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Non-Invasive Biopsies Offer Ease, Early Detection
Endobronchial ultrasound (EBUS) helps doctors explore the lymph nodes located between the two lungs, said Shyam Ivaturi, M.D., Medical Director of Pulmonology and Pulmonologist with St. Anthony’s Pulmonary Specialists. Thoracic navigational bronchoscopy allows doctors to reach and explore nodules at the periphery of the lungs.
During both outpatient procedures, a flexible, fiber-optic tube called a bronchoscope is directed into the windpipe and bronchial areas. The patient is kept comfortable with light sedation and local anesthesia.
“In the past, patients who needed a biopsy of their lymph nodes underwent a procedure called a mediastinoscopy, a surgical procedure in which the surgeon makes an incision in the chest,” Dr. Ivaturi explained. “It’s more invasive, and it’s performed in the OR under anesthesia. And previously, some nodules were hard to reach with a bronchoscope, so we had to follow them until they got bigger, or we used a CT-guided needle biopsy, which couldn’t always reach every suspicious nodule.
“Results from EBUS and thoracic navigational bronchoscopy outpatient procedures are obtained rapidly in a few days, so further management can be planned by the treating physicians,” Dr. Ivaturi added. “There are no incisions or cutting. And the cost of the procedure is much less than the cost of a mediastinoscopy. We are able to better identify and stage, or determine the amount and location of cancer in a patient’s body, much faster. The results, reliability and safety profile from these procedures are very encouraging.”
During endobronchial ultrasound, the bronchoscope is fitted with a transducer that creates sound waves that image the inside of the patient’s body. Navigational bronchoscopy is done in stages, with mapping. Tiny instruments equipped with electromagnetic sensors create impulses that guide doctors to the area(s) where biopsy is needed.
“They’re two different procedures, and we can combine the two on the same patient to get even more accuracy,” Dr. Ivaturi said.