Feasibility of Using the O-Arm Imaging System During ENB-rEBUS–guided Peripheral Lung Biopsy
- Resource Type
- Authors
- George E. Abraham; Hamid Khosravi; Roy Cho; Erhan H. Dincer; Jennifer Wong; Michal Senitko
- Source
- Journal of Bronchology & Interventional Pulmonology. 28:248-254
- Subject
- Pulmonary and Respiratory Medicine
Lung Neoplasms
Biopsy
Bronchi
Lung biopsy
Effective dose (radiation)
03 medical and health sciences
Imaging, Three-Dimensional
0302 clinical medicine
Bronchoscopy
medicine
Humans
030212 general & internal medicine
Lung cancer
Retrospective Studies
Bronchus
Lung
medicine.diagnostic_test
business.industry
Nodule (medicine)
medicine.disease
medicine.anatomical_structure
Surgery, Computer-Assisted
030228 respiratory system
Feasibility Studies
medicine.symptom
Tomography, X-Ray Computed
Nuclear medicine
business
Electromagnetic Phenomena
Electromagnetic navigation bronchoscopy
- Language
- ISSN
- 1944-6586
Background There is a paucity of real-time imaging modalities available for the bronchoscopic biopsy of peripheral lung nodules. We aim to demonstrate the feasibility of the O-arm imaging system to guide real-time biopsies of peripheral lung nodules during electromagnetic navigation bronchoscopy. Methods A retrospective review was performed at 2 academic medical centers utilizing O-arm guidance. Results The average nodule size was 2.1×2.0 cm and were mostly solid (66%) with a positive bronchus sign (83%). O-arm imaging confirmed tool-in-lesion in all cases. The diagnostic yield was 33%. Four cases were nondiagnostic of the 6 cases performed. In these cases, necrotic tissue was the most common (75%) and showed resolution following subsequent imaging. The average 3-dimensional (3D) spin time was 23.5 seconds. The average number of 3D spins performed per case was 4.33. The average effective dose per 3D spin was 3.73 mSv. Conclusion We have demonstrated the O-arm's feasibility with electromagnetic navigation bronchoscopy for peripheral lung nodules. The O-arm was able to confirm tool-in-lesion in all cases which added confidence to the biopsy. Four high-resolution 3D spins per case may limit the total computed tomography effective dose. We also noted that both metal and radiation scatter were minimal when appropriate radiation safety standards were met. Although additional experience and data will be required to verify the O-arm approach for routine use, our initial experience is promising.