{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:41:36Z","timestamp":1786678896590,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Lung cancer is the most lethal cancer type in Taiwan and worldwide. Early detection and treatment advancements have improved survival. However, small peripheral pulmonary nodules (PPN) biopsy is often challenging, relying solely on bronchoscopy with radial endobronchial ultrasound (EBUS). Augmented fluoroscopy overlays the intra-procedural cone-beam computed tomography (CBCT) images with fluoroscopy enabling real-time three-dimensional localization during bronchoscopic transbronchial biopsy. The hybrid operating room (HOR), equipped with various types of C-arm CBCT, is a perfect suite for PPN diagnosis and other interventional pulmonology. This study shares the single institute experience of EBUS transbronchial biopsy of PPN with the aid of augmented fluoroscopic bronchoscopy (AFB) and CBCT in an HOR. We retrospectively enrolled patients who underwent robotic CBCT, augmented fluoroscopy-guided, radial endobronchial ultrasound-confirmed transbronchial biopsy and cryobiopsy in a hybrid operating room. Patient demographic characteristics, computed tomography images, rapid on-site evaluation cytology, and final pathology reports were collected. Forty-one patients underwent transbronchial biopsy and 6 received additional percutaneous transthoracic core-needle biopsy during the same procedure. The overall diagnostic yield was 88%. The complications included three patients with pneumothorax after receiving subsequent CT-guided percutaneous transthoracic needle biopsy, and two patients with hemothorax who underwent transbronchial cryobiopsy. Overall, the bronchoscopic biopsy of PPN using AFB and CBCT as precise guidance in the hybrid operating room is feasible and can be performed safely with a high diagnostic yield.<\/jats:p>","DOI":"10.3390\/diagnostics13061055","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T01:31:41Z","timestamp":1678411901000},"page":"1055","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cone-Beam Computed-Tomography-Derived Augmented Fluoroscopy-Guided Biopsy for Peripheral Pulmonary Nodules in a Hybrid Operating Room: A Case Series"],"prefix":"10.3390","volume":"13","author":[{"given":"Lun-Che","family":"Chen","sequence":"first","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6129-627X","authenticated-orcid":false,"given":"Shun-Mao","family":"Yang","sequence":"additional","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shwetambara","family":"Malwade","sequence":"additional","affiliation":[{"name":"Department of Advanced Therapies, Siemens Healthcare Limited, Taipei City 11503, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Chun","family":"Chang","sequence":"additional","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Kai","family":"Chang","sequence":"additional","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Yuan","family":"Chung","sequence":"additional","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen-Chung","family":"Ko","sequence":"additional","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-9392","authenticated-orcid":false,"given":"Chong-Jen","family":"Yu","sequence":"additional","affiliation":[{"name":"Interventional Pulmonology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu County 302, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu County 302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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