Portable Cone-Beam Computed Tomography System for Intraoperative Localization of Pulmonary Nodules: An Initial...

Area of Science:

• Medical Imaging
• Thoracic Surgery
• Pulmonology

Background:

• Advancements in medical imaging enhance diagnostic and therapeutic capabilities for pulmonary nodules.
• Cone-beam computed tomography (CBCT) presents a potential alternative to hybrid operating rooms for identifying impalpable nodules.

Purpose of the Study:

• To report the initial clinical application of a portable CBCT system for intraoperative localization of small pulmonary nodules.
• To evaluate the feasibility and effectiveness of portable CBCT in a surgical setting.

Main Methods:

• Four patients with peripheral pulmonary nodules underwent localization using a portable CBCT system (Cios Spin, Siemens).
• Procedures involved general anesthesia, preoperative imaging, and intraoperative scanning with the portable CBCT system.
• Surgical clips were placed on the visceral pleura based on preoperative CT predictions.

Main Results:

• All pulmonary nodules, including ground-glass, part-solid, and small nodules, were clearly visualized with CBCT.
• Image quality was comparable to preoperative CT scans.
• The portable system demonstrated flexibility in accommodating patient positioning, with acceptable radiation exposure and no complications.

Conclusions:

• Portable CBCT enables accurate, flexible, and real-time intraoperative localization of pulmonary nodules.
• This technology can be utilized without the need for a hybrid operating room.
• This represents the first report demonstrating the clinical utility of portable CBCT for this application.