Do you favor transthoracic needle biopsy or navigational biopsy for diagnosis of intermediate risk pulmonary nodules?

I prefer navigational bronchoscopy if it is available. This is supported by a recent NEJM article (May 18, 2025) that reported that navigational bronchoscopy was non-inferior for diagnosis and safer in terms of pneumothorax.

I agree as well. The Veritas trial just published in the NEJM confirms that navigational bronchoscopy is non-inferior to CT guided needle biopsy (with some limitations) even without the use of intra-operative cone beam CT or cryobiopsy which increase the diagnostic yield even further and would likel...