Pulmonary & Sleep Medicine
Patient Information: 67 y/o, M
Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol
Nodule: RML 17mm
Target Motion: 8mm
Biopsy Result: Non-Small Cell Lung Cancer
Instruments Used: Always-On Tip Tracked® Triple Needle Brush & 21 ga Needle
Conclusion: Stereotactic Body Radiation Therapy (SBRT)
“The cardiac border proximity was not a reservation in this case. The SPiN System™ allowed me to safely biopsy this nodule, despite its location. The Always-On Tip Tracked® Triple Needle Brush and 21ga Needle helped to accurately biopsy this right middle lobe nodule in a non-invasive manner.”
This 67-year-old-male was referred to Dr. Raval approximately one year ago. The patient has a 50-year smoking history and quit approximately one year ago. He was originally seen for a right middle lobe nodule, which was confirmed to be non-small cell lung cancer. As a result, the patient underwent SBRT and the nodule decreased in size. During a surveillance scan, a new 5mm right middle lobe nodule was discovered. This newly well-circumscribed right middle lobe nodule grew in size from 5mm to 12mm over the course of three months. Dr. Raval decided to schedule the patient to undergo a navigated bronchoscopy procedure.
Dr. Raval conducted the planning portion of the procedure utilizing a same-day inspiration / expiration CT scan. He segmented the right middle lobe nodule using the SPiN Planning™ software, which revealed the lesion was now 17mm in size. The planning software also showed that the nodule moved 8mm during respiration.
Dr. Raval started the procedure with navigation. After conducting an automatic registration, he was able to reach the area of interest using the Always-On Tip Tracked® Triple Needle Brush. Dr. Raval carefully timed each biopsy with matched respiration. After talking several passes with the tip-tracked triple needle brush, Dr. Raval then used the tip-tracked 21ga needle to obtain samples. He relied on tip-tracked tools to accurately biopsy this right middle lobe nodule. The final pathology report revealed that collected samples from the tip-tracked triple needle brush and 21ga needle were morphologically consistent with non-small cell. The patient will undergo stereotactic therapy radiation.