Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists

Onyancha, Sammy; Merali, Naveed Mohamoud; Gajjar, Nishma Elesh; Munyu, Peter Waweru; Holland, Angelique; Rohde, Gernot

doi:10.3390/diagnostics16111616

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Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists

by

Sammy Onyancha

^1,*

,

Naveed Mohamoud Merali

²,

Nishma Elesh Gajjar

²,

Peter Waweru Munyu

²,

Angelique Holland

³ and

Gernot Rohde

³

¹

Department of Pulmonology, St. Elisabethen Krankenhaus, Ginnheimer Str. 3, 60487 Frankfurt, Germany

²

Department of Respiratory Medicine, Avenue Hospital, Nairobi P.O. Box 45280-00100, Kenya

³

Department of Respiratory Medicine, Universitätsklinikum Marburg, 35043 Marburg, Germany

^*

Author to whom correspondence should be addressed.

Diagnostics 2026, 16(11), 1616; https://doi.org/10.3390/diagnostics16111616

Submission received: 2 March 2026 / Revised: 15 May 2026 / Accepted: 18 May 2026 / Published: 25 May 2026

(This article belongs to the Special Issue Advances in Interventional Pulmonology)

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Abstract

Cone beam computed tomography (CBCT)-guided bronchoscopy has emerged as a powerful tool in the diagnosis of peripheral lung lesions, offering real-time, image-confirmed biopsy capabilities that enhance precision and diagnostic yield. However, implementation of a CBCT program presents significant logistical and technical challenges. This article presents an experience-based implementation tutorial outlining a stepwise approach to establishing a CBCT-guided bronchoscopy program. The framework is derived from iterative workflow development across more than 300 procedures at our institution, St. Elisabethen Hospital in Frankfurt, Germany, as well as our implementation efforts at Avenue Hospital Parklands in Nairobi, Kenya. Key domains addressed include infrastructure assessment, access strategy, training, procedural logistics, ventilation protocols, case selection, workflow optimization, safety considerations, and business case development. This roadmap aims to support interventional pulmonologists in integrating CBCT into clinical practice, while emphasising the need for local adaptation based on institutional resources and multidisciplinary collaboration.

Keywords: conebeam CT; CBCT; navigational bronchoscopy

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MDPI and ACS Style

Onyancha, S.; Merali, N.M.; Gajjar, N.E.; Munyu, P.W.; Holland, A.; Rohde, G. Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists. Diagnostics 2026, 16, 1616. https://doi.org/10.3390/diagnostics16111616

AMA Style

Onyancha S, Merali NM, Gajjar NE, Munyu PW, Holland A, Rohde G. Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists. Diagnostics. 2026; 16(11):1616. https://doi.org/10.3390/diagnostics16111616

Chicago/Turabian Style

Onyancha, Sammy, Naveed Mohamoud Merali, Nishma Elesh Gajjar, Peter Waweru Munyu, Angelique Holland, and Gernot Rohde. 2026. "Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists" Diagnostics 16, no. 11: 1616. https://doi.org/10.3390/diagnostics16111616

APA Style

Onyancha, S., Merali, N. M., Gajjar, N. E., Munyu, P. W., Holland, A., & Rohde, G. (2026). Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists. Diagnostics, 16(11), 1616. https://doi.org/10.3390/diagnostics16111616

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Establishing a Cone Beam CT-Guided Bronchoscopy Program: A Stepwise Guide for Interventional Pulmonologists

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