Radiation Dose of Cone Beam CT Combined With Shape Sensing Robotic Assisted Bronchoscopy For The Evaluation Of Pulmonary Lesions: An Observational Single Center Study

Styrvoky K et al.

J Thorac Dis Volume 15, Issue 9, August 2023, Pages 4836-4848

What is the key question?

  • What is the radiation dose of cone beam computed tomography (CBCT) combined with shape sensing robotic-assisted bronchoscopy (ssRAB)?

What is the bottom line?

  • This is a single center, prospective observational study of patients undergoing ssRAB combined with fixed CBCT for the pulmonary lesion biopsy.
  • A total of 241 ssRAB procedures were performed to biopsy 269 pulmonary lesions. The mean lesion size was measured in the following dimensions: anteroposterior (18.0±8.8 mm), transverse (17.2±10.5 mm), and craniocaudal (17.7±10.2 mm).
  • A mean of 1.5±0.7 (median: 1, range: 1--4) CBCT spins were performed. The mean total fluoroscopy time (FT) was 5.6±2.9 minutes. The mean radiation dose of cumulative air kerma (CAK) was 63.5±46.7 mGy and the mean cumulative dose area product (DAP) was 22.6±16.0 Gy·cm2.
  • Diagnostic yield calculated based on results at index bronchoscopy was 85.9%.
  • There was a low rate of complications with 8 pneumothoraces (3.3%), 5 (2.1%) of which required chest tube placement.

Why read on?

  • In this study, the use of ssRAB combined with CBCT to biopsy pulmonary lesions appears to be a safe diagnostic modality with relatively low radiation dose that is potentially comparable to other image guided sampling modalities. Further studies are needed to confirm the radiation safety of CBCT.