Single-stage hybrid localization: a combination of bronchoscopic lung mapping followed by post-mapping computed tomographic reconstruction and additional transthoracic needle localization in a cone beam computed tomography room

Yang, Shun-Mao; Ko, Wei-Chun; Meng, Ling-Hsuan; Chen, Liwei; Lin, Kun-Hsien; Liu, Yueh-Lun; Sun, Shao-En; Ko, Huan-Jang

doi:10.21037/atm.2018.10.65

Cited by 3 publications

(3 citation statements)

References 15 publications

(19 reference statements)

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“…Several studies have reported that severe radiation injuries can occur because of prolonged interventional procedures (Krim et al 2011, Padovani et al 2011, Sun et al 2013. Although the effectiveness of AFB has been demonstrated in numerous clinical cases (Fang et al 2019, Yang et al 2019a, 2020b, no evaluation of patients' and medical staff 's exposure to radiation during these procedures has been performed. The present study evaluated the skin and effective doses received by patients and the personal dose equivalent to the eye lens [H p (3)] of physicians during AFB procedures.…”

Section: Introductionmentioning

confidence: 99%

Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians

Lian,

Yee,

et al. 2024

J. Radiol. Prot.

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Objective. Cancer is a major health challenge and causes millions of deaths worldwide each year, and the incidence of lung cancer has increased. Augmented fluoroscopic bronchoscopy (AFB) procedures, which combine bronchoscopy and fluoroscopy, are crucial for diagnosing and treating lung cancer. However, fluoroscopy exposes patients and physicians to radiation, and therefore, the procedure requires careful monitoring. The National Council on Radiation Protection and Measurement and the International Commission on Radiological Protection have emphasized the importance of monitoring patient doses and ensuring occupational radiation safety. The present study evaluated radiation doses during AFB procedures, focusing on patient skin doses, the effective dose, and the personal dose equivalent to the eye lens for physicians.Approach. Skin doses were measured using thermoluminescent dosimeters. Peak skin doses were observed on the sides of the patients’ arms, particularly on the side closest to the X-ray tube. Differences in the procedures and experience of physicians between the two hospitals involved in this study were investigated. Main results. AFB procedures were conducted more efficiently at Hospital A than at Hospital B, resulting in lower effective doses. Cone-beam computed tomography contributes significantly to patient effective doses because it has higher radiographic parameters. Despite their higher radiographic parameters, AFB procedures resulted in smaller skin doses than did image-guided interventional and computed tomography fluoroscopy procedures. The effective doses differed between the two hospitals of this study due to workflow differences, with cone-beam computed tomography playing a dominant role. No significant differences in left and right eye Hp(3) values were observed between the hospitals. For both hospitals, the Hp(3) values were below the recommended limits, indicating that radiation monitoring may not be required for AFB procedures.Significance. This study provides insights into radiation exposure during AFB procedures, concerning radiation dosimetry, and safety for patients and physicians.

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Section: Introductionmentioning

confidence: 99%

Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians

Lian,

Yee,

et al. 2024

J. Radiol. Prot.

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“…Recently, the cone-beam CT (CBCT) suite-which can provide both real-time 2D fluoroscopy and 3D CBCT scans for definite visualization of small lesions-has been used more frequently for localizing pulmonary nodules [8,9]. To overcome the limitation of the standard 2D fluoroscopy, we developed a novel technique, termed augmented fluoroscopic bronchoscopy (AFB), using CBCT with an annotation software, which provides both 2D fluoroscopic view and 3D image data, allowing for real-time guidance during bronchoscopic localization [10,11].…”

Section: Introductionmentioning

confidence: 99%

Localization of Small Pulmonary Nodules Using Augmented Fluoroscopic Bronchoscopy: Experience from 100 Consecutive Cases

Yang

Lin

et al. 2020

World j. surg.

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Background We developed augmented fluoroscopic bronchoscopy (AFB) for the localization of small pulmonary nodules. Here, we review the results of 100 consecutive cases of AFB localization performed in our institute in order to evaluate its efficacy, safety, and procedural details. Methods This study was a retrospective analysis of prospectively collected data. Between July 2018 and September 2019, a total of 100 patients with 124 small lung nodules underwent AFB localization with dye marking and/or microcoil placement. All localizations were performed in a cone-beam computed tomography examination room followed by thoracoscopic resection within 3 days. Results The mean nodule size was 9.7 mm, and the mean distance from the pleural space was 18.6 mm. Sixty-three patients received dye marking only, and 37 patients received microcoil placement with/without additional dye marking. The mean bronchoscopy duration was 10.4 min, and the mean fluoroscopy duration was 3.4 min. The mean radiation exposure (expressed as the dose-area product) was 3140.8 lGy 9 m 2 . The AFB procedures were successful in 94 patients [augmented fluoroscopy discrepancy (n = 2), incomplete C-arm confirmation (n = 3), microcoil unlooping (n = 1)]; of those, 91 received successful marker-guided resection [invisible dye (n = 2), failed nodule resection with first wedge (n = 1)]. The mean length of postoperative stay and chest drainage was 4.2 and 2.9 days, respectively. Conclusions The AFB technique is a safe and reproducible alternative for localizing small pulmonary nodules, and various localization strategies can be implemented for different nodule locations and resection plans.

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“…As imaging techniques develop so rapidly, using CT has increased greatly in the past few years (1). Many new techniques including CT angiography (CTA), CT perfusion imaging (CTP), and gemstone spectral imaging (GSI) are providing more and more valuable information for clinical diagnosis (2)(3)(4)(5). However, the diagnostic benefits of CT imaging are associated with unavoidable radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

Radiation doses in CT examinations from the West China Hospital, Sichuan University and setting local diagnostic references levels

Li¹,

Zhang²,

Xia³

et al. 2020

Ann Transl Med

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Background: Our study aims to summarize the data of radiation doses collected from consecutive CT examinations by using the Radiometrics software and contributing to the establishment of the region's diagnostic reference levels (DRLs). Methods:The radiation doses in 158,463 CT examinations performed on 106,275 adults between April 2017 and April 2019 were retrospectively analyzed. The median value and interquartile range (IQR) of volumetric CT dose index (CTDIvol), dose-length product (DLP), effective dose (ED), and size-specific dose estimate (SSDE) were calculated according to the scanning region.Results: The median CTDIvol (mGy) for each scanning region was 42.3 (head), 6.2 (chest), and 9.0 (abdomen). The median DLPs (mGy.cm) for single-phase, multi-phase, and all examinations were as follows:

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Single-stage hybrid localization: a combination of bronchoscopic lung mapping followed by post-mapping computed tomographic reconstruction and additional transthoracic needle localization in a cone beam computed tomography room

Cited by 3 publications

References 15 publications

Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians

Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians

Localization of Small Pulmonary Nodules Using Augmented Fluoroscopic Bronchoscopy: Experience from 100 Consecutive Cases

Radiation doses in CT examinations from the West China Hospital, Sichuan University and setting local diagnostic references levels

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