Cios Spin in endobronchial interventionsHow a mobile CBCT system can address your clinical and cost challenges

Is your pulmonology practice changing to meet safety and efficiency demands? If not, you may need to consider how you will handle three immediate challenges:

  • Accurate targeting of pulmonary lesions
  • Increasing caseload because of lung cancer screening and incidental findings
  • Cost effective solutions
3D visualization of lung cancer nodules, airways and devices to support lung cancer biopsy interventions

3D visualization of lung cancer nodules, airways and devices with Cios Spin to support lung cancer biopsy interventions

Courtesy of Roberto Casal, MD Anderson

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Bronchoscopic and percutaneous biopsies are established methods to assess the potential malignancy of suspicious lung lesions. For certain indications bronchoscopic biopsy is preferred. However, low diagnostic yield (~50%) from bronchoscopic biopsy is a reality with standard approaches such as traditional bronchoscopy, fluoroscopic or ultrasound guidance.8,9 However, cone-beam CT tool-in-lesion confirmation by cone-beam CT (CBCT) proves navigation success and may lead to increased diagnostic yield.10,5,6 In one study, tool-in-lesion confirmation was the strongest predictor of biopsy success.9

With intra-procedural 2D and 3D imaging Cios Spin may improve diagnostic yield due to controlled navigation when compared to fluoroscopy.8,10 Cios Spin provides sufficient image quality to visualize airways and certain pulmonary nodules during endobronchial interventions.10

Doubling Number of biopsies due to screening

Doubling Number of biopsies due to screening5,6,7

There is a projected two-fold increase of lung cancer biopsies due to the shift in global patient volume toward stage I/II patients. Following the success of the National Lung Screening Trail (NLST) and the NELSON trial, lung cancer screening programs are considered.7,11,12,13,14 In addition to biopsy procedures, there are a variety of additional needs to be met. 


Cios Spin offers technology that can be a true multidisciplinary imaging solution across disciplines, which may help to expand return on investment. The system has the potential to effectively guide endobronchial interventions such as biopsies thanks to its 3D imaging. The initial experience shows that Cios Spin could potentially be useful as another modality to assist with the localization of suspicious pulmonary nodules.10

Cios Spin

Elective procedures have been postponed because of the pandemic.15 Therefore, many providers are now faced with the pressure to reduce spending.


Cios Spin is a state-of-the-art mobile C-arm that offers 2D fluoroscopy and CBCT in the bronchoscopy suite. The system can be used straight away, without time and costs associated with fixed room installation.


Many pulmonologists have small intervention rooms and little or no access to the hybrid OR, making flexibility important. Cios Spin uses less than 13 square feet (~1.2 m²) of space, making it ideal for procedural rooms of any size. With its compact mobile platform, it can be wheeled from room to room and used independent of hybrid OR scheduling.


Recent studies show combinations of Cios Spin with electromagnetic navigation systems16 and endoluminal robots.

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