Observational studyJournal of bronchology & interventional pulmonology2021
Cone-beam CT and Augmented Fluoroscopy-guided Navigation Bronchoscopy: Radiation Exposure and Diagnostic Accuracy Learning Curves.
Observational study in Journal of bronchology & interventional pulmonology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Artificial intelligence in bronchoscopy: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Shape-sensing robotic-assisted bronchoscopy (ss-RAB) for peripheral pulmonary nodules: learning curve and diagnostic performance from an initial multicenter experience in China.Respiratory research · 2026Trial
- High diagnostic yield of electromagnetic navigation bronchoscopy performed under cone beam CT guidance: results of a randomized Belgian monocentric study.BMC pulmonary medicine · 2023Trial
- RoboticERJ open research · 2026Article
- Double-Lumen Intubation Facilitating a Single-Anesthesia Workflow in Robot-Assisted Navigational Bronchoscopy and Subsequent Lung Resection: A Single-Center, Retrospective Study.Journal of clinical medicine · 2026Article
- Learning Shape-Sensing Robotic-Assisted Bronchoscopy after Mastering Advanced Image-Guided Navigation Bronchoscopy.Respiration; international review of thoracic diseases · 2026Article
- The Additional Accuracy Gained by Cone Beam CT in Shape-Sensing Robotic Bronchoscopy.CHEST pulmonary · 2025Article
- Cone beam computed tomography for navigational bronchoscopy.Journal of thoracic disease · 2025Review
- First 50 Cases with the ION Robotic-Assisted Navigational Bronchoscopy System in Routine Clinical Use in Germany: The Bonn Experience.Journal of clinical medicine · 2025Article
- Development of a headgear-based eye protection device for physicians performing fluoroscopy-guided bronchoscopy.Journal of radiation research · 2025Article
- Exploring barriers and facilitators for implementation of novel image-guided minimally invasive procedures: nationwide experiences on navigation bronchoscopy.BMJ open respiratory research · 2025Article
- Effectiveness of Radiation Shields to Minimize Operator Dose in the Bronchoscopy Suite: A Phantom Study and Clinical Application.Journal of clinical medicine · 2025Article
- Two-phase radial endobronchial ultrasound bronchoscopy registration.Journal of medical imaging (Bellingham, Wash.) · 2025Article
- Cone Beam Computed Tomography-Guided Navigation Bronchoscopy with Augmented Fluoroscopy for the Diagnosis of Peripheral Pulmonary Nodules: A Step-by-Step Guide.Respiration; international review of thoracic diseases · 2025Article
- Feasibility and Impact on Diagnosis of Peripheral Pulmonary Lesions under Real-Time Direct Vision by Iriscope®.Respiration; international review of thoracic diseases · 2025Article
- Article
- Cone-beam computed tomography-guided shape-sensing robotic bronchoscopyJournal of thoracic disease · 2024Article
- Determinants of radiation exposure during mobile cone-beam CT-guided robotic-assisted bronchoscopy.Respirology (Carlton, Vic.) · 2024Article
- State of the art: peripheral diagnostic bronchoscopy.Journal of thoracic disease · 2024Review
- The Diagnostic Yield of Cone Beam CT Combined With Radial-Endobronchial Ultrasound for the Diagnosis of Peripheral Pulmonary Nodules: Systematic Review and Meta-Analysis.CHEST pulmonary · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe endobronchial diagnosis of peripheral lung lesions suspected of lung cancer remains a challenge from a navigation as well as an adequate tissue sampling perspective. Cone-beam computed tomography (CBCT) guidance is a relatively new technology and allows for 3-dimensional imaging confirmation as well as navigation and biopsy guidance, but, also involves radiation. This study investigates how radiation exposure and diagnostic accuracy in the CBCT-guided navigation bronchoscopy evolves with increasing experience, and, with a specific tailoring of CBCT and fluoroscopic imaging protocols towards the procedure. PATIENTS AND
methodsIn this observational clinical trial, all 238 consecutive patients undergoing a CBCT-guided navigation bronchoscopy from the start of our CBCT-guided navigation bronchoscopy program (December 2017) until June 2020 were included. Procedural dose characteristics and diagnostic accuracy are reported as a function of time.
resultsProcedural radiation exposure as measured by the dose area product initially was 47.5 Gy·cm2 (effective dose: 14.3 mSv) and gradually reduced to 25.4 Gy·cm2 (5.8 mSv). The reduction in fluoroscopic dose area product was highest, from 19.0 Gy·cm2 (5.2 mSv) to 2.2 Gy·cm2 (0.37 mSv, 88% reduction), despite a significant increase of fluoroscopy time. The diagnostic accuracy of navigation bronchoscopy increased from 72% to 90%.
conclusionA significant learning effect can be seen in the radiation safety and diagnostic accuracy of a CBCT-guided and augmented fluoroscopy-guided navigation bronchoscopy. With increasing experience and tailoring of imaging protocols to the procedure, the procedural accuracy improved, while the effective dose for patients and staff was reduced.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.