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.