GPS-like Technology Puts Lung Lesions in Reach

Physicians at the University of Rochester Medical Center are the first in Rochester to use a new, minimally invasive technique called Electromagnetic Navigation Bronchoscopy (ENB) to locate, biopsy and plan treatment for deep lung lesions.

Specially trained experts at URMC’s Strong Memorial Hospital are offering superDimension® inReach® System as an option for patients who have a hard-to-reach lesion on their lung. ENB combines GPS-like technology with a catheter-based system that uses the patient’s natural airways to access lesions that are hard to reach with traditional procedures.

“Prior to ENB, options for a patient with a spot on their lung included an invasive surgery to remove a section of the lung, traditional bronchoscopy – which cannot reach lesions deep in the lung, CT-guided needle biopsy, or watchful waiting,” said Michael Nead, M.D., Ph.D., assistant professor of Medicine in URMC’s Pulmonary and Critical Care Division. “Standard bronchoscopy allows us to reliably see only about a third of the lung; ENB gives us access to the boundaries of the lungs, avoiding more invasive procedures that may not be options for all patients.”

ENB uses proprietary software coupled with a standard CT image of the lungs to create a three-dimensional roadmap to the lesion. That roadmap guides the electromagnetic localization system to track the real-time position of a guide catheter with a location sensor at its tip to the target lesion area in the lungs – much like a GPS system guides a vehicle’s driver to his destination. Once arriving at the target, the location sensor is removed and the guide catheter provides a channel for diagnostic or therapeutic tools.

Navigational bronchoscopy extends beyond the reach of the bronchoscope and guides endoscopic tools and catheters deep into the lung, providing additional options for diagnosis and treatment of lung disease. The system allows physicians to find positive pathology sooner, enabling treatment earlier and potentially expanding treatment options and reducing the need for invasive, high-risk alternative procedures.

“For many patients, navigational bronchoscopy is a good alternative to other invasive procedures, such as transthoracic needle aspiration, which may not reach some lesions and carries with it a risk for pneumothorax of up to 30 percent, or more invasive surgical biopsy,” said Sandhya Khurana, M.D., assistant professor of Medicine in Pulmonary and Critical Care.

ENB is also a useful tool for patients who are not candidates for thoracic surgery. The inReach System provides the ability to safely and efficiently reach lesions deep in the lung transbronchially, carrying only an approximate 3 percent risk of pneumothorax. The system also permits placement of markers to help guide radiation therapy, should a cancer be diagnosed.

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