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A Comparative Study of Radiation Exposure in Conventional and Robotic Bronchoscopy
Nakul Ravikumar1, Elliot Ho2, Gaurav Ajmani3
1Division of Pulmonary and Critical Care, University of Massachusetts Chan Medical School-Baystate, Springfield, MA.
Chest
|July 2, 2026
Summary
Robotic bronchoscopy (RAB) with conventional fluoroscopy did not reduce operator radiation exposure. However, RAB using C-arm-based tomosynthesis significantly increased radiation dose, highlighting the need to align usage with regulatory guidelines.
Area of Science:
- Medical Imaging and Interventional Pulmonology
- Radiation Safety in Medical Procedures
Background:
- Radiation exposure during bronchoscopy is a concern for operators and staff.
- The impact of robotic bronchoscopy (RAB) on radiation dose compared to conventional methods is not well-established.
Purpose of the Study:
- To compare radiation doses received by bronchoscopists and staff during conventional bronchoscopy versus RAB.
- To evaluate the influence of different fluoroscopic imaging modalities within RAB on radiation exposure.
Main Methods:
- A prospective study analyzed radiation exposure during 54 fluoroscopy-guided bronchoscopies (15 conventional, 39 RAB).
- RAB procedures included standard C-arm fluoroscopy (CF) and C-arm-based tomosynthesis (CABT).
- Radiation dose was measured according to International Commission on Radiological Protection (ICRP) and National Council on Radiation Protection and Measurements (NCRP) guidelines.
Main Results:
- RAB with CABT showed the highest median radiation exposure per case (0.237 mSv) compared to conventional (0.065 mSv) and RAB with CF (0.02 mSv).
- No significant difference in radiation exposure per case was found between conventional bronchoscopy and RAB with CF.
- RAB with CABT significantly increased operator skin exposure under the thyroid collar; staff exposure was minimal across all procedures.
Conclusions:
- Robotic bronchoscopy using conventional fluoroscopy does not reduce operator radiation exposure compared to traditional methods.
- The addition of C-arm-based tomosynthesis to RAB significantly increases radiation dose.
- Annual usage of RAB with advanced imaging modalities should adhere to regulatory recommendations for radiation safety.
