Have a suspicious lung nodule?
Ion robotic-assisted lung biopsy can help you get an answer sooner.
Real stories of diagnosis from Ion lung biopsy patients.
Getting an answer after four years of worry.
Paula’s story • McLeansboro, IL
Getting an answer without major lung surgery.
Doug’s story • Stedman, NC
Getting an answer by advocating for herself.
Joanne’s story • Sandusky, OH
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Weighing your options
During a lung biopsy, your doctor removes a tiny piece of tissue from a nodule in your lung. This sample is then tested to find out if it's cancer. Today, the most common ways to collect samples from lung nodules are through transthoracic needle aspiration (TTNA)* or with the Ion robotic-assisted bronchoscopy system.4Both TTNA and Ion are likely to give you an answer after your procedure,5,7 but other factors can help you and your doctor determine which is right for you.With Ion | With TTNA | ||
|---|---|---|---|
| Risk of lung collapse | 0–3.3%8-10 | 28%6 | |
| Ability to sample multiple nodules in one procedure | Yes11 | No12 | |
| Staging† can be performed during the same procedure | Yes7,12 | No7Requires a separate, second procedure | |
| Sedation (anesthesia) type | GeneralFully asleep | Conscious sedationRelaxed and drowsy but awake | |
| Procedure duration | 40–60 min8,13 | 25 min6 |
* Transthoracic needle aspiration (TTNA), transthoracic needle biopsy (TTNB), CT-guided needle biopsy, and percutaneous lung biopsy refer to the same procedure.† Staging is a way for doctors to take small samples from lymph nodes near the main airways to determine whether cancer has spread. The resulting cancer stage helps guide the best treatment plan.
Procedure types:
Know your lung biopsy options
In the U.S., almost half of all lung biopsies are now performed with the Ion robotic-assisted bronchoscopy system.4 Transthoracic needle aspiration is another approach that’s commonly used.
Transthoracic needle aspiration (TTNA)
A minimally invasive procedure in which a long, thin needle is advanced between the ribs, into the lung to reach a nodule for tissue sampling. While a TTNA procedure can be quick and accurate, it is associated with a higher risk of lung collapse ("pneumothorax") than other approaches.5,6 If you have multiple nodules that require sampling or your nodule is determined to be cancer, a separate diagnostic or staging† procedure may be required before starting cancer treatment.7
Ion robotic-assisted bronchoscopy
A minimally invasive procedure that allows your doctor to reach one or more lung nodules through your airways. Small tissue samples are collected without any incisions or punctures to the lung and are sent to a lab to determine if they contain cancer cells. If cancer is found, staging† can be performed with standard tools during the same procedure to determine if it has spread.7
How Ion works
Lung nodules often form in the outer parts of the lungs, at the end of small, twisting airways. These areas have traditionally been challenging to access from the inside of the lung because the lung's structure is complex and always moving as you breathe.That's where Ion helps. Ion is a robotic system physicians use to guide a thin, flexible scope through the complex twists and turns of your airways. Its unique technology holds the scope steady so your doctor can guide it with great precision, allowing them to navigate directly to the nodule and feel confident that they are sampling tissue from the correct spot.
The system uses your CT scan to create a detailed, GPS-like map of your lungs, providing your doctor with real-time, turn-by-turn directions to reach the nodule.
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- Munden RF, Chiles C, Boiselle PM, Sicks JD, Aberle DR, Gatsonis CA. Micronodules Detected on Computed Tomography During the National Lung Screening Trial: Prevalence and Relation to Positive Studies and Lung Cancer. J Thorac Oncol. 2019;14(9):1538-1546. doi:10.1016/j.jtho.2019.05.045
- State of Lung Cancer 2024. American Lung Association. www.lung.org/research/state-of-lung-cancer
- Ettinger DS, Wood DE, Aisner DL, et al. Non-Small Cell Lung Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2022;20(5):497-530. doi:10.6004/jnccn.2022.0025
- Intuitive internal data on file.
- Balasubramanian P, Abia-Trujillo D, Barrios-Ruiz A, et al. Diagnostic yield and safety of diagnostic techniques for pulmonary lesions: systematic review, meta-analysis and network meta-analysis. Eur Respir Rev. 2024;33(173):240046. Published 2024 Sep 18. doi:10.1183/16000617.0046-2024
- Lentz RJ, Frederick-Dyer K, Planz VB, et al. Navigational bronchoscopy or transthoracic needle biopsy for lung nodules. New England Journal of Medicine. Published online May 18, 2025. doi:10.1056/nejmoa2414059
- Yu Lee-Mateus A, Reisenauer J, Garcia-Saucedo JC, et al. Robotic-assisted bronchoscopy versus CT-guided transthoracic biopsy for diagnosis of pulmonary nodules. Respirology. 2023;28(1):66-73. doi:10.1111/resp.14368
- Paez R, Lentz RJ, Duke JD, et al. Robotic versus Electromagnetic Bronchoscopy for Peripheral Pulmonary Lesions: A Randomized Trial (RELIANT). Am J Respir Crit Care Med. 2025;211(9):1644-1651. doi:10.1164/rccm.202409-1846OC
- Brownlee AR, Perez C, Weiser L, et al. 1121 Shape-sensing Robotic-assisted Bronchoscopic Biopsies: Diagnostic Yield and Surgical Implications. Ann Thorac Surg. Published online April 17, 2025. doi:10.1016/j.athoracsur.2025.03.043
- Husta B, Batra H, Cheng G, et al. A prospective multicenter evaluation of shape-sensing robotic-assisted bronchoscopy with integrated mobile cone-beam CT: interim results from the CONFIRM study. Abstract presented at: AABIP; August 22, 2024;Charlotte, NC. Session 0430.
- Chrissian AA, Khosa J, Daher N, et al. Diagnostic Utility of Sampling Multiple Synchronous Pulmonary Nodules During Same-Session Robotic-Assisted Bronchoscopy. J Bronchology Interv Pulmonol. 2025;32(4):e1029. Published 2025 Sep 18. doi:10.1097/LBR.0000000000001029
- Fernandez-Bussy S, Valdes-Camacho S, Barrios-Ruiz A, et al. Streamlining Lung Cancer Diagnosis: One Procedure for Multi-Site Biopsy Using Shape-Sensing Robotic-Assisted Bronchoscopy. Respiration. Published online July 4, 2025. doi:10.1159/000547174
- Styrvoky K, Schwalk A, Pham D, Madsen K, Chiu H, Abu-Hijleh M. Procedural times with robotic-assisted bronchoscopy: a high volume single-center study. Ther Adv Respir Dis. 2024;18:17534666241277668. doi:10.1177/17534666241277668
- Horeweg N, van der Aalst CM, Thunnissen E, et al. Characteristics of lung cancers detected by computer tomography screening in the randomized NELSON trial. Am J Respir Crit Care Med. 2013;187(8):848-854. doi:10.1164/rccm.201209-1651OC
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