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Abstract
Objective Three recently introduced techniques can diagnose and treat a pulmonary nodule through a single skin puncture of 3 mm or less. This review examines how these techniques work, what evidence stands behind each of them, and where they might reasonably fit in clinical practice.
Methods PubMed, Web of Science, CNKI, and Wanfang were searched for publications from January 2019 to August 2026, together with guidelines, consensus documents, patents, and regulatory records. Before adopting a narrative approach, we formally assessed whether the data could be pooled. They could not: no technique has more than one published clinical series, and no study compares any two of the three techniques. Safety benchmarks were therefore taken from published meta-analyses of the parent procedures rather than from new pooled estimates.
Results The three techniques share the same access size but little else. LCEC combines cryoablation, biopsy, and aspiration in one local-anesthesia session and follows the 2022 Chinese consensus on imaging-guided cryoablation; its evidence is a single-center retrospective series. The Prana system, cleared by the FDA through the 510(k) pathway in April 2026, excises tissue with bipolar electrosurgical energy; no peer-reviewed clinical study of it has appeared. Percutaneous spherical resection, introduced by Professor Lunxu Liu’s team in 2025, removes small ground-glass nodules while sparing almost all surrounding lung; its evidence is an institutional report of the first few cases. For none of the three do we have long-term oncological outcomes or comparative trials.
Conclusion These techniques answer a real need, but they are at very different stages of proof, and none is yet supported by the kind of evidence that changes guidelines. Multicenter prospective studies with standardized complication reporting should come before wider adoption.