Augmented Fluoroscopic Bronchoscopy 2.0

Yang, Shun-Mao; Yu, Kai-Lun; Chen, Lun-Che; Chung, Wen-Yuan; Ko, Huan-Jang; Chen, Chung-Ming

doi:10.1097/lbr.0000000000000786

Cited by 2 publications

(4 citation statements)

References 10 publications

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“…Our development of the AFB technique in HOR, which links the endobronchial road mapping of preprocedural CT and the target lesion derived from intraprocedural CBCT, presents a new platform for fluoroscopy-guided endobronchial intervention [ 20 ]. This new navigation technique provides the ease of visibility of small lung nodules and the location of lesions masked by other organs and differentiates AFB from standard fluoroscopic procedures [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Cone-Beam Computed-Tomography-Derived Augmented Fluoroscopy-Guided Biopsy for Peripheral Pulmonary Nodules in a Hybrid Operating Room: A Case Series

et al. 2023

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Lung cancer is the most lethal cancer type in Taiwan and worldwide. Early detection and treatment advancements have improved survival. However, small peripheral pulmonary nodules (PPN) biopsy is often challenging, relying solely on bronchoscopy with radial endobronchial ultrasound (EBUS). Augmented fluoroscopy overlays the intra-procedural cone-beam computed tomography (CBCT) images with fluoroscopy enabling real-time three-dimensional localization during bronchoscopic transbronchial biopsy. The hybrid operating room (HOR), equipped with various types of C-arm CBCT, is a perfect suite for PPN diagnosis and other interventional pulmonology. This study shares the single institute experience of EBUS transbronchial biopsy of PPN with the aid of augmented fluoroscopic bronchoscopy (AFB) and CBCT in an HOR. We retrospectively enrolled patients who underwent robotic CBCT, augmented fluoroscopy-guided, radial endobronchial ultrasound-confirmed transbronchial biopsy and cryobiopsy in a hybrid operating room. Patient demographic characteristics, computed tomography images, rapid on-site evaluation cytology, and final pathology reports were collected. Forty-one patients underwent transbronchial biopsy and 6 received additional percutaneous transthoracic core-needle biopsy during the same procedure. The overall diagnostic yield was 88%. The complications included three patients with pneumothorax after receiving subsequent CT-guided percutaneous transthoracic needle biopsy, and two patients with hemothorax who underwent transbronchial cryobiopsy. Overall, the bronchoscopic biopsy of PPN using AFB and CBCT as precise guidance in the hybrid operating room is feasible and can be performed safely with a high diagnostic yield.

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Section: Discussionmentioning

confidence: 99%

Cone-Beam Computed-Tomography-Derived Augmented Fluoroscopy-Guided Biopsy for Peripheral Pulmonary Nodules in a Hybrid Operating Room: A Case Series

et al. 2023

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“…Recently, CBCT-guided bronchoscopy (without ENB) for image-based navigation and 3D confirmation of tool-in-lesion was published by Verhoeven et al 22 Although a learning effect for CBCT-guided bronchoscopy with AF of the 3D segmented lesion was reported, the diagnostic accuracy increased over time from 72% to 90% 22 . In a recent research letter, Yang et al 23 reported on AF enhanced with the bronchial anatomy for image-guided endobronchial interventions. In their work, georeferencing of the bronchial anatomy from preoperative CT images with intraprocedural CBCT images was accomplished by manual calibration in the axial, coronal, and sagittal planes 23 …”

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confidence: 99%

“…In a recent research letter, Yang et al 23 reported on AF enhanced with the bronchial anatomy for image-guided endobronchial interventions. In their work, georeferencing of the bronchial anatomy from preoperative CT images with intraprocedural CBCT images was accomplished by manual calibration in the axial, coronal, and sagittal planes 23 …”

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“…In their work, georeferencing of the bronchial anatomy from preoperative CT images with intraprocedural CBCT images was accomplished by manual calibration in the axial, coronal, and sagittal planes. 23 In the present AIRWAZE study, we evaluated CBCT-guided bronchoscopy with advanced AF views of the bronchial tree generated by automatic elastic registration of intraprocedural CBCT data with preoperative computed tomography (CT) information for navigation of endobronchial devices to PPNs. The primary endpoints of our prospective clinical study are the navigational success and diagnostic yield for biopsy of PPNs STARD checklist SDC, http://links.lww.com/LBR/A309.…”

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Cone-beam CT-based Navigation With Augmented Fluoroscopy of the Airways for Image-guided Bronchoscopic Biopsy of Peripheral Pulmonary Nodules

Pritchett,

Williams,

Schirmer

et al. 2023

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: Cone-beam computed tomography (CBCT) and augmented fluoroscopy (AF), in which intraprocedural CBCT data are fused with fluoroscopy, have been utilized as a novel image-guidance technique for biopsy of peripheral pulmonary lesions. The aim of this clinical study is to determine the safety and diagnostic performance of CBCT-guided bronchoscopy with advanced software tools for procedural planning and navigational guidance with AF of the airways for biopsy of peripheral pulmonary nodules. Methods: Fifty-two consecutive subjects were prospectively enrolled in the AIRWAZE study (December 2018 to October 2019). Image-guided bronchoscopic biopsy procedures were performed under general anesthesia with specific ventilation protocols in a hybrid operating room equipped with a ceiling-mounted C-arm system. Procedural planning and image-guided bronchoscopy with CBCT and AF were performed using the Airwaze investigational device. Results: A total of 58 pulmonary lesions with a medium size of 19.0 mm (range 7 to 48 mm) were biopsied. The overall diagnostic yield at index procedure was 87.9% (95% CI: 77.1%-94.0%). No severe adverse events related to CBCT-guided bronchoscopy, such as pneumothorax, bleeding, or respiratory failure, were observed. Conclusion: CBCT-guided bronchoscopic biopsy with augmented fluoroscopic views of the airways and target lesion for navigational guidance is technically feasible and safe. Three-dimensional image-guided navigation biopsy is associated with high navigational success and a high diagnostic yield for peripheral pulmonary nodules.

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Augmented Fluoroscopic Bronchoscopy 2.0

Abstract: Supplemental Digital Content is available in the text.

Cited by 2 publications

References 10 publications

Cone-Beam Computed-Tomography-Derived Augmented Fluoroscopy-Guided Biopsy for Peripheral Pulmonary Nodules in a Hybrid Operating Room: A Case Series

Cone-Beam Computed-Tomography-Derived Augmented Fluoroscopy-Guided Biopsy for Peripheral Pulmonary Nodules in a Hybrid Operating Room: A Case Series

Cone-beam CT-based Navigation With Augmented Fluoroscopy of the Airways for Image-guided Bronchoscopic Biopsy of Peripheral Pulmonary Nodules

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