensional reconstruction technology with enhanced fluoroscopy and electromagnetic navigation. It has shown a high diagnostic rate and low risk of complications in the diagnosis of small peripheral pulmonary nodules, laying an important foundation for subsequent clinical applications and multi-center studies [2]. It is like equipping the bronchoscopy with 'real-time navigation + high precision aiming scope', which does not deviate in front of small lesions and provides accurate diagnostic basis for subsequent treatment (such as surgery and targeted therapy).

Galaxy Bronchoscope Robot

【1】Mahajan AK, Duong DK, Cortes J, Bhadra K. The match 2 study: Robotic assisted bronchoscopy with integrated imaging with assessment of digital tomosynthesis (DT) and augmented fluoroscopy (AF): Three-Dimensional accuracy as confirmed by cone beam computed tomography (CBCT). Respir Med. 2026 Mar;253:108693. doi: 10.1016/j.rmed.2026.108693. Epub 2026 Jan 29. PMID: 41620189.

【2】Saghaie T, Williamson JP, Phillips M, Kafili D, Sundar S, Hogarth DK, Ing A. First-in-human use of a new robotic electromagnetic navigation bronchoscopic platform with integrated Tool-in-Lesion Tomosynthesis (TiLT) technology for peripheral pulmonary lesions: The FRONTIER study. Respirology. 2024 Nov;29(11):969-975.

Disclaimer: The content on this platform is for academic exchange among medical professionals only and does not constitute any medical advice. Patients with medical needs should consult a doctor for professional guidance. The technical opinions of medical professionals published on this platform do not represent the position of this company.

Copyright of all content in this article belongs to Puli Ark. Unauthorized reproduction or adaptation in any form is prohibited. Our company assumes no responsibility for any losses caused by improper reproduction or citation of this article and reserves the right to pursue legal action against infringers.