To evaluate the diagnostic value of virtual bronchoscopic navigation (VBN) combined with radial endobronchial ultrasound (R-EBUS) in peripheral lung cancer.

A total of 96 patients who underwent VBN+ R-EBUS guided lung biopsy in our hospital from January 2022 to January 2024 were selected. Chi-square test was used to compare the correlation between homogeneous/heterogeneous nodule echo, boundary characteristics, CT diagnosis and pathological diagnosis. Logistic regression analysis and receiver operating characteristic curvecurve (ROC) curve were used. To investigate the diagnostic value of R-EBUS imaging features in peripheral lung cancer.

Sixty-six cases (68.75%) showed homogeneous solid echogenicity, 30 cases (43.48%) showed heterogeneous solid echogenicity, 57 cases (59.38%) showed clear border, and 39 cases (40.62%) showed unclear border. 67 cases (69.79%) of lung cancer and 29 cases (30.21%) of other non-neoplastic diseases were diagnosed by spiral CT before operation. 58 cases (60.42%) of lung tumors were diagnosed by histopathology, including 39 cases (40.63%) of adenocarcinoma, 9 cases(9.38%) of squamous cell carcinoma and 10 cases (10.42%) of other tumors. There were 38 cases (39.58%) of non-tumor diseases diagnosed by histopathology, including 24 cases (25.00%) of inflammation, 6 cases(6.25%) of focal granulomatous inflammation or tuberculosis, and 8 cases (8.33%) of other non-tumor diseases. There were 51 cases of lung cancer (53.13%) and 15 cases of non-lung cancer (15.63%) with homogeneous echo and histopathologic diagnosis, 7 cases of lung cancer (7.29%) and 23 cases of non-lung cancer (23.96%) with heterogeneous echo.Homogeneous echo was correlated with pathological diagnosis of lung cancer (P<0.001). The sensitivity and specificity of echo diagnosis of lung cancer were 87.93% and 60.53%, respectively. Borderless and histopathologically diagnosed were lung cancer in 24 cases (25.00%) and non-lung cancer in 34 cases (35.41%). Borderless and histopathologically diagnosed were lung cancer in 15 cases(15.63%) and non-lung cancer in 23 cases (23.96%).There was no correlation between boundary features and pathological diagnosis of lung cancer (P>0.05). Logistic regression analysis showed that echo, CT and echo combined with CT detection were consistent with pathological diagnosis of lung cancer (P<0.001). ROC curve analysis showed that echo AUC: 0.7423, CTAUC: 0.7945, and echo combined with CTAUC: 0.8827.

The solid homogeneous echo in R-EBUS image is significantly correlated with the pathological diagnosis of lung cancer. R-EBUS combined with CT can improve the diagnostic accuracy of lung cancer.