Mobile 3-dimensional (3D) C-arm system-assisted transbronchial biopsy under conscious sedation.

<bold>Background and Aims:</bold> It has been reported that a mobile 3D imaging system (Cios Spin, Siemens Healthineers, Germany), which requires 30 seconds for a scan, is useful for real-time accurate identification of the target lung lesion and confirmation of bronchoscopic tools within the lesion during bronchoscopy under general anesthesia; however, the usefulness of the system under conscious sedation have little known. <bold>Methods:</bold> We retrospectively reviewed consecutive patients undergoing transbronchial biopsy with mobile 3D imaging under conscious sedation. We evaluated the categorization of mobile 3D imaging and diagnostic yield. <bold>Result:</bold> A total of 4 patients were identified. 2 ground glass opacity (GGO) predominant nodules and 2 solid nodules. The median lesion diameter was 12mm [10-15mm]. Only one patient had a positive bronchial sign on CT. EBUS images included 1 within the lesion, 1 adjacent to the lesion, and 2 mixed blizzard signs. Mobile 3D imaging categorization included 3 positive (inside or next to the lesion) and 1 inconclusive (difficult to judge whether the tool had reached the lesion). Pathological findings were specific in all patients (2 adenocarcinoma, 1 suspicious of adenocarcinoma, and 1 adenomatous hyperplasia). There was one case of pneumonia as a major complication. <bold>Conclusion:</bold> The mobile 3D imaging system has the potential to provide useful real-time guidance for transbronchial biopsies of small nodules under conscious sedation.