{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:53:49Z","timestamp":1791726829694,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"Abstract<\/jats:title>\n \n Background and Objective<\/jats:title>\n Robotic\u2010assisted bronchoscopy (RAB) is an emerging modality to sample pulmonary lesions. Cone\u2010beam computed tomography (CBCT) can be incorporated into RAB. We investigated the magnitude and predictors of patient and staff radiation exposure during mobile CBCT\u2010guided shape\u2010sensing RAB.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patient radiation dose was estimated by cumulative dose area product (cDAP) and cumulative reference air kerma (cRAK). Staff equivalent dose was calculated based on isokerma maps and a phantom simulation. Patient, lesion and procedure\u2010related factors associated with higher radiation doses were identified by logistic regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 198 RAB cases were included in the analysis. The median patient cDAP and cRAK were 10.86\u2009Gy\u2009cm\n 2<\/jats:sup>\n (IQR: 4.62\u201320.84) and 76.20\u2009mGy (IQR: 38.96\u2013148.38), respectively. Among staff members, the bronchoscopist was exposed to the highest median equivalent dose of 1.48\u2009\u03bcSv (IQR: 0.85\u20132.69). Both patient and staff radiation doses increased with the number of CBCT spins and targeted lesions (\n p<\/jats:italic>\n \u2009<\u20090.001 for all comparisons). Patient obesity, negative bronchus sign, lesion size <2.0\u2009cm and inadequate sampling by on\u2010site evaluation were associated with a higher patient dose, while patient obesity and inadequate sampling by on\u2010site evaluation were associated with a higher bronchoscopist equivalent dose.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The magnitude of patient and staff radiation exposure during CBCT\u2010RAB is aligned with safety thresholds recommended by regulatory authorities. Factors associated with a higher radiation exposure during CBCT\u2010RAB can be identified pre\u2010operatively and solicit procedural optimization by reinforcing radiation protective measures. Future studies are needed to confirm these findings across multiple institutions and practices.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/resp.14765","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T21:58:06Z","timestamp":1716933486000},"page":"803-814","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Determinants of radiation exposure during mobile cone\u2010beam\n CT<\/scp>\n \u2010guided robotic\u2010assisted bronchoscopy"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9856-627X","authenticated-orcid":false,"given":"Or","family":"Kalchiem\u2010Dekel","sequence":"first","affiliation":[{"name":"Section of Interventional Pulmonology, Pulmonary Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York New York 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