{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:41:28Z","timestamp":1792842088841,"version":"4.5.0"},"reference-count":24,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T00:00:00Z","timestamp":1600473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Thin-section computed tomography (CT) is essential for identifying small bronchi during bronchoscopy using radial endobronchial ultrasound. Some patients should receive an additional CT for a thin-section image. We performed a retrospective study with a prospectively collected database to identify the optimal radiation dose for thin-section CT during peripheral bronchoscopy. Materials and Methods: In total, 91 patients with peripheral lung lesions underwent thin-section CT (both standard CT as a reference and ultra-low-dose CT (ultra-LDCT)). The patients were randomly assigned to one of four groups according to the ultra-LDCT parameters: group 1 = 120 kVp, 25 mAs; group 2 = 100 kVp, 15 mAs; group 3 = 120 kVp, 5 mAs; and group 4 = 100 kVp, 5 mAs. Two radiologists and two physicians analyzed both the standard CT and ultra-LDCT. Results: The effective doses (EDs) of ultra-LDCT significantly differed among the four groups (median EDs were 0.88, 0.34, 0.19, and 0.12 mSv for groups 1\u20134, respectively; p &lt; 0.001). Median differences in peripheral airway wall thickness were higher in group 4 than in other groups (differences in median wall thickness measured by two radiologists were 0.4\u20130.5 mm and 0.8\u20130.9 mm for groups 1\u20133 and group 4, respectively). Bronchus signs on ultra-LDCT in groups 1 and 2 were well correlated with those of the standard-dose CT (accuracies of two radiologists and two pulmonary physicians were 95\u2013100%). Conclusions: Our results indicate that ultra-LDCT with ED of &gt;0.34 mSv (ED of group 2) is feasible for peripheral bronchoscopy.<\/jats:p>","DOI":"10.3390\/medicina56090479","type":"journal-article","created":{"date-parts":[[2020,9,20]],"date-time":"2020-09-20T21:20:28Z","timestamp":1600636828000},"page":"479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility of Ultra-Low-Dose CT for Bronchoscopy of Peripheral Lung Lesions"],"prefix":"10.3390","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0832-1314","authenticated-orcid":false,"given":"Jung Seop","family":"Eom","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine, Busan 43241, Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 43241, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geewon","family":"Lee","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 43241, Korea"},{"name":"Department of Radiology, Pusan National University School of Medicine, Busan 43241, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyeon","family":"Roh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine, Busan 43241, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Sung","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine, Busan 43241, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Joo","family":"Jeong","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 43241, Korea"},{"name":"Department of Radiology, Pusan National University School of Medicine, Busan 43241, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"National Lung Screening Trial Research Team, Church, T.R., Black, W.C., Aberle, D.R., Berg, C.D., Clingan, K.L., Duan, F., Fagerstrom, R.M., Gareen, I.F., and Gierada, D.S. (2013). Results of initial low-dose computed tomographic screening for lung cancer. N. Engl. J. Med., 368, 1980\u20131991.","DOI":"10.1056\/NEJMoa1209120"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.2214\/ajr.178.5.1781053","article-title":"CT screening for lung cancer: Frequency and significance of part-solid and nonsolid nodules","volume":"178","author":"Henschke","year":"2002","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7S","DOI":"10.1378\/chest.12-2377","article-title":"Executive Summary: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"143","author":"Detterbeck","year":"2013","journal-title":"Chest"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/JTO.0b013e318233d7dd","article-title":"Percutaneous computed tomography-guided coaxial core biopsy for small pulmonary lesions with ground-glass attenuation","volume":"7","author":"Lu","year":"2012","journal-title":"J. Thorac. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e93S","DOI":"10.1378\/chest.12-2351","article-title":"Evaluation of individuals with pulmonary nodules: When is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"143","author":"Gould","year":"2013","journal-title":"Chest"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1378\/chest.126.3.959","article-title":"Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically","volume":"126","author":"Kurimoto","year":"2004","journal-title":"Chest"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Eom, J.S., Mok, J.H., Kim, I., Lee, M.K., Lee, G., Park, H., Lee, J.W., Jeong, Y.J., Kim, W.Y., and Jo, E.J. (2018). Radial probe endobronchial ultrasound using a guide sheath for peripheral lung lesions in beginners. BMC Pulm. Med., 18.","DOI":"10.1186\/s12890-018-0704-7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1164\/rccm.201502-0205OC","article-title":"Ultrathin bronchoscopy with multimodal devices for peripheral pulmonary lesions. A randomized trial","volume":"192","author":"Oki","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1136\/thx.2010.145490","article-title":"Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: A randomised trial","volume":"66","author":"Ishida","year":"2011","journal-title":"Thorax"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1164\/rccm.200612-1866OC","article-title":"Multimodality bronchoscopic diagnosis of peripheral lung lesions: A randomized controlled trial","volume":"176","author":"Eberhardt","year":"2007","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1118\/1.598948","article-title":"Calculation of effective dose","volume":"27","author":"McCollough","year":"2000","journal-title":"Med. Phys."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1148\/radiol.2292021114","article-title":"Thin-section CT of the lung: Does electrocardiographic triggering influence diagnosis?","volume":"229","author":"Boehm","year":"2003","journal-title":"Radiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1007\/s11604-019-00818-2","article-title":"Airway quantification using adaptive statistical iterative reconstruction-V on wide-detector low-dose CT: A validation study on lung specimen","volume":"37","author":"Zhang","year":"2019","journal-title":"Jpn. J. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.2214\/ajr.157.6.1950861","article-title":"Bronchus sign on CT in peripheral carcinoma of the lung: Value in predicting results of transbronchial biopsy","volume":"157","author":"Gaeta","year":"1991","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1378\/chest.93.3.595","article-title":"Solitary pulmonary nodules. CT-bronchoscopic correlation","volume":"93","author":"Naidich","year":"1988","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"National Lung Screening Trial Research Team, Aberle, D.R., Adams, A.M., Berg, C.D., Black, W.C., Clapp, J.D., Fagerstrom, R.M., Gareen, I.F., Gatsonis, C., and Marcus, P.M. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. N. Engl. J. Med., 365, 395\u2013409.","DOI":"10.1056\/NEJMoa1102873"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"485","DOI":"10.7326\/M14-2086","article-title":"Performance of Lung-RADS in the National Lung Screening Trial: A retrospective assessment","volume":"162","author":"Pinsky","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1186\/s12931-019-1149-0","article-title":"Clinical outcomes of radial probe endobronchial ultrasound using a guide sheath for diagnosis of peripheral lung lesions in patients with pulmonary emphysema","volume":"20","author":"Lee","year":"2019","journal-title":"Respir. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.chest.2018.04.029","article-title":"The evolutional history of electromagnetic navigation bronchoscopy: State of the art","volume":"154","author":"Mehta","year":"2018","journal-title":"Chest"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Chaddha, U., Kovacs, S.P., Manley, C., Hogarth, D.K., Cumbo-Nacheli, G., Bhavani, S.V., Kumar, R., Shende, M., Egan, J.P., and Murgu, S. (2019). Robot-assisted bronchoscopy for pulmonary lesion diagnosis: Results from the initial multicenter experience. BMC Pulm. Med., 19.","DOI":"10.1186\/s12890-019-1010-8"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1159\/000503329","article-title":"Navigation Bronchoscopy","volume":"99","author":"Kemp","year":"2020","journal-title":"Respiration"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1378\/chest.130.2.559","article-title":"A virtual bronchoscopic navigation system for pulmonary peripheral lesions","volume":"130","author":"Asano","year":"2006","journal-title":"Chest"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1183\/09031936.00075310","article-title":"Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: Systematic review and meta-analysis","volume":"37","author":"Steinfort","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1378\/chest.11-1764","article-title":"Meta-analysis of guided bronchoscopy for the evaluation of the pulmonary nodule","volume":"142","author":"Nietert","year":"2012","journal-title":"Chest"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/9\/479\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:11:42Z","timestamp":1760177502000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/9\/479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,19]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["medicina56090479"],"URL":"https:\/\/doi.org\/10.3390\/medicina56090479","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-17926\/v1","asserted-by":"object"}]},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,19]]}}}