This is a 54 y.o. female presenting with a 10 mm lesion in the left lower lobe (Figure 1). She was a non-smoker and had a history of breast cancer. She was scheduled forendobronchial biopsy to achieve adequate tissue sampling for pathology analysis and diagnosis.
Subsequent to patient intubation, the ceiling mounted C-arm system (Allura Xper FD20, Philips) was positioned on the left side of the patient, centering the field of view of the detector to include both lungs. Cone Beam CT data (XperCT, Philips) was acquired during an 8-second roll protocol, while temporarily suspending mechanical ventilation. Using the Cone Beam CT data, the lung nodule was highlighted by the physician using commercially available software (Lung suite, Philips)* during a process known as segmentation. During the biopsy procedure, this 3D nodule segmentation was visualized in an overlay with live fluoroscopy (3D Roadmap, Philips) parallel to standard fluoroscopy imaging and electromagnetic navigation bronchoscopy (ENB) (SuperDimension, Medtronic) (Figure 2). This was particularly critical in this patient as the lesion was fluoroscopically invisible. Geometric correspondence of live fluoroscopy and 3D tumor segmentation was maintained throughout the case while manipulating C-arm angulation, table position, and image-zoom settings.
Results from case studies are not predictive of results in other cases. Results in other cases may vary.
* Lung suite is the combination of our XperCT Dual, XperGuide Ablation and Dynamic 3D Roadmap solutions