title: Radiation Exposure of Patients by Cone Beam CT during Endobronchial Navigation - A Phantom Study.
abstract: BACKGROUND
  Cone Beam Computed Tomography imaging has become increasingly important in many fields of interventional therapies.
  
  
  OBJECTIVE
  Lung navigation study which is an uncommon soft tissue approach.
  
  
  METHODS
  As no effective organ radiation dose levels were available for this kind of Cone Beam Computed Tomography application we simulated in our DynaCT (Siemens AG, Forchheim, Germany) suite 2 measurements including 3D acquisition and again for 3D acquisition and 4 endobronchial navigation maneuvers under fluoroscopy towards a nodule after the 8(th) segmentation in the right upper lobe over a total period of 20 minutes (min). These figures reflect the average complexity and time in our experience. We hereby describe the first time the exact protocol of lung navigation by a Cone Beam Computed Tomography approach.
  
  
  METHODS
  The hereby first time measured body radiation doses in that approach showed very promising numbers between 0,98-1,15mSv giving specific lung radiation doses of 0,42-0,38 mSv.
  
  
  RESULTS
  These figures are comparable or even better to other lung navigation systems. Cone Beam Computed Tomography offers some unique features for lung interventionists as a realtime 1-step navigation system in an open structure feasible for endobronchial and transcutaneous approach.
  
  
  CONCLUSIONS
  Due to this low level of radiation exposure Cone Beam Computed Tomography is expected to attract interventionists interested in using and guiding endobronchial or transcutaneous ablative procedures to peripheral endobronchial and other lung lesions.
authors.affiliation: 1. II Medical Clinic, Coburg Hospital, University of Wuerzburg, Coburg, Germany;
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hohenforst-Schmidt
authors.affiliation: 2. Siemens AG Healthcare Sector, Forchheim, Germany;
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Banckwitz
authors.affiliation: 3. Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; ; 4. Department of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany;
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 5. Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany;
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogl
authors.affiliation: 4. Department of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany;
authors.forename: Kaid
authors.initials: K
authors.lastname: Darwiche
authors.affiliation: 6. Biomaterials Science and Engineering, Department of Materials Science and Engineering, University of Florida, FL, USA;
authors.forename: Eugene
authors.initials: E
authors.lastname: Goldberg
authors.affiliation: 7. Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai, People's Republic of China; ; 8. Bronchoscopy and Interventional Pulmonology, Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, School of Medicine, MI, USA;
authors.forename: Haidong
authors.initials: H
authors.lastname: Huang
authors.affiliation: 8. Bronchoscopy and Interventional Pulmonology, Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, School of Medicine, MI, USA;
authors.forename: Michael
authors.initials: M
authors.lastname: Simoff
authors.affiliation: 7. Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai, People's Republic of China;
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: 9. Pulmonary and Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, MD, USA;
authors.forename: Robert
authors.initials: R
authors.lastname: Browning
authors.affiliation: 4. Department of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany;
authors.forename: Lutz
authors.initials: L
authors.lastname: Freitag
authors.affiliation: 10. Pulmonary Medicine, University of Nevada School of Medicine, National Supercomputing Center for Energy and the Environment University of Nevada, Las Vegas, NV, USA;
authors.forename: J Francis
authors.initials: JF
authors.lastname: Turner
authors.affiliation: 11. Interventional Drug Delivery Systems and Strategies (ID2S2), Medical Cryogenics, Jupiter, FL, USA;
authors.forename: Patrick Le
authors.initials: PL
authors.lastname: Pivert
authors.affiliation: 12. Division of Pulmonary and Critical Care Medicine, Sheikh Zayed Cardiovascular & Critical Care Tower, Johns Hopkins University, Baltimore, U.S.A.
authors.forename: Lonny
authors.initials: L
authors.lastname: Yarmus
authors.affiliation: 3. Pulmonary Department-Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.affiliation: 1. II Medical Clinic, Coburg Hospital, University of Wuerzburg, Coburg, Germany;
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
keywords: Dyna CT; diagnosis.; lung cancer