Radiation Exposure Trends with Augmented Fluoroscopy and C-arm-based Tomosynthesis for Navigated Bronchoscopy.

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Respiratory medicine Pub Date : 2025-03-11 DOI:10.1016/j.rmed.2025.108035

Roshen Mathew, Winnie Elma Roy, Nikhil Meena, Harmeen Goraya

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引用次数: 0

Abstract

Background: Augmented fluoroscopy (AF) and C-arm-based tomography (CABT) have enhanced diagnostic outcomes in navigated bronchoscopy, though there is limited documentation on radiation dose trends.

Methods: A two-year prospective study with 67 cases was conducted. Patients underwent bronchoscopy biopsies with AF and CABT under general anesthesia. AF used a GE C-arm 9900, and lesion localization was done with Body Vision's CABT system. Radiation doses were measured using cumulative air kerma (CAK), dose area product (DAP), effective dose (ED), and fluoroscopy time (FT) over three two-month phases.

Results: The average lesion size was 2.1 cm, with a diagnostic yield of 72% (48/67) using strict criteria. Intermediate criteria, including follow-up CT, increased the yield to 84% (56/67). Radiation doses averaged CAK 42 mGy, DAP 27 Gy·cm², ED 5 mSv, with 7 minutes of FT and 1.7 rotations per lesion. Over the study, FT increased (4 to 7 minutes), but CAK (54 to 44 mGy) and DAP (34 to 26 Gy·cm²) decreased. Significant associations with increased CAK radiation doses were found with multiple C-arm spins (P = 0.03), tool adjustments (P = 0.01), BMI above 30 (P = 0.01), extended FT (P = 0.04), higher DAP (P = 0.04), and increased ED (P < 0.001).

Conclusions: AF and CABT provide high diagnostic yield with minimal radiation exposure. Pulsed fluoroscopy and careful technique can reduce radiation risk, supporting the use of AF and CABT in navigated bronchoscopy for lung nodules.

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.