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
{"title":"Radiation exposure trends with augmented fluoroscopy and C-arm-based tomosynthesis for navigated bronchoscopy","authors":"Roshen Mathew ,&nbsp;Winnie Elma Roy ,&nbsp;Nikhil Meena ,&nbsp;Harmeen Goraya","doi":"10.1016/j.rmed.2025.108035","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 cm<sup>2</sup>, ED 5 mSv, with 7 min of FT and 1.7 rotations per lesion. Over the study, FT increased (4–7 min), but CAK (54–44 mGy) and DAP (34–26 Gy cm<sup>2</sup>) 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 &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108035"},"PeriodicalIF":3.5000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0954611125000976","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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 min of FT and 1.7 rotations per lesion. Over the study, FT increased (4–7 min), but CAK (54–44 mGy) and DAP (34–26 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.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Respiratory medicine
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.
期刊最新文献
Corrigendum to "Optimising outcomes for adults with Cystic Fibrosis taking CFTR modulators by individualising care: Personalised data linkage to understand treatment optimisation (PLUTO), a novel clinical framework" [Respirat. Med. 239 (2025)]. Lung ultrasound in children with cystic fibrosis – A new promising approach Clinical predictive model for identifying high-risk factors in pleurisy tuberculoma patients. Factors Affecting the Probability of Pulmonary Embolism in Lung Ventilation/Perfusion Scintigraphy. Palliative care education as an integrated component of pulmonary rehabilitation: a real-world mixed-methods feasibility study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1