New Robotic Bronchoscopy Software Enhances Lung Nodule Navigation and Targeting

Accurate bronchoscopy to lung nodules can be technically challenging because patient anatomy may shift between pre-procedure computed tomography and the live procedure. These changes, together with CT-to-body divergence, can reduce confidence in nodule localization during navigation and biopsy. A new system has launched to improve planning, navigation, and targeting for early lung cancer evaluation..

Johnson & Johnson has introduced MONARCH QUEST 3, the latest software update for the MONARCH Platform, following U.S. 510(k) regulatory clearance. The platform is positioned as the first flexible, robotically assisted system for bronchoscopy. The update follows three launches over the past 18 months and is aimed at improving clinician confidence during complex procedures.

The MONARCH QUEST platform provides continuous visualization during robotically assisted bronchoscopy, supporting navigation to and biopsy of lung targets under direct vision. Its bronchoscope is designed to provide precise control and stable reach, while navigation and targeting tools account for computed tomography (CT)-to-body divergence. Building on this foundation, MONARCH QUEST 3 introduces advances in planning, navigation, and targeting to help clinicians adapt to anatomic changes that occur during procedures.

New capabilities include artificial intelligence (AI)-powered nodule segmentation, which generates nodule boundaries with a single click during pre-procedural planning. Additional software enhancements are designed to improve registration and navigation accuracy as anatomy shifts, while a 3D Compass overlay helps clinicians maintain visual orientation between joystick controls and patient anatomy. Expanded compatibility with commonly used mobile and fixed cone-beam computed tomography (CBCT) systems further helps address CT-to-body divergence and improve targeting. Together, these features support continuous registration and real-time tracking of the scope tip relative to patient anatomy.

The release also incorporates Polyphonic, an open digital ecosystem that supports review of procedural volume data and collaboration through a centralized video library. By organizing each case in a consistent, reviewable format, the system is intended to facilitate procedural learning and assessment. In the United States, the MONARCH Bronchoscope and Platform are intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures. 

“Being first to market carries a responsibility to keep advancing. With MONARCH QUEST 3, we’re continuing to evolve the MONARCH Platform in close partnership with clinicians, applying artificial intelligence, expanding imaging integration, and delivering software enhancements that support greater procedural confidence and precision for patients,” said Aleksandra Popovic, PhD, President, MONARCH, MedTech, Johnson & Johnson.

“This release reflects our ongoing commitment to innovation in robotically‑assisted bronchoscopy. MONARCH QUEST 3 builds on a series of advancements introduced over the past several years, all focused on helping clinicians navigate with greater confidence and target lung nodules with accuracy,” said Gaetane Michaud, M.D., interventional pulmonologist and Senior Director of Medical Affairs, MedTech, Johnson & Johnson.