Dr. Nikhil Meena
Interventional Pulmonologist
University of Arkansas Medical Sciences
Little Rock, AR
Patient Information: 62 y/o, M
Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol
Nodule: LUL 9mm
Target Motion: 8.6mm
Biopsy Result: Adenocarcinoma
Instruments Used: SPiN Access Catheter®, Always-On Tip Tracked® 22ga SPiN Flex® Needle & Serrated Forceps
Conclusion: Stereotactic Body Radiation Therapy (SBRT)
“This subcentimeter aortic arch nodule was in a tough location to biopsy. The SPiN Thoracic Navigation System® gave me the confidence to accurately biopsy this challenging target. I would not have planned to biopsy this nodule without the system.”
Patient History
This was a 62-year-old male with a long history of smoking. The patient was undergoing repeat imaging that revealed that the left upper lobe nodule increased by 2mm over the course of three months. This nodule was deemed highly suspicious for malignancy.
Planning
A same-day Inspiration/Expiration CT scan was performed using Veran’s CT protocol. Dr. Meena utilized the SPiN Planning® software to segment a left upper lobe nodule. The SPiN Planning® software revealed that the nodule was 9mm in size and moving 8.6mm during respiration. Given the target’s challenging location, Dr. Meena planned to utilize the SPiN Access Catheter®.
Procedure
Dr. Meena started the procedure with EBUS in order to stage the mediastinum. After obtaining adequate samples, he transitioned to navigation. Dr. Meena was able to reach the area of interest with the SPiN Access Catheter®. Once in position, Dr. Meena obtained biopsies of the subcentimeter nodule using tip-tracked serrated forceps and SPiN Flex® needle. Adequate samples were obtained utilizing the tip-tracked instruments, which provided navigational guidance throughout the time of biopsy. The final pathology report revealed the collected samples were morphologically consistent with Adenocarcinoma. The patient was scheduled for SBRT treatment.
