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SPiN System® Helps Prevent Unnecessary Procedures

INVASIVE METASTATIC ADENOCARCINOMA FOUND IN RIGHT MIDDLE LOBE (RML)
Author
Dr. Andres F. Yepes-Hurtado

Pulmonologist

University Medical Center

Lubbock, Texas

Patient Information: 53 y/o, M

Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol

Nodule: RML 1.4mm

Biopsy Result: Invasive Adenocarcinoma

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

Conclusion: Oncologic Therapy

Observations

“This approach to diagnosis lung cancer prevented the patient from having several procedures including a CT guided Biopsy, PET scan and unnecessary time between bronchoscopic and radiological approaches to achieve a diagnosis.”

Patient History
This 53 year-old male patient presented with Hypertriglyceridemia, gout, benign essential hypertension, and alcoholic liver disease. He was referred to Southwest Cancer Center (SWCC) due to a CT scan of the chest that showed a spiculated nodule within the right middle lobe (RML). The patient had a lengthy history of smoking and reported unintentional weight loss of roughly 40 pounds within the past two years.

Planning
Using a same-day respiratory gated scan with the SPiN Planning® software, Dr. Yepes-Hurtado segmented a 14mm nodule located in the RML. The nodule was very distal and a definite airway could not be identified leading towards the lesion. This was deemed a difficult case because of the location, the size of the lung nodule, and no apparent bronchus sign.

Procedure
Dr. Yepes-Hurtado started with endobronchial bronchoscope ultrasound (EBUS) and then transitioned to the SPiN Thoracic Navigation System®. After verifying registration with an Always- On Tip Tracked® instrument, the physician was able to successfully reach the target located in the RML. He was able to obtain multiple transbronchial biopsies utilizing tip tracked serrated forceps, needle, and brush. The SPiN System® aided in the diagnosis of invasive metastatic adenocarcinoma of the lung.

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