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Patient Avoids Invasive Procedure

SUCCESSFUL BIOPSY OF RML TARGET
Author
Gordon Downie, MD, PhD

Pulmonologist

Titus Regional Medical Center

Mount Pleasant, TX

Patient Information: 74 y/o, F

Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol

Nodule: RML 36mm

Target Motion: 9mm

Biopsy Result: Aspergillosis

Instruments Used: Always-On Tip Tracked® 21ga Needle & Brush

Conclusion: Antibiotic Regimen & Follow Up

Observations

“Anytime you can save a patient from an invasive procedure, this time a lobectomy, it is a huge accomplishment. Veran’s technology allowed me the ability to accomplish this for my patient.”

Patient History
This was a 74-year-old female patient with a history of breast cancer. The patient also experienced two falls that resulted in broken ribs. Routine surveillance revealed a lesion within the right middle lobe. Given the patient’s history, a right middle lobe lobectomy with nodule sampling was recommended due to the suspicion of the lesion being cancerous. The patient was then referred to Dr. Downie, who decided to biopsy the right middle lobe lesion with the SPiN Thoracic Navigation System™.

Planning
Dr. Downie utilized a same-day CT scan in conjunction with the SPiN Planning™ software. The same-day CT scan revealed that the right middle lobe target had increased in size. After segmenting the lesion, the planning software revealed that the target was 36mm in size and moved 9mm during respiration.

Procedure
Dr. Downie started the procedure with EBUS to stage the mediastinum. After obtaining samples, he transitioned to navigation. Dr. Downie was able to successfully reach the right middle lobe target utilizing the tip-tracked 21ga needle. After obtaining multiple passes with the needle, Dr. Downie used the tip-tracked brush to sample the target. The final pathology report revealed that collected samples from EBUS were negative for malignancy and collected samples from navigation were consistent with aspergillosis. The patient was placed on an antibiotic regimen and enrolled in a two year follow-up protocol. This minimally-invasive approach spared the patient a more invasive procedure.

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