Detecting lung cancer early can save lives, but diagnosing small tumors deep in the outer regions of the lungs remains a major clinical challenge. Although CT scans frequently identify tiny suspicious lesions in the lung periphery, confirming cancer still requires a biopsy. Conventional bronchoscopes often cannot physically reach these areas because the airways become narrower and more complex the deeper they extend into the lungs, forcing clinicians to stop short and limiting diagnostic accuracy. A new approach now allows for safely widening these airways for accurate access to these hidden tumors.

Researchers at The University of Osaka (Osaka, Japan) have demonstrated that gently dilating narrowed bronchi with a small inflatable balloon enables bronchoscopes to reach peripheral lung lesions and safely obtain tissue samples from early-stage tumors. The research team developed a method called Balloon-Assisted Bronchoscope Delivery, which uses a thin catheter with a small balloon to widen the airway just enough to advance the bronchoscope further into the lung.

Rather than redesigning bronchoscopes to be thinner, the researchers took a different route by modifying the airway itself. During the procedure, the balloon catheter is guided to the point where the bronchial pathway becomes too narrow. The balloon is then gently inflated, expanding the airway and creating a temporary passage that allows the bronchoscope to move closer to the lesion.

In a first-in-human clinical trial, the technique proved both safe and effective. Physicians were able to reach and biopsy lung lesions smaller than 20 millimeters that would otherwise be inaccessible using standard bronchoscopy. No significant complications related to airway dilation were reported in the findings published in the journal Thorax.

By improving access to the peripheral lung field, this approach is expected to significantly increase diagnostic accuracy for early-stage lung cancer. Earlier diagnosis could translate into faster treatment decisions and better outcomes for patients. In addition to diagnosis, the technique may also enable future minimally invasive endoscopic therapies, potentially allowing tumors to be treated directly without major surgery.

“By allowing us to reach deep into the lungs where we couldn’t before, we expect to significantly expand the options for early diagnosis and minimally invasive treatment of lung cancer,” said Professor Atsushi Kumanogoh, who led the study.

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