The VERITAS Trial and the Future of Transthoracic Biopsy: A Call to Action for Radiologists.

The VERITAS trial challenges the long-held superiority of transthoracic needle biopsy (TTNB) for peripheral lung nodules by showing noninferior diagnostic yield with navigational bronchoscopy. However, underuse of rapid on-site evaluation (ROSE) in the TTNB arm likely disadvantaged its performance. This Viewpoint contextualizes VERITAS, underscores the ongoing importance of TTNB, and calls radiologists to action-integrating ROSE, innovating procedural safety, and engaging in multidisciplinary decision-making to sustain radiology's leadership in lung cancer diagnosis.