Mobile 3D Intraprocedural Fluoroscopy in Combination With Ultrathin Bronchoscopy for Biopsy of Peripheral Lung Nodules

Ali Sadoughi, Sahil Virdi, Ali Sadoughi, Sahil Virdi

Abstract

Despite development of multiple technologies, distinguishing benign from malignant lung nodules when they are still small in size is challenging. A high yield and minimally invasive bronchoscopic technology with low cost for diagnosis of small lung lesions is needed in pulmonary and lung cancer clinical practice. Peripheral airway bronchoscopy using thin and most recently ultrathin bronchoscopes improve visualization of small airways. The novel mobile 2D/3D C-Arm fluoroscopy system is a complementary tool along with radial endobronchial ultrasound in detecting small lung nodules with real-time high-quality multidimensional image confirmation during bronchoscopy. This combined technology can be easily acquired in any bronchoscopy room, and potentially affect lung nodule practice significantly.

Conflict of interest statement

Disclosure: A.S. has been a consultant to Olympus Corporation of Americas. S.V. has no conflict of interest or other disclosures.

Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.

Figures

FIGURE 1
FIGURE 1
Bronchoscopy with the ultrathin scope, radial endobronchial ultrasound (r-EBUS) and 2D/3D fluoroscopy of a 12 mm right upper lobe (RUL) lung nodule. A, Coronal plane view showing r-EBUS probe inside the nodule and cross section of bronchoscope in trachea. B, Axial plane view showing r-EBUS probe inside the nodule and cross section of bronchoscope in trachea. C, Sagittal plane view showing r-EBUS probe inside the nodule and the distal end of bronchoscope touching the nodule. D, 3D configuration with bone enhancing view showing the entire bronchoscope in lung. E, A representative axial plane cut of the CT scan showing the RUL anterior segment nodule (white arrow). F, Concentric r-EBUS view of the lung nodule.
FIGURE 2
FIGURE 2
Bronchoscopy with the ultrathin scope, radial endobronchial ultrasound (r-EBUS) and 2D/3D fluoroscopy of a 14 mm right upper lobe (RUL) lung nodule. A, Coronal plane view showing r-EBUS probe inside the nodule and the distal end of bronchoscope touching the nodule. B, Axial plane view showing r-EBUS probe inside the nodule and cross section of bronchoscope in trachea. C, Sagittal plane view showing r-EBUS probe inside the nodule and the distal end of bronchoscope touching the nodule. D, 3D configuration with bone enhancing view showing the entire bronchoscope in lung. E, A representative axial plane cut of the CT scan showing the RUL apical segment nodule (white arrow). F, R-EBUS view of the lung nodule.
FIGURE 3
FIGURE 3
Cios Spin mobile hybrid 2D/3D C-arm.

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Source: PubMed

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