Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

A guided broncoscope achieves biopsy of 75% pulmonary nodules of 2 cm or more without puncture or surgery

21.05.2008
A broncoscope guided by means of electromagnetic navigation has managed to achieve the biopsy of 75% of pulmonary nodules greater than 2 cm, according to Doctor Luis Seijo, specialist in Pneumology at the University Hospital of Navarra.

This is the hospital in the whole of Spain which has the greatest experience in the use of this novel device and which enables access to pulmonary lesions without recourse to surgery or transthoracic puncture, conventional techniques that increase risk for the patient.

The basics of navigator-guided broncoscopy is in accessing the interior of the bronchial “tree” of the patient and to the affected nodule(s). It is guided by a system which shows the position of the instrument used to carry out the biopsy in real time. In the case of the lung, the system is equipped with an electromagnetic probe, which acts as the guide.

On reaching the nodule in question, the probe is substituted by a biopsy pincers or cytological needle, instruments that enable a sample of the lesion to be obtained. The procedure also facilitates sampling adenopathies or mediastinic ganglia that are of interest for analysis. At the University Hospital of Navarra this procedure, which can be carried out on a day-patient basis, is undertaken with the patient under sedation.

Basic planning

To initiate the broncoscopy it is necesary to plan the operation with the data previously obtained from a conventional thorax CAT scan. This information is transferred to a computer software programme which recreates the patients bronchial tree in a virtual manner.

With this graphical information the pneumologist can plan the operation in detail. “The planning is a key stage in carrying out the procedure successfully. The specialist marks reference points on the computer images which will subsequently enable him or her to navigate in real time to the nodule”, according to Doctor Seijo.

The virtual references marked include the lesion which is the target of the biopsy. It is important to mark identifiable points which, during the operation, will enable a triangulation of the position of the probe within the bronchial tree. Prior to initiating the endoscopic procedure, the specialist refers to this computer planning data from a hard disc inserted into a computer in the operating theatre.

During the broncoscopy

The navigation team creates an electromagnetic field which encompasses the patient’s thorax and enables placing the probe in three-dimensional space within the bronchial tree of the patient. The technique makes it possible to know the position and orientation of the probe at all times, as well as the direction of the lesion to be diagnosed from the probe and the distance separating the two. “The concept is similar to that of a GPS”, said Doctor Seijo.

Once the broncoscope is introduced orally or nasally, the same reference points marked in the virtual planning have now to be marked in real time. With the electromagnetic probe, the same points marked in the virtual planning of the bronchial tree of the patient are fixed. The computer detects if there exist divergences between the virtual and real reference points or not. A divergence of less than 4 mm is ideal.

In this way the system makes ongoing calculations, fixing the position of the probe within the patient’s thorax and, thereby, within the virtual recreation generated from the prior scan. “This is how we manage to navigate to the lesion on which we wish to carry out a biopsy. Normally 5 or 6 reference points are marked although, given the complexity of the bronchial tree, with its multitude of bifurcations, intermediate reference points are marked that act as “radio beacons” during the navigation to the nodule in question”, stated the pneumologist.

The electromagnetic probe travels through the interior of the bronchial ramifications of the patient, inserted within an extendable working tube. Once the target is reached, this tube can be fixed and the probe substituted by the instrument required to take the tissue sample (the biopsy) of the lesion.

The risks involved with this diagnostic procedure are much less than those of transthoracic puncturing and, of course, than those of a thoracotomy (open surgery of the thorax). As an illustration of this reduced risk, the incidence of pneumothorax caused by the conventional transthoracic technique is 20% while, using navigation-guided broncoscopy, this figure drops to 6%.

Irati Kortabitarte | alfa
Further information:
http://www.basqueresearch.com/berria_irakurri.asp?Berri_Kod=1751&hizk=I

More articles from Medical Engineering:

nachricht Novel chip-based gene expression tool analyzes RNA quickly and accurately
18.01.2018 | University of Illinois College of Engineering

nachricht Potentially life-saving health monitor technology designed by Sussex University physicists
10.01.2018 | University of Sussex

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Artificial agent designs quantum experiments

On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.

We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Let the good tubes roll

19.01.2018 | Materials Sciences

How cancer metastasis happens: Researchers reveal a key mechanism

19.01.2018 | Health and Medicine

Meteoritic stardust unlocks timing of supernova dust formation

19.01.2018 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>