Lung nodule biopsies performed with latest robotic bronchoscopy technology could also be safer and more practical than those done by traditional methods, a study by researchers at UT Southwestern suggests.

UT Southwestern was the primary medical center in Dallas-Fort Value – and among the many first within the country – to make use of robotic-assisted bronchoscopy (RAB) to biopsy pulmonary lesions. Paired with advanced imaging that gives real-time 3D visuals, the technology enables UTSW’s Interventional Pulmonology team to navigate an ultra-thin, ultra-flexible tube with light and camera capabilities right into a patient’s lungs to pinpoint and test suspicious abnormalities.

The increased dexterity of the steerable tube makes it possible to securely reach areas within the lungs that couldn’t be accessed through traditional bronchoscopy and other sampling tools.

A retrospective evaluation of 200 of those procedures – the biggest cohort studied thus far – found that shape-sensing, robotic-assisted bronchoscopy (ssRAB), when combined with technologies equivalent to intra-procedure cone beam CT imaging (CBCT) and radial endobronchial ultrasound, offers high diagnostic accuracy, sensitivity, and specificity with a superb safety profile. The findings were published in Lung.

“The goal of advanced bronchoscopy is to diagnose lung nodules and perform mediastinal staging in a single procedure, while achieving a comparable diagnostic yield to percutaneous biopsy and at the identical time, minimizing complications,” said Kim Styrvoky, M.D., Assistant Professor of Internal Medicine within the Division of Pulmonary and Critical Care Medicine at UT Southwestern, and Muhanned Abu-Hijleh, M.D., Professor of Internal Medicine within the Division of Pulmonary and Critical Care Medicine. Drs. Styrvoky and Abu-Hijleh are members of the Interventional Pulmonary section at UTSW and the Harold C. Simmons Comprehensive Cancer Center.

The diagnostic yield of current bronchoscopic techniques is proscribed, and there may be a few 1 in 4 likelihood of pneumothorax, or collapsed lung, with percutaneous biopsy. Our study showed that this latest technology provided accuracy of 91.4%, on par with traditional biopsy methods, while reducing the danger of pneumothorax complication to 1%.”

Dr. Kim Styrvoky, M.D., Assistant Professor of Internal Medicine within the Division of Pulmonary and Critical Care Medicine at UT Southwestern

Lung cancer stays the leading reason behind cancer-related deaths for each men and ladies within the U.S. Every year, between 1.5 million and a couple of million pulmonary nodules – spots or related abnormalities – are identified through diagnostic imaging. UT Southwestern is using robotic bronchoscopy in cases where traditional biopsies present the next risk of complications, including patients with lesions deep within the lung, near major blood vessels, or adjoining to a portion of diseased lung.

This was UTSW’s first reported study detailing the usage of ssRAB-CBCT, but other trials specializing in various features of robotic bronchoscopy are underway.

If further studies confirm the findings, ssRAB-CBCT has the potential to change into the usual of take care of targeted lung sampling, Drs. Styrvoky and Abu-Hijleh said.

Other UTSW researchers who contributed to this study include Audra Schwalk, David Pham, Hsienchang T. Chiu, Kristine Madsen, Stephen Carrio, Elizabeth M. Kurian, and Luis De Las Casas.

All Interventional Pulmonary faculty at UT Southwestern, including Drs. Abu-Hijleh, Chiu, Styrvoky, and Schwalk, in addition to bronchoscopy support staff in UTSW’s Endoscopy unit, received training related to robotic bronchoscopy procedures through Intuitive Surgical Inc. This included lab procedures and equipment, following standards of care, and the credentialing process. Dr. De Las Casas has served as a consultant for Intuitive since 2021.

Source:

UT Southwestern Medical Center

Journal reference:

Styrvoky, K., et al. (2022) Shape-Sensing Robotic-Assisted Bronchoscopy with Concurrent use of Radial Endobronchial Ultrasound and Cone Beam Computed Tomography within the Evaluation of Pulmonary Lesions. Lung. doi.org/10.1007/s00408-022-00590-7.