Dignity Health – Dominican Hospital
Santa Cruz, CA
Patient Information: 75 y/o, M
Nodule Location: Lung, Left Upper Lobe
Target Size: 14mm
Biopsy Result: Malignant; Adenocarcinoma
Instruments Used: SPiN Perc® Kit, 20cm
Conclusion: Surgical resection
“I immediately knew I was in the correct location for biopsy due to the solid nature of the core samples. This procedure using SPiN IR® took no more than 20 minutes to biopsy and get a diagnosis of this nodule.”
This patient previously underwent a bronchoscopy as an attempt to obtain a diagnosis of this suspicious pulmonary nodule. Pathology results proved inconclusive, citing the need for more tissue. Pulmonary referred the patient to Dr. Rodriguez in interventional radiology for a biopsy to obtain more tissue from this nodule.
Upon review of the patient’s most recent CT scan, Dr. Rodriguez decided to perform the procedure with the patient in the supine position and biopsy the lung nodule from an anterior approach. The patient was placed on the CT bed with a vPad® placed on the right anterior chest. An initial scan using Veran CT parameters was taken to plan the best access path to the nodule. Using the SPiN IR® software, Dr. Rodriguez carefully planned his needle trajectory.
The patient received IV sedation and the anterior chest was sterilely prepped and draped. The entry point was identified, and 1% lidocaine was administered subcutaneously around the entry point. Dr. Rodriguez first used the 19g SPiN Perc® introducer needle to access the nodule for biopsy. As he visualized his needle tip on the SPiN Thoracic Navigation System®, he used respiratory gating to make one initial push through the pleural wall into the nodule on an exhalation. One CT scan was taken to confirm spoton placement of the needle. Dr. Rodriguez then took multiple biopsies using the core biopsy gun, scanning once more in between biopsies 2 and 3 to ensure the needle did not shift from the correct location. Pathology reviewed the samples and confirmed there was enough tissue to call a diagnosis of adenocarcinoma.