Dr. Eric Flenaugh
Pulmonologist
Grady Hospital
Atlanta, GA
Patient Information: 65 y/o, M
Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol
Nodule: RLL 35mm
Target Motion: 12mm
Biopsy Result: Infection
Instruments Used: Always-On Tip Tracked® Triple Needle Brush, Serrated Forceps & 21ga Needle
Conclusion: Aspergilloma
“The SPiN Thoracic Navigation System® helped to rule out malignancy for this patient with a minimally invasive approach. The Always-On Tip Tracked® Triple Needle Brush allowed us to penetrate the lesion to sample a wider area with three brushes at the same time to ultimately get an answer for the patient.”
Patient History
This 65-year-old male presented with multiple lung nodules and a history of smoking. After repeat imaging, it was discovered that a right lower lobe lesion persisted. The patient underwent a conventional bronchoscopy, which resulted in non-yielding samples. The patient was referred to Dr. Flenaugh, who opted to schedule the patient for a navigational bronchoscopy to facilitate biopsy of the right lower lobe target.
Planning
A same-day Inspiration/Expiration CT scan was performed using Veran’s CT protocol. Dr. Flenaugh utilized the SPiN Planning® software to segment the right lower lobe target. The SPiN Planning® software revealed that the segmented target was 35mm in size and moving 12mm during respiration.
Procedure
Dr. Flenaugh started the procedure with navigation. He was able to reach the area of interest utilizing a slim scope in conjunction with the Always-On Tip Tracked® Triple Needle Brush. Once trajectory was properly aligned, Dr. Flenaugh advanced the tip-tracked triple needle brush into the center of the target. Once deployed, suction was applied to the suction port to obtain additional cellular material during agitation. After multiple passes, Dr. Flenaugh also obtained additional biopsies with the tip-tracked 21ga needle and serrated forceps. The final pathology report revealed that collected samples from all three tip-tracked biopsy instruments were morphologically consistent with aspergilloma. The patient underwent an antibiotic regimen and was spared additional, more invasive treatment.
