The VERITAS trial compared navigational bronchoscopy to CT-guided transthoracic needle biopsy (TTNB) in evaluating peripheral lung nodules (10–30 mm). The study found that bronchoscopy was noninferior to TTNB in diagnostic accuracy, with significantly lower complication rates.
Diagnostic accuracy was 79.0% for bronchoscopy and 73.6% for TTNB, with a noninferiority margin met (p = 0.003). Importantly, pneumothorax occurred in only 3.3% of patients in the bronchoscopy group versus 28.3% with TTNB. Severe pneumothorax requiring chest tube or hospitalization occurred in 0.8% vs. 11.5%, respectively.
This study supports the use of navigational bronchoscopy as a safer, less invasive alternative to TTNB for peripheral lung nodules, with comparable diagnostic yield and fewer adverse events