Fig. 4

REBUS- nodule relationship during robotic bronchoscopy. a REBUS probe (thick arrow) is advanced under direct visualization and seen exiting the scope at the site of the indicator (at 11 o’clock position on the screen- thin arrow). b in that airway, the REBUS image only showed air artifact. c In the same location, the REBUS probe is then oriented towards 6 O’clock position on the screen. The probe is in partial contact with the airway wall (thick arrow). d In that position, REBUS screen shows the nodule as an isoechoic image- highlighted with a dashed line). It is also obvious that nodule as seen on REBUS, although it appears to be at 12 o’clock position relative to the probe, it is clearly at 6’o’clock position as that is where the probe touches the airway wall. This relationship is crucial to identify as the needle orientation is dependent on it. e The panel shows the chest CT scan with the nodule biopsied in this case (a 15.9 X 18.8 mm nodule in RB10) REBUS: radial probe ultrasound