Krish Bhadra, M.D., interventional pulmonologist at the Rees Skillern Cancer Institute, is one of the world’s first pulmonologists using Cone Beam CT (CBCT) bronchoscopy, an advanced technology that is enhancing diagnostic yield of biopsies of difficult peripheral lung lesions. It’s the most advanced form of diagnostic bronchoscopy available today.
Only a few interventional pulmonologists in the country have access to the type of technology that’s readily available in CHI Memorial’s hybrid operating room – it’s an option for the pulmonary world that’s truly unique. CBCT bronchoscopy overcomes some of the challenges with traditional bronchoscopy that can lead to a non-diagnostic biopsy result. This technology puts us into a new era of extremely precise biopsies that achieve a higher diagnostic yield.
With existing electromagnetic navigational bronchoscopy, physicians must work in a virtual platform that makes it more challenging to target lesions deep in the lung. Cone beam CT provides real-time 3D imaging that confirms that the diagnostic tool is in the proper location in relation to the lesion. When it’s on target, the procedure progresses. If it’s slightly off target, the low dose 3D CT scan provides information that allows for re-navigation and a greater level of confidence that the biopsy is coming from the center of the lesion itself.
CBCT bronchoscopy uses the existing navigational bronchoscopy and layers in the 3D CT technology to drive toward the target lesions, leading to a higher level of accuracy while lowering the possibility for non-diagnostic bronchoscopies and repeat procedures. CBCT bronchoscopy will be useful for many people with peripheral lung lesions or nodules and nearly all are candidates if they can tolerate general anesthesia. The technology has a very low risk profile and is one of the safest modalities among options for lung biopsies.
A recent meta-analysis of studies on all guided bronchoscopies resulted in a 70 percent diagnostic yield. In the 31 patients where Dr. Bhadra has used CBCT bronchoscopy, “tool-in-lesion” confirmation was 97 percent and the diagnostic yield rate was 91 percent. According to Dr. Bhadra, CBCT bronchoscopy has the potential to radically change the nature of lung cancer diagnosis and the ability to target smaller and more difficult-to-reach lesions for analysis and treatment. Innovative diagnostic tools like CBCT bronchoscopy are aiding in early detection of lung cancer – leading to improved treatment outcomes and survival rates.
There’s an amazingly talented team of physicians at CHI Memorial, and together we are shifting the stage of lung cancer diagnoses in this community. When it comes to coordinated lung cancer care, we are pushing the needle – with new technologies, new therapies, and advanced research – to find cancer earlier and treat it more effectively than ever before.
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