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Lung health, prevention, and treatment

Advanced Diagnostic Technologies: ION and EBUS

 

Advanced Diagnostic & Biopsy Technologies

Dignity Health is committed to delivering accurate and timely diagnoses for a comprehensive range of lung conditions. Our program integrates advanced, minimally invasive technologies to precisely identify and stage respiratory concerns, including those located in hard-to-reach areas of the lung.

Our sophisticated diagnostic capabilities include:

  • ION Robotic Bronchoscopy System: This state-of-the-art system represents a significant advancement in the detection and diagnosis of lung nodules. Leveraging robotic precision and enhanced maneuverability, the ION system allows our physicians to navigate an ultra-thin catheter through the intricate airways to reach peripheral lung nodules that are often inaccessible with traditional bronchoscopy. 

  • Endobronchial Ultrasound (EBUS): EBUS is a crucial minimally invasive procedure employed for the diagnosis and accurate staging of lung cancer, as well as for the evaluation of various other thoracic diseases. Utilizing a flexible bronchoscope equipped with an integrated ultrasound probe, EBUS provides real-time visualization of airways, blood vessels, and mediastinal lymph nodes. This advanced imaging capability allows our specialists to precisely target, characterize, and obtain tissue biopsies from lymph nodes and lesions adjacent to the airways, significantly enhancing diagnostic yield and often precluding the need for more invasive surgical procedures.

These integrated technologies underscore our commitment to providing our patients with the most advanced diagnostic pathways, facilitating early intervention and the development of highly individualized treatment strategies.

What is a Lung Biopsy

If a spot or nodule has been found on your lung, your doctor might suggest a lung biopsy. While most lung nodules (over 95%) are not cancerous, a biopsy can provide a definitive diagnosis. A biopsy involves taking a small tissue sample from the nodule, which is then examined under a microscope to determine if cancer or another condition is present.

There are different methods for performing a lung biopsy, and the best approach for you will depend on factors like the nodule's size, location, and your overall lung health.Your doctor may recommend one of the following biopsy methods:

  • Surgical biopsy
  • Transthoracic needle aspiration
  • Manual bronchoscopy with or without electromagnetic navigation
  • Robotic-assisted minimally invasive biopsy with IonRhythm irregularities.

When is a Lung Biopsy Needed?

 When is a Lung Biopsy Needed?

A lung biopsy is a critical diagnostic procedure performed when imaging tests, such as X-rays, CT scans, or PET scans, reveal suspicious findings in the lungs that require further investigation. These findings often include:

  • Suspicious Lung Nodules or Masses: The most common reason for a lung biopsy is the detection of an abnormal growth (nodule or mass) in the lung. While many nodules are benign, a biopsy is essential to determine if the growth is cancerous or non-cancerous.
  • Abnormalities on Lung Scans: Persistent or worsening abnormalities seen on imaging that cannot be definitively diagnosed through other means.
  • Enlarged or Abnormal Lymph Nodes: Especially those in the chest (mediastinal or hilar lymph nodes), which can indicate the spread of lung cancer or other serious conditions like sarcoidosis or infections.
  • Unexplained Fluid Around the Lungs (Pleural Effusion): If fluid samples don't provide a clear diagnosis, a biopsy of the pleural lining may be necessary.
  • Interstitial Lung Disease (ILD): In some cases of unexplained scarring or inflammation of the lung tissue, a biopsy can help differentiate between various types of ILD and guide treatment.
  • Confirming Infection: Rarely, a biopsy might be needed to identify unusual or persistent lung infections that haven't responded to standard treatments or where initial tests are inconclusive.

What a Lung Biopsy Determines:

The primary goal of a lung biopsy is to obtain a tissue sample that can be analyzed by a pathologist. This analysis helps to:

  • Diagnose Cancer: Confirm the presence of cancer cells and identify the specific type of lung cancer (e.g., non-small cell lung cancer, small cell lung cancer). This information is vital for treatment planning.
  • Determine if a Nodule is Benign: Rule out cancer, providing peace of mind.
  • Identify Other Conditions: Diagnose non-cancerous conditions such as infections, inflammatory diseases (like sarcoidosis), or various types of interstitial lung disease.

At Dignity Health, our pulmonology experts use advanced, minimally invasive techniques like EBUS and ION robotic bronchoscopy to perform precise lung biopsies, reducing patient discomfort and expediting accurate diagnoses. Your physician will discuss whether a lung biopsy is necessary for your specific condition and which biopsy method is most appropriate.

Precision Lung Nodule Biopsy: Featuring ION Robotic Bronchoscopy

When a suspicious spot on your lung (known as a lung nodule) is identified through screening or other imaging tests, the next critical step is often a biopsy to determine if it's cancerous or benign. At Dignity Health, we are proud to offer ION robotic bronchoscopy, an advanced, minimally invasive technology that revolutionizes the way we diagnose even the most challenging-to-reach lung nodules.

What is ION Robotic Bronchoscopy?

The ION system represents a significant leap forward in lung biopsy technology. It utilizes a highly maneuverable, ultra-thin robotic catheter that our board-certified pulmonologists expertly navigate through your natural airways. Guided by a sophisticated 3D mapping system of your lungs, the ION robot can reach deep into the lung periphery – areas previously inaccessible without more invasive surgical procedures.

How ION Works for You: The Process

  1. 3D Airway Map: Before the procedure, your doctor uses your CT scan to create a detailed 3D roadmap of your lung airways, pinpointing the exact location of the nodule.
  2. Robotic Navigation: During the procedure, the precise ION robotic catheter follows this pre-planned path. Its unprecedented flexibility allows it to articulate and bend through the intricate branches of your lungs.
  3. Targeted Biopsy: Once at the nodule, specialized instruments are advanced through the catheter to safely and accurately collect tissue samples for pathology analysis. Real-time imaging helps confirm the catheter's position and the success of the biopsy.
minimally invasive ION robotic-assisted bronchoscopy

The ION Advantage: Why It Matters for Patients

  • Unmatched Precision: ION's robotic controls and advanced navigation allow for exceptional accuracy in reaching even the smallest and most peripheral lung nodules. This means a higher chance of obtaining a diagnostic sample on the first attempt.
  • Minimally Invasive: By navigating through natural airways, ION avoids the need for larger incisions, contributing to less discomfort and faster recovery compared to more invasive methods.
  • Access to Difficult Nodules: ION enables access to nodules that were previously difficult or impossible to biopsy non-surgically, offering earlier diagnostic capabilities for more patients.
  • Earlier Diagnosis, Better Outcomes: Timely and accurate diagnosis is paramount in lung cancer. By providing a definitive diagnosis for hard-to-reach nodules, ION helps accelerate the path to personalized treatment plans, potentially leading to better outcomes.
  • Highly Skilled Team: Our pulmonologists are specially trained and highly experienced in operating the ION robotic bronchoscopy system, ensuring you receive expert care with this cutting-edge technology.

At Dignity Health, our investment in ION robotic bronchoscopy underscores our commitment to advanced lung health and providing our community with the most precise diagnostic tools available. If you have a suspicious lung nodule, discuss with your physician whether ION could be part of your diagnostic pathway.

Endobronchial Ultrasound (EBUS)

EBUS stands for Endobronchial Ultrasound.

It's a minimally invasive, sophisticated procedure used primarily in pulmonology to diagnose and stage lung cancer and other chest conditions.

What is EBUS and How Does It Work?

EBUS is a specialized bronchoscopy that combines conventional bronchoscopy with ultrasound technology. During an EBUS procedure, a thin, flexible tube (bronchoscope) equipped with a tiny ultrasound probe at its tip is guided into the airways. This allows our expert pulmonologists to:

  • Visualize Beyond the Airways: The ultrasound provides real-time, high-resolution imaging of structures located outside the bronchial walls, such as lymph nodes, masses, and lesions in the mediastinum (the space between the lungs).
  • Targeted Biopsy: Once a suspicious area is identified, a fine needle can be passed through the bronchoscope under direct ultrasound guidance to collect tissue samples (biopsy). This ensures highly accurate sampling of the precise target, minimizing risks and maximizing diagnostic yield.

Why EBUS is Important (Its Uses):

  1. Lung Cancer Diagnosis and Staging: This is its most common and critical application.
    • Biopsy of Lymph Nodes: Lung cancer often spreads to the lymph nodes in the chest. EBUS allows for precise sampling of these nodes (mediastinal and hilar lymph nodes) to determine if cancer has spread, which is crucial for accurate staging and treatment planning.
    • Biopsy of Tumors: EBUS can also be used to biopsy tumors located near the airways, or even to directly sample the tumor itself.
  2. Diagnosis of Other Conditions:
    • Sarcoidosis: EBUS is excellent for diagnosing this inflammatory disease by sampling affected lymph nodes.
    • Infections: It can help diagnose certain fungal or bacterial infections that cause lymph node enlargement.
    • Other Mediastinal Masses: It can be used to biopsy other unexplained masses or enlarged lymph nodes in the mediastinum (the area between the lungs).

Key Benefits of EBUS:

  • Minimally Invasive: EBUS offers an effective alternative to more invasive surgical procedures, resulting in quicker recovery times and reduced discomfort for the patient.
  • Highly Accurate Diagnosis: The real-time ultrasound guidance allows for precise targeting, leading to more accurate diagnoses of lung cancer, sarcoidosis, infections, and other mediastinal conditions.
  • Lung Cancer Staging: EBUS is invaluable for lung cancer staging, enabling our team to determine if cancer has spread to lymph nodes, which is critical for planning the most effective treatment strategy.
  • Outpatient Procedure: Most EBUS procedures are performed on an outpatient basis, meaning patients typically return home the same day.

In simple terms, EBUS gives pulmonologists "eyes" outside the airways, allowing them to safely and accurately biopsy critical structures in the chest without major surgery.

At Dignity Health, EBUS is another example of our commitment to providing advanced diagnostic tools for comprehensive lung care, helping our patients receive timely and precise answers.

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