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17 March 2011 Real-time scanning beam digital x-ray image guidance system for transbronchial needle biopsy
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We investigate a real-time digital tomosynthesis (DTS) imaging modality, based on the scanning beam digital x-ray (SBDX) hardware, used in conjunction with an electromagnetic navigation bronchoscopy (ENB) system to provide improved image guidance for minimally invasive transbronchial needle biopsy (TBNbx). Because the SBDX system source uses electron beams, steered by electromagnets, to generate x-rays, and the ENB system generates an electromagnetic field to localize and track steerable navigation catheters, the two systems will affect each other when operated in proximity. We first investigate the compatibility of the systems by measuring the ENB system localization error as a function of distance between the two systems. The SBDX system reconstructs DTS images, which provide depth information, and so we investigate the improvement in lung nodule visualization using SBDX system DTS images and compare them to fluoroscopic images currently used for biopsy verification. Target localization error remains below 2mm (or virtually error free) if the volume-of-interest (VOI) is at least 50cm away from the SBDX system source and detector. Inside this region, tomographic angle ranges from 3° to 10° depending on the VOI location. Improved lung nodule (≤ 20mm diameter) contrast is achieved by imaging the VOI near the SBDX system detector, where the tomographic angle is maximized. The combination of the SBDX image guidance with an ENB system would provide real-time visualization during biopsy with improved localization of the target and needle/biopsy instruments, thereby increasing the average and lowering the variance of the yield for TBNbx.
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Sungwon Yoon, Brian P. Wilfley, Keith Jasperson, Ganesh Krishna, and Rebecca Fahrig "Real-time scanning beam digital x-ray image guidance system for transbronchial needle biopsy", Proc. SPIE 7961, Medical Imaging 2011: Physics of Medical Imaging, 79611F (17 March 2011);

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