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Format: 04/15/2014
Format: 04/15/2014

News

WPAHS Offers New Electromagnetic Navigation Bronchoscopy (ENB) Procedure to Diagnose and Treat Lung Lesions

Tuesday, November 27th, 2012

West Penn Allegheny Health System now offers a state-of-the-art procedure to provide minimally-invasive treatment options for patients who have had a spot or nodule detected deep within their lungs.

The superDimension iLogic Electromagnetic Navigation Bronchoscopy (ENB) uses GPS-like technology to extend the reach of a bronchoscope deep into the lungs, helping physicians locate, biopsy and treat lesions more effectively.

The ENB uses the patient’s natural airways to access lesions that were previously hard to reach. Typically, a patient with a newly detected nodule in their lung would undergo either a standard bronchoscopy which may or may not reach the deeply located lesion, a CT scan-guided biopsy, or video-assisted surgery to remove a portion of the lung. Each of these techniques has unique limitations and risks.

“We are pleased to offer a minimally-invasive alternative for patients who have a lesion on their lung that is difficult to reach or patients who cannot tolerate a more invasive procedure,” said Marvin Balaan, MD, interim director of the Division of Pulmonary/Critical Care Medicine at West Penn Allegheny Health System. “This unique approach may increase the chances that a patient will safely get a diagnosis and begin treatment.”

ENB now can be performed as an outpatient procedure at both Allegheny General and Forbes hospitals.

Using a pre-operative CT image of the lungs, the iLogic system’s software creates a “roadmap” to the lesion. Once a route to the lesion is planned, a guide catheter with a location sensor at the tip and 360 degree steering capabilities is threaded through the patient’s airways. The location sensor tracks the real-time position of the catheter as it makes its way along the path to the lesion. When the target area is reached, the location sensor is removed and the guide catheter serves as a channel for diagnostic or therapeutic tools that can be used to initiate treatment.

Once diagnosis of lung nodules and mediastinal lymph nodes is achieved, the iLogic system may be used to place brachytherapy catheters and markers which help radiation oncologists to deliver radiation therapy directly to the area of a tumor while preserving as much healthy tissue as possible.

ENB technology represents a significant advance in the treatment of lung disease as two-thirds of all lung lesions are out of the reach of a typical bronchoscope, Dr. Balaan said. The ability to reach and stage spots on the lung sooner may help some patients achieve better outcomes. More than 75 percent of new lung cancer diagnoses are late-stage cases in which the present 5-year survival rate is only 15 percent. A recent study published in the New England Journal of Medicine showed that lung cancer diagnosed at Stage I resulted in a 10-year survival rate of 88 percent.

“Many patients diagnosed with lung cancer are not good candidates for surgery because of the extent of their lung disease or other medical problems,” Dr. Balaan said. “This system gives us a safe and effective way to stage and treat lesions in non-operable patients.”

As many as 226,000 people in the United States will be diagnosed with lung cancer in 2012, according to the American Cancer Society. Lung cancer is the number one cause of cancer-related death in both men and women in the US.

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