Navigation & Imaging

Real-Time Peripheral Imaging Techniques

Covers workflow integration, radiation safety, lesion visualization strategies, and troubleshooting for real-time guidance systems.

Cone-beam CT • Augmented fluoroscopy • TomosynthesisReading time · 30mWord count · 4,061

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Exam mapping & scope

This chapter covers real‑time imaging used to localize and biopsy peripheral pulmonary lesions during bronchoscopy, focusing on digital tomosynthesis (DTS), cone‑beam CT (CBCT), and augmented fluoroscopy workflows. It maps to AABIP domains on diagnostic bronchoscopy for peripheral nodules, image‑guided navigation, radiation awareness, and intraprocedural troubleshooting.

Focus this round

Workflow integration
Radiation considerations
Target visualization

Interactive chapter

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Real-Time Peripheral Imaging Techniques

Exam mapping & scope

Focus this round

Exam Mapping & Scope

By the end, the learner should be able to:

High‑Yield One‑Pager (Pearls, Pitfalls, Traps)

Platforms in practice:

Common traps:

CT‑to‑Body Divergence

Indications & Contraindications

Planning CT:

Equipment & Setup

Scopes & Channels:

A. DTS‑assisted navigation (Illumisite‑style)

B. DTS‑based augmented fluoroscopy (LungVision‑style)

C. Robotic bronchoscopy with integrated DTS (Galaxy‑style)

D. CBCT‑guided navigation bronchoscopy (with augmented fluoroscopy when available)

Troubleshooting & Intra‑procedure Management

Post‑procedure Care & Follow‑up

Complications (prevention, recognition, management)

Special Populations

Evidence & Outcomes (selected signals from the literature)

Bulleted algorithm (parallel):

Algorithm 2 — Managing CT‑to‑Body Divergence and Atelectasis Intra‑procedure

Bulleted algorithm (parallel):

Table 2. Real‑Time Imaging Platforms for Peripheral Bronchoscopy (Selected Features)

Table 3. DTS vs CBCT: Practical Differences

Imaging & Figure Callouts (Placeholders)

Cases & Applied Learning

Question Bank (MCQs)

Controversies, Variability, and Evolving Evidence

Take‑Home Checklist

CBCT: Cone‑beam computed tomography (3D imaging from a rotational cone‑beam)

References (AMA Style; drawn from primary documents’ bibliographies)