Asano F, et al. - Virtual bronchoscopic navigation (VBN) as a substitute for X-ray fluoroscopy (XRF) was assessed in this randomized multicenter trial (non-inferiority trial) performed in VBN- and XRF -assisted groups. Findings indicated that a bronchoscope and biopsy instruments may be guided to the lesions using VBN without XRF, on endobronchial ultrasonography with a guide sheath (EBUS/GS), but to improve the accuracy of sample collection from lesions, XRF was mandatory. Overall, it was concluded that VBN cannot substitute XRF during transbronchial biopsy for peripheral pulmonary lesions.