Dr. Harsha Banavasi
Pulmonologist
Redmond Regional Medical Center
Rome, GA
Patient Information: 73 y/o, F
Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol
Nodule: 20mm RUL
Target Motion: 10.8mm
Biopsy Result: Stage Ia Adenocarcinoma
Instruments Used: Always-On Tip Tracked® Forceps and SPiN Flex® 22ga Needle
Conclusion: Referred to thoracic team for surgical resection
This nodule was in a difficult location even for CT-guided biopsy. Since the PET scan was positive and this was a high-risk nodule, time spent diagnosing this patient was important in her treatment outcome. Utilizing the SPiN Thoracic Navigation System® helped Dr. Banavasi navigate to the target and confidently sample the area of interest.
Patient History
This 73-year-old female patient with a history of hypertension, hyperlipidemia, and greater than a 50-pack-year smoking history came to Dr. Banavasi with a 17mm right upper lobe nodule incidentally found on a thorax CT. The patient underwent a PET scan which showed increased metabolic activity in the nodule. Dr. Banavasi scheduled a navigational bronchoscopy using the SPiN Thoracic Navigation System®.
Planning
Dr. Banavasi used the SPiN Planning® software with the patient’s same-day respiratory gated CT scan. The 20mm nodule was segmented revealing the nodule was moving 10.8mm throughout respiration. Dr. Banavasi was able to utilize the mapping features in the software to have a better understanding of the nodule’s location. He noted the target was in a challenging position through the apical segment in the posterior subsegment of the right upper lobe.
Procedure
The procedure began with an automatic registration in the SPiN Drive® software. Dr. Banavasi waited for matched respiration and began taking biopsies with the Always-On Tip Tracked® Forceps. Once adequate number of biopsies were taken, he switched instruments and gathered fine needle aspirations (FNA) with the SPiN Flex® 22ga Needle. Rapid On-Site Examination (ROSE) determined the samples were consistent with Non-Small Cell Lung Cancer with detection of malignant cells on the first FNA pass’s slide. The patient was diagnosed with Stage Ia Adenocarcinoma and referred to a cardiothoracic surgeon for a lobectomy.
