Pulmonary & Critical Care Medicine
Iowa Methodist Medical Center
Des Moines, IA
Patient Information: 64 y/o, F
Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol
Nodule: LUL 37mm
Target Motion: 18mm
Biopsy Result: Adenocarcinoma
Instruments Used: Always-On Tip Tracked® SPiN Flex® Needle, SPiN Flex® Stylet, SPiN Xtend®, Serrated Forceps & Brush
Conclusion: Targeted Therapy
“The SPiN Xtend® needle allowed me to access the left upper lobe mass and obtain enough tissue for rapid onsite examination, which diagnosed malignancy. This allowed for timely completion of the case and assurance that the biopsies were on target.”
This patient was a 64-year-old female that presented with a history of smoking and no history of cancer. The left upper lobe mass was found after a recent PET scan that was ordered due to disease in the liver. The patient was then referred to Dr. Trump and he decided to biopsy the mass with the SPiN System®.
A same-day Inspiration/Expiration CT scan was performed using Veran’s CT protocol. Dr. Trump utilized the SPiN Planning® software to segment a left upper lobe mass. The SPiN Planning® software revealed that the mass was 37mm in size and moving 18mm during respiration.
Dr. Trump started the procedure with EBUS to stage the mediastinum. Rapid on-site evaluation (ROSE) examined collected samples from stations 11R and 7 with negative findings. After negative findings from EBUS, Dr. Trump transitioned to navigation. He was able to reach the apical segment of the LUL utilizing a slim scope in conjunction with the 22ga SPiN Flex® needle. Collected samples from the SPiN Flex® needle revealed benign bronchial epithelial cells. Dr. Trump opted to transition to the SPiN Xtend® needle to better access the target. Once his trajectory was aligned and the needle was properly positioned, he adjusted the throw to 3cm and was able to sample the central part of the LUL mass. Upon inspection of the collected samples from the SPiN Xtend® needle, ROSE noted malignant material. He then took additional samples with the SPiN Xtend® needle. The final pathology report revealed collected samples from the SPiN Xtend® needle were morphologically consistent with adenocarcinoma. The patient was referred to Oncology for targeted therapy.