Effective Radiation Dose from Cone-Beam Computed Tomography Guidance during Bronchoscopic Tumour Ablation

Respiration. 2024;103(8):498-502. doi: 10.1159/000539862. Epub 2024 Jun 17.

Abstract

Introduction: Endobronchial radiofrequency ablation (RFA) is a novel minimally invasive approach to management of peripheral non-small-cell lung cancer (NSCLC) in medically inoperable patients. Minimally invasive ablative techniques are generally delivered with cone-beam computed tomography (CBCT) guidance. CBCT requires a significant number of two dimensional imaging projections to be acquired which is then reconstructed as a three-dimensional cone-beam image. The objective of this study was to determine the radiation dosimetry consequent to use of CBCT guidance for bronchoscopic RFA.

Methods: Post hoc analysis of data following bronchoscopic RFA of stage I biopsy-confirmed NSCLC performed with CBCT. Effective dose estimates for these patients were calculated using PCXMC2.0 software.

Results: Ten patients underwent bronchoscopic RFA, with a median 3 (range 2-4) CBCT spins per procedure. Mean dose area product (DAP) per procedure was 7,778 μGy.m2 (±4,743) with an effective dose of 11.6 mSv (±7.4). The DAP per spin for these 10 patients varied from 83.8 to 8,625.6 μGy.m2 (effective dose range 0.15-13.81 mSv).

Conclusion: This is the first study to report radiation dosimetry consequent to CT guidance for bronchoscopic RFA procedures. Effective doses appear comparable to other CT fluoroscopic procedures.

Keywords: Bronchoscopy; Interventional pulmonology; Lung cancer; Radiation.

Publication types

  • News

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bronchoscopy* / methods
  • Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Carcinoma, Non-Small-Cell Lung* / radiotherapy
  • Carcinoma, Non-Small-Cell Lung* / surgery
  • Cone-Beam Computed Tomography* / methods
  • Female
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / radiotherapy
  • Lung Neoplasms* / surgery
  • Male
  • Middle Aged
  • Radiation Dosage*
  • Radiofrequency Ablation / methods
  • Retrospective Studies