superDimension ENB: New technology helps diagnose lung nodules

Every year, a half million bronchoscopies are performed in the U.S. in order to investigate lesions within patients' lungs. Because conventional bronchoscopy cannot reach the distant regions of the lungs, more invasive surgical procedures are often needed to diagnose lung nodules that may be malignant.

The General Thoracic Surgery Division at NewYork-Presbyterian/Columbia has begun using a new technology, superDimension Electromagnetic Navigation Bronchoscopy™ (ENB). ENB creates a computer-generated reconstruction of the lungs from a CT scan of the tracheobronchial tree, explains Lyall A. Gorenstein, MD, FRCS (C), FACS, Director, Minimally Invasive Thoracic Surgery. Using these reconstructed images, the system creates a visual pathway so that surgeons can guide steerable catheters to where lung nodules are located, facilitating examination and biopsy.

"This enables us to diagnose lung nodules which may not be easily diagnosed without surgical procedures," Dr. Gorenstein says. "It also allows better staging of lung cancers in patients with a known lung cancer who may have other nodules in the lung." By enabling surgeons to determine whether nodules in a patient's other lung may be malignant, ENB improves their ability to accurately determine what stage a cancer has progressed to (staging) and provide better treatment.

"Traditionally, we do not try to biopsy small lesions because such biopsies are not reliable," Dr. Gorenstein continues. "Instead, we usually follow the patient with CT scans over time. For patients with lesions as small as 7 or 8 mm, this technology will alleviate the need for surveillance CT and its radiation exposure."

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