LUNG BIOPSY
Today, there are more than 500,000 bronchoscopies performed annually in the U.S. to diagnose lung disease; approximately two-thirds of those fail to reach the distant regions of the lungs.3,4 For these distal lesions, conventional bronchoscopy has been used in conjunction with more invasive surgical procedures to enable a definitive diagnosis. More invasive procedures, however, may present higher complications for some patients, including pneumothorax (collapsed lung), hospitalization and long-term chest pain.
Here are a few of the common procedures used today to sample or biopsy lung tissue.
Transbronchial Biopsy
This is an outpatient procedure, where a thin, flexible tube called a bronchoscope is used to examine the inside of your air passages and a small tissue sample or biopsy is taken for laboratory analysis. It is important to remember that this procedure produces a diagnosis for only approximately 13% of lesions deep in the lungs and it cannot reach out to the multiple branches of the bronchial tree.5 Therefore, more invasive surgical techniques must be used to make a diagnosis.
Transthoracic Needle Aspiration or CT-Guided Needle Aspiration
This is an outpatient procedure where a needle is passed between the ribs and into the lung lesion and a tissue sample or biopsy is taken to make a definitive diagnosis. Transthoracic needle aspiration or CT-guided needle aspiration can be complicated by pneumothorax (collapsed lung). Because of the higher risk of pneumothorax, only patients who meet certain criteria are candidates for this procedure. If pneumothorax does occur, a chest tube may be inserted between the ribs to re-expand the lungs; this requires hospitalization.
Thoracotomy
During a thoracotomy, an incision is made between the ribs and often a wedge resection (triangular piece of lung tissue) is removed for determining a diagnosis. During this invasive procedure, a chest tube is inserted and hospitalization of approximately one week is required.
Video-Assisted Thoracic Surgery
Video-assisted thoracic surgery is a less invasive option used today when compared to traditional thoracotomy. An incision is still made between the ribs to acquire a tissue sample; however, the incision is much smaller in length. Hospitalization is still required but the recovery time is potentially shorter.
Both thoracotomy and video-assisted thoracotomy produce a higher risk of morbidity and mortality.5 In addition, only patients who meet certain criteria are candidates for these procedures.
Watchful Waiting
Watchful waiting is an approach in which time is allowed to pass before further medical intervention is considered. Repeated testing may be performed during this time, but it can also allow for malignant lesions to spread.6
inReach™ System
Now, a unique solution is available for obtaining lung tissue for biopsy. The inReach System™ by superDimension uses electromagnetic navigation bronchoscopy to access lesions and lymph nodes deep in the lungs in a minimally invasive manner.
Many of the surgical options today can be used only in patients who meet certain criteria. However, the inReach System can be used with a broad group of patients, even those who are not suitable for other surgical techniques.7 With the inReach System, physicians can locate, test and plan treatment for small lung lesions not accessible through traditional bronchoscopy means.
