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Apical Lesion Biopsied with Tip-Tracked Biopsy Tools

Adenocarcinoma found in LUL
Author
Dr. Hammad Qureshi

Pulmonologist

Millennium Physicians

Houston, TX

Patient Information: 71 y/o, F

Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol

Nodule: LUL 34mm

Target Motion: 4mm

Biopsy Result: Adenocarcinoma

Instruments Used: Always-On Tip Tracked® Forceps & Brush

Conclusion: Surgical Resection

Observations

“By utilizing the SPiN Thoracic Navigation System™, I was able to reach a difficult target with no definite airway and achieve a diagnosis for the patient.”

Patient History
This 71-year-old female patient presented with a history of squamous cell carcinoma and underwent a RUL resection two years prior. She was referred to Dr. Qureshi for the evaluation of a LUL mass that was recently found during routine surveillance. He opted to utilize the SPiN Thoracic Navigation System™ to facilitate biopsy of the difficult-to-reach lesion.

Planning
Dr. Qureshi utilized a same-day inspiratory and expiratory CT scan with SPiN Planning™ software. After segmenting the LUL target, the software revealed the lesion was 34mm in size and moved 4mm during the patient’s respiratory cycle. A positive bronchus sign was not seen on the CT scan.

Procedure
Dr. Qureshi started the procedure with navigation. After conducting an automatic registration, he was able to successfully navigate to the apical segment of the LUL using a diagnostic scope in conjunction with tip-tracked serrated forceps. Once in place, Dr. Qureshi was able to successfully biopsy the LUL target using tip-tracked serrated forceps and brush. He relied upon the guidance of tip-tracked biopsy tools to reach this challenging target given there was not an apparent positive bronchus. The final pathology report revealed that collected specimens obtained with tip-tracked serrated forceps and brush were morphologically consistent with adenocarcinoma. The patient will undergo a surgical resection.

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