Development of a Novel Fluorescent Recognition Guidewire System Toward Early Lung Cancer Biopsy

Obtaining tissue biopsies from peripheral pulmonary lesions remains challenging due to the limited maneuverability of conventional bronchoscopic instruments in distal airways and the inability to distinguish malignant from benign tissue in real time. Here, we present a proof-of-concept guidewire-based biopsy system that integrates magnetic actuation for flexible navigation with fluorescence imaging for targeted lesion identification. The system comprises a magnetically driven biopsy tool, a miniaturized camera with an optical filter, a 488 nm laser fiber for fluorescence excitation, and a white-light illumination fiber. Under external magnetic field control (10-40 mT), the system achieved a maximum deflection angle of 32.60° ± 1.03° (90° magnetic field) and successfully navigated through a scaled bronchial phantom to reach multiple target branches. Using FITC-conjugated anti-EGFR antibody-labeled A549 cell spheroids as simulated tumor targets, the system demonstrated real-time fluorescence identification and targeted biopsy, recovering 23.40% ± 2.63% of spheroid cells per sampling session. Navigation and biopsy capabilities were further validated in ex vivo porcine lungs. This integrated approach addresses both the navigation and target identification challenges inherent in peripheral lung biopsy and provides a foundation for future development toward clinical application.