Single-Encounter Augmented Reality-Guided Localization for Resection of Suspected Early-Stage Lung Cancer: A Randomized Clinical Trial

2026 · Randomised non-inferiority clinical trial

The takeaway

Single-encounter AR-guided localisation in theatre was non-inferior to CT-guided localisation for successful sublobar resection, with less radiation, pain and delay.

Randomised non-inferiority trial at 5 centres in China, August 2024 to September 2025; 270 of 296 randomised patients in the mITT analysis (134 AR, 136 CT).
Successful sublobar resection: 98.5% with AR vs 99.3% with CT (risk difference -0.8 percentage points; 95% CI -2.7 to 3.9), meeting non-inferiority.
Radiation exposure: median 456.50 vs 1260.11 mGy·cm (P < .001).
Preoperative pain (NRS): median 0 vs 5 (P < .001).
Localisation-to-incision interval: median 2.00 vs 33.50 minutes (P < .001); pneumothorax in 40 of 136 CT-guided cases (29.4%).

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Why it matters

Conventional CT-guided localisation of small pulmonary nodules involves a multiple-encounter workflow that may cause pain, radiation exposure and complications. In this randomised trial, augmented-reality-guided localisation performed in the operating room under general anaesthesia was non-inferior for successful sublobar resection and was associated with lower radiation exposure, lower pain, shorter puncture time and a shorter localisation-to-incision interval.

— surgeon's take

Single-Encounter Augmented Reality-Guided Localization for Resection of Suspected Early-Stage Lung Cancer: A Randomized Clinical Trial

Why it matters

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