The incremental contribution of mobile cone-beam computed tomography to the tool–lesion relationship during shape-sensing robotic-assisted bronchoscopy Journal Article


Authors: Husta, B. C.; Menon, A.; Bergemann, R.; Lin, I. H.; Schmitz, J.; Rakočević, R.; Nadig, T. R.; Adusumilli, P. S.; Beattie, J. A.; Lee, R. P.; Park, B. J.; Rocco, G.; Bott, M. J.; Chawla, M.; Kalchiem-Dekel, O.
Article Title: The incremental contribution of mobile cone-beam computed tomography to the tool–lesion relationship during shape-sensing robotic-assisted bronchoscopy
Abstract: Introduction This study aims to answer the question of whether adding mobile cone-beam computed tomography (mCBCT) imaging to shape-sensing robotic-assisted bronchoscopy (ssRAB) translates into a quantifiable improvement in the tool–lesion relationship. Methods Data from 102 peripheral lung lesions with ⩾2 sequential mCBCT orbital spins and from 436 lesions with 0–1 spins were prospectively captured and retrospectively analysed. The primary outcome was the tool–lesion relationship status across the first and the last mCBCT spins. Secondary outcomes included 1) the change in distance between the tip of the sampling tool and the centre of the lesion between the first and the last spins and 2) the per-lesion diagnostic yield. Results Compared to lesions requiring 0–1 spins, lesions requiring ⩾2 spins were smaller and had unfavourable bronchus sign and intra-operative sonographic view. On the first spin, 54 lesions (53%) were designated as non-tool-in-lesion (non-TIL) while 48 lesions (47%) were designated as TIL. Of the 54 initially non-TIL cases, 49 (90%) were converted to TIL status by the last spin. Overall, on the last spin, 96 out of 102 lesions (94%) were defined as TIL and six out of 102 lesions (6%) were defined as non-TIL (p<0.0001). The mean distance between the tool and the centre of the lesion decreased from 10.4 to 6.6 mm between the first and last spins (p<0.0001). The overall diagnostic yield was 77%. Conclusion Targeting traditionally challenging lung lesions, intra-operative volumetric imaging allowed for the conversion of 90% of non-TIL status to TIL. Guidance with mCBCT resulted in a significant decrease in the distance between the tip of the needle to lesion centre. © The authors 2024.
Keywords: aged; major clinical study; hypertension; follow up; heart failure; bronchoscopy; coronary artery disease; chronic kidney failure; cone beam computed tomography; artificial ventilation; fluoroscopy; finite element analysis; three-dimensional imaging; human; male; female; article; elemental analysis; obstructive lung disease
Journal Title: ERJ Open Research
Volume: 10
Issue: 4
ISSN: 2312-0541
Publisher: European Respiratory Society  
Date Published: 2024-07-01
Start Page: 00993
End Page: 2023
Language: English
DOI: 10.1183/23120541.00993-2023
PROVIDER: scopus
PMCID: PMC11261373
PUBMED: 39040587
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Bryan C. Husta -- Source: Scopus
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MSK Authors
  1. Mohit Chawla
    48 Chawla
  2. Bernard J Park
    265 Park
  3. Robert Piljae Lee
    31 Lee
  4. Matthew Bott
    136 Bott
  5. Gaetano Rocco
    132 Rocco
  6. Bryan C. Husta
    17 Husta
  7. I-Hsin Lin
    16 Lin
  8. Jason Anthony Beattie
    22 Beattie
  9. Anu Menon
    6 Menon
  10. Tejaswi Ramananda Nadig
    4 Nadig