NL
Navigational bronchoscopy is an innovative and safe technique for diagnosing hard-to-reach lung abnormalities. Since January 2024, this method has been included in the basic health insurance package and is now being used in nine Dutch centers. Thanks to a national implementation strategy led by Radboudumc, its availability is growing rapidly. The technique offers accurate tissue sampling with significantly fewer complications and also opens the door to future therapeutic applications.
Lung cancer is one of the most common and deadly forms of cancer in the Netherlands. Early, reliable diagnosis is of great importance, but conventional diagnostic techniques, such as bronchoscopy or CT-guided needle biopsy (TTNB), have significant limitations. Many suspicious lung abnormalities are difficult to reach via the airways or involve high risks when punctured from the outside. As a result, a large proportion of patients undergo curative treatment without pathological confirmation, which can lead to overtreatment and unnecessary complications.
Navigational bronchoscopy offers an innovative and safe solution. This technique uses advanced image guidance to take tissue samples from hard-to-reach lung abnormalities with great precision via the airways. The diagnostic accuracy is comparable to TTNB, but with a much lower risk of complications.
Since January 1, 2024, this technique has been included in the basic health insurance package. Led by Radboudumc, a nationwide implementation project was launched in 2023, co-financed by KWF. This project focuses on the widespread dissemination of the technique in Dutch hospitals through targeted training, guidance, and quality monitoring. As of April 2025, nine centers will be operational, with several other hospitals in the preparatory phase.
The implementation strategy has been carefully constructed with an eye for practical and organizational challenges, such as available personnel, equipment, and local financing. In addition, work is being done on future-oriented applications such as local, endobronchial treatments with radiofrequency or microwave ablation.
The future of navigation bronchoscopy extends beyond diagnostics. Work is underway on therapeutic applications such as local tumor treatment via endobronchial ablation. This technique is thus developing into a powerful, minimally invasive tool in the fight against lung cancer—now and in the future.
drs. F. Beyaz , dr. J.E.M. Swillens , dr. R.L.J. Verhoeven , prof. dr. E.H.F.M. van der Heijden , prof. dr. R.P.M.G. Hermens