Improving Shape-Sensing Robotic-Assisted Bronchoscopy Outcomes with Mobile Cone-Beam Computed Tomography Guidance
Abstract
:1. Introduction
2. Methods
2.1. Study Setting and Subjects
2.2. Study Design and Procedures
2.3. Primary, Secondary Endpoints, and Definitions
2.4. Statistics
2.5. Study Registration
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | N = 67 |
---|---|
Gender (%) | |
- Female | 37 (55) |
- Male | 30 (45) |
Smoking History, | |
- Never | 22 (33) |
- Ex-smoker | 34 (51) |
- Current | 11 (16) |
Prior Malignancy (n = 37) | |
- Lung cancer | 7 (19) |
- Others | 30 (81) |
BMI | |
Median (range) | 27.9 (16.9–44.2) |
ECOG | |
Median (range) | 1 (0–2) |
ASA Score | |
Median (range) | 3 (1–3) |
Target Size (cm) | |
Median (range) | 1.7 (0.9–3) |
Target Characteristics | |
- Solid | 62 (93) |
- Semi-solid | 5 (7) |
Target Location | |
- Right Upper Lobe | 22 (33) |
- Right Middle Lobe | 6 (9) |
- Right Lower Lobe | 13 (19) |
- Left Upper Lobe | 19 (29) |
- Left Lower Lobe | 7 (10) |
Bronchus Sign | 25 (37) |
Distance to Pleura (cm) | |
Median (range) | 0.73 (0–4.7) |
PET Avidity (n = 34) | 29 (85) |
Procedure Characteristics | N = 67 |
---|---|
Total Procedure Time (min) | |
Mean (range) | 51 (21–127) |
Mediastinal Staging | 47 (70) |
Virtual Target Reached | 65 (97) |
Target Visualized by 2D Fluoroscopy | 19 (28) |
Sampling Tools (%) | |
- Needle | 67 (100) |
- Cytology brush | 25 (37) |
- Forceps or Cryobiopsy | 24 (36) |
First mCBCT Spin Findings | |
- No TIL | 44 (66) |
- TIL/center of lesion | 18 (27) |
- TIL/periphery of lesion | 5 (7) |
% of Patients with TIL at Each mCBCT Spin | |
- 1st spin | 34.3 |
- 2nd spin | 58.3 |
- 3rd spin | 70.4 |
- 4th spin | 81.8 |
- 5th spin | 98.6 |
Distance from Needle to Target (cm) (n = 44) * | |
Median (interquartile range) | 0.2 (0.47) |
Fluoroscopy Time (min) | |
Median (interquartile range) | 8.5 (4.85) |
Number of CBCT Spins | |
Median (interquartile range) | 3 (1.5) |
Diagnosis Obtained via Bronchoscopy | Diagnosis Obtained “Post” Bronchoscopy * | ||
---|---|---|---|
Malignant (n = 52) -Lung Adenocarcinoma -Lung Squamous Cell Carcinoma -Non-Small Cell Lung Cancer -Small Cell Lung Cancer -Carcinoid -Head and Neck Squamous Cell Carcinoma -Melanoma -Renal Cell Carcinoma | 29 9 3 3 4 2 1 1 | Malignant (n = 7) -Lung Squamous Cell carcinoma -Lung Adenocarcinoma -Colorectal carcinoma -Clear Cell Hemangioblastoma-Like Stromal Tumor of the Lung -Mantle cell lymphoma | 2 2 1 1 1 |
Benign (n = 6) -Cryptococcal infection -Mucoid impaction due to bronchial atresia -Haemophilus influenzae pneumonia -Organizing pneumonia -Granulomatous inflammation -Amyloidoma | 1 1 1 1 1 1 | Benign (n = 2) -Acute inflammation in CT-FNA -No further samples | 1 1 |
Non-Diagnostic Samples (n = 9) -Bronchial cells -Atypical cells -Acute inflammation -Atypical lymphocytes -Necrosis | 2 2 2 1 2 |
Total Fluoroscopy Time | Number of mCBCT Spins | Total Exposure (Entire Procedure) | Reference Air Kerma (Entire Procedure) | Total Exposure from mCBCT Spins | Reference Air Kerma for Spins | |
---|---|---|---|---|---|---|
min | Gy-cm2 | mGy | Gy-cm2 | mGy | ||
Median | 8.5 | 3 | 50.55 | 363.2 | 19.83 | 124.9 |
IQR | 4.85 | 1.5 | 34.50 | 249.1 | 17.08 | 107.55 |
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Bashour, S.I.; Khan, A.; Song, J.; Chintalapani, G.; Kleinszig, G.; Sabath, B.F.; Lin, J.; Grosu, H.B.; Jimenez, C.A.; Eapen, G.A.; et al. Improving Shape-Sensing Robotic-Assisted Bronchoscopy Outcomes with Mobile Cone-Beam Computed Tomography Guidance. Diagnostics 2024, 14, 1955. https://doi.org/10.3390/diagnostics14171955
Bashour SI, Khan A, Song J, Chintalapani G, Kleinszig G, Sabath BF, Lin J, Grosu HB, Jimenez CA, Eapen GA, et al. Improving Shape-Sensing Robotic-Assisted Bronchoscopy Outcomes with Mobile Cone-Beam Computed Tomography Guidance. Diagnostics. 2024; 14(17):1955. https://doi.org/10.3390/diagnostics14171955
Chicago/Turabian StyleBashour, Sami I., Asad Khan, Juhee Song, Gouthami Chintalapani, Gerhard Kleinszig, Bruce F. Sabath, Julie Lin, Horiana B. Grosu, Carlos A. Jimenez, Georgie A. Eapen, and et al. 2024. "Improving Shape-Sensing Robotic-Assisted Bronchoscopy Outcomes with Mobile Cone-Beam Computed Tomography Guidance" Diagnostics 14, no. 17: 1955. https://doi.org/10.3390/diagnostics14171955