{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T18:47:13Z","timestamp":1769280433669,"version":"3.49.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Advances in imaging have expanded options for diagnosis and therapy, including wedge resection of small pulmonary nodules. Cone-beam computed tomography (CBCT) can substitute for hybrid operating rooms (ORs) to identify impalpable nodules. We report the initial clinical use of a portable CBCT system (Cios Spin, Siemens, Germany) for intraoperative localization of small pulmonary nodules.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Four patients (3 men, 1 woman; mean age, 68.3 years) with peripheral nodules were included. Under general anaesthesia, an initial pre-scan confirmed that the lesion was within the field of view. Thoracoscopic surgery was initiated, and a surgical clip was placed on the visceral pleura at the site predicted from preoperative computed tomography (CT) to be closest to the tumour. During surgery, the C-arm was removed and later repositioned for intraoperative scanning.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n All nodules, 1.4-cm ground-glass, 2.0-cm part-solid, and two 0.7-cm, were clearly visualized, with image quality comparable to preoperative CT. The portable system accommodated table flexion and lateral decubitus positioning. No complications occurred, and radiation exposure, measured in one case, was acceptable.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n To our knowledge, this is the first report to demonstrate that portable CBCT enables accurate, flexible, and real-time intraoperative localization of pulmonary nodules without requiring a hybrid OR.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf314","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T12:35:12Z","timestamp":1767098112000},"source":"Crossref","is-referenced-by-count":0,"title":["Portable Cone-Beam Computed Tomography System for Intraoperative Localization of Pulmonary Nodules: An Initial Experience"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1782-891X","authenticated-orcid":false,"given":"Masahiro","family":"Mitsuoka","sequence":"first","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagiko","family":"Mitsuoka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Ueta","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Hashiguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2520-9230","authenticated-orcid":false,"given":"Masaki","family":"Kashihara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3961-2723","authenticated-orcid":false,"given":"Yasuhiro","family":"Terazaki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kurume University School of Medicine , Fukuoka, 830-0011,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"2026012304320861100_ivaf314-B1","doi-asserted-by":"crossref","first-page":"ivac236","DOI":"10.1093\/icvts\/ivac236","article-title":"Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules","volume":"35","author":"Kaiho","year":"2022","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2026012304320861100_ivaf314-B2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.2739\/kurumemedj.MS6834006","article-title":"Cone-beam computed tomography-guided marking of small pulmonary nodules with surgical clips","volume":"68","author":"Mitsuoka","year":"2023","journal-title":"Kurume Med J"},{"key":"2026012304320861100_ivaf314-B3","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.21037\/jtd-22-190","article-title":"A pilot study of intraoperative localization of peripheral small pulmonary tumors by cone beam computed tomography: sandwich marking technique","volume":"14","author":"Saito","year":"2022","journal-title":"J Thorac Dis"},{"key":"2026012304320861100_ivaf314-B4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.21037\/acr-22-5","article-title":"Combined portable cone beam computed tomography and robotic-assisted bronchoscopy impacting diagnosis of a solitary pulmonary nodule: a case report","volume":"6","author":"Duke","year":"2022","journal-title":"AME Case Rep"},{"key":"2026012304320861100_ivaf314-B5","doi-asserted-by":"crossref","first-page":"7933","DOI":"10.21037\/jtd-24-951","article-title":"Intraoperative transbronchial metallic coil marking guided by mobile 3D C-arm for resection of a small peripheral lung lesion","volume":"16","author":"Takizawa","year":"2024","journal-title":"J Thorac Dis"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivaf314\/66159683\/ivaf314.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/1\/ivaf314\/66159683\/ivaf314.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/1\/ivaf314\/66159683\/ivaf314.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:32:20Z","timestamp":1769160740000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivaf314\/8407302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,30]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaf314","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,12,30]]},"article-number":"ivaf314"}}