Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray.
Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT.
J Bronchology Interv Pulmonol. 2023 Apr 1;30(2):155-162. doi: 10.1097/LBR.0000000000000894.
Robotic assisted bronchoscopy (RAB) is designed to increase bronchoscopic accessibility for difficult to reach pulmonary lesions. One limitation to success of RAB is computed tomography (CT) to body divergence. Real time imaging with cone beam CT is increasingly utilized for confirmation of correct navigation and tool-in-lesion during RAB. O-arm CT is a 3-dimensional imaging modality, which has not previously been described for use with RAB. Our purpose is to display the feasibility, ease of use, and high rate of confirmation of tool-in-lesion when using O-arm CT during RAB.
Single center, retrospective review of 75 patients undergoing RAB with intraprocedural use of O-arm CT.
Median patient age was 65 years. Forty-nine percent of cases involved nodules ≤2 cm. Bronchus sign was absent in 44% of cases. Median procedure time was 80 minutes. Median number of O-arm CT runs per case was 2. The median effective dose of radiation was 7.2 millisieverts. Tool-in-lesion was confirmed in 97% (77 of 79) of cases. Definitive diagnosis was reached in 61 to 68 of 79 cases (77% to 86%). There were 2 cases of pneumothorax (2.5%), one of which needed intervention with tube thoracostomy.
O-arm CT is an effective, and convenient alternative to other 3-dimensional imaging modalities for intraprocedural confirmation of tool-in-lesion during RAB.
机器人辅助支气管镜检查（RAB）旨在增加难以到达的肺部病变的支气管镜检查可及性。RAB 成功的一个限制因素是计算机断层扫描（CT）与身体的发散。随着锥形束 CT 的实时成像，越来越多地用于确认 RAB 过程中正确的导航和工具进入病变。O 臂 CT 是一种三维成像方式，以前尚未描述过用于 RAB。我们的目的是展示在 RAB 过程中使用 O 臂 CT 时，工具进入病变的可行性、易用性和高确认率。
回顾性分析 75 例接受 RAB 并在术中使用 O 臂 CT 的患者。
中位患者年龄为 65 岁。49%的病例涉及直径≤2cm 的结节。44%的病例不存在支气管征。中位手术时间为 80 分钟。中位每例 O 臂 CT 运行次数为 2 次。中位有效辐射剂量为 7.2 毫西弗。97%（77/79）的病例确认了工具进入病变。79 例中有 61-68 例（77%-86%）达到了明确诊断。有 2 例气胸（2.5%），其中 1 例需要胸腔引流管干预。
O 臂 CT 是一种有效且方便的替代其他三维成像方式，可在 RAB 过程中实时确认工具进入病变。
