• The technology described in this briefing is the Archimedes System. It is used to take image-guided biopsies of lung lesions.

  • The innovative aspects are that it allows healthcare professionals to see where the bronchoscope is going in real time using pattern recognition software to reconstruct CT scans and create full 3D images of the airways.

  • The intended place in therapy would be as an alternative to CT‑guided trans-thoracic biopsy for definitive diagnosis of lung lesions in people with suspicious nodules in the airways or beyond.

  • The main points from the evidence summarised in this briefing are from 4 observational studies including a total of 59 people with lung lesions in secondary care. They showed that Archimedes enabled healthcare professionals to access lesions anywhere in the lung, with a diagnostic yield of 75% to 85%. They also showed that the risks of major complications such as pneumothorax are low using the system.

  • Key uncertainties around the evidence are that no comparators were included, study sample sizes were small (6 to 25 people), and none of the studies were in the UK.

  • The cost of the Archimedes System is £240,000 (exclusive of VAT). The resource impact would be greater than standard care (a CT‑guided trans-thoracic biopsy procedure), the average cost of which is estimated at £1,357. Some of the extra costs may be offset because of fewer complications such as pneumothorax and a shorter inpatient stay. There is limited evidence to support these claims.