Doctors says high-tech procedure increases early detection of lung cancer

A high-tech procedure newly available through Saint Francis Healthcare System increases the possibility of early detection of lung cancer, doctors say.

Hussein Asad

Hussein Asad

The procedure is called a robotic bronchoscopy, which is a minimally invasive biopsy of nodules in the lung.

Hussein Asad is an interventional pulmonologist at Cape Pulmonology and Sleep Medicine, a Saint Francis Medical partner. Asad said for patients at risk of lung cancer, early detection can mean the difference between life and death.

"Lung cancer is the third most common cancer in the U.S., but it's the No. 1 killer," Asad said.

For patients who have received scans showing nodules in their lungs, a biopsy is necessary to determine not only whether the nodule is cancerous, but the type of cancer and most importantly the stage the cancer has reached, Asad said.

For many years, the best way to perform a biopsy in the lungs was through a transthoracic needle aspiration (TTNA) procedure. This is piercing the chest wall with a needle, from the outside-in, through the patient's side or back, depending on where the nodule is located in the lung.

Asad performs the relatively new robotic bronchoscopy procedure, which uses a catheter fed down the patient's windpipe into the lungs. He said this is an outpatient procedure involving almost "zero pain."

He uses the Ion Endoluminal System created by Intuitive, a company that specializes in minimally invasive surgical procedures. Intuitive's website, intuitive.com, describes the Ion endoluminal system as a robotic-assisted platform for minimally invasive biopsy in the lung.

The term "robotic" can be misleading. No part of the procedure is automated by a robot or computer. The navigation to the lungs and the actual biopsy are completely under Asad's control.

"Robotic" refers to the mapping of the path to the nodule. Asad described it as similar to using Google Maps. The Ion system uses computed tomography (CT) scans of the patients' lungs to create a three-dimensional map to guide doctors to the nodule.

"Essentially, the robot helps in the shape sensing technology," Asad said. "The robot cannot drive itself. Without me and my team, the robot is useless."

Asad said the advantage of a robotic bronchoscopy over a TTNA is the Ion system enables him to do more biopsies in one procedure and get to previously unreachable nodules. He said that while a TTNA can gather more tissue than the Ion system, it was only about 70% to 80% accurate in reaching the nodule while the Ion is closer to 95% accurate.

Asad said the robotic bronchoscopy procedure is for any type of patient who would require a biopsy to confirm a diagnosis of malignancy of lung cancer, especially smokers.

"This procedure is for patients who need an early answer," Asad said. "The entire usefulness of this procedure is going to depend on how early you catch lung cancer. Time is money. Time means more life."