{"id":5016,"date":"2015-11-11T00:00:00","date_gmt":"2015-11-11T07:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2015\/11\/11\/closer-look\/"},"modified":"2021-08-03T09:25:20","modified_gmt":"2021-08-03T15:25:20","slug":"closer-look","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/closer-look\/","title":{"rendered":"Closer look"},"content":{"rendered":"
<\/div>

The spot on Roy Yant\u2019s lung X-ray was in the far corner of his left upper lobe \u2014 a notoriously challenging place to biopsy. The 70-year-old doesn\u2019t use GPS himself, and he never imagined he\u2019d be the first patient in northern Colorado to benefit from a new GPS-like technology designed to navigate tiny lung airways in such a situation.<\/p>\n

Called Electromagnetic Navigation Bronchoscopy, or ENB, the technology is a new development in bronchoscopy, which is a common procedure that allows pulmonologists to see into the throat, larynx, trachea and lower lungs. Bronchoscopies are used to diagnose various airway diseases, from lung inflammation to infections to cancer. Trouble is, traditional bronchoscopy equipment can\u2019t reach into the smallest airways, which narrow down to less than 1 millimeter in diameter. And over two-thirds of lung masses are located in those tricky nooks, according to the ENB superDimension system\u2019s manufacturer, Covidien.<\/p>\n

\u201cNow we have the ENB,\u201d said Kirk DePriest, MD, a pulmonologist with UCHealth Pulmonology in Fort Collins and Loveland. \u201cMy colleague, Dr. Richard Milchak, and I are using it for all areas where we can\u2019t see with a regular bronchoscope. It\u2019s safer for the patient than CT-guided needle biopsy, and it\u2019s helping us pick up more lung cancers sooner. The earlier the stage of the cancer when found, the better the outcome.\u201d<\/p>\n

\"screen
Photo source: Covidien<\/figcaption><\/figure>\n

The ENB\u2019s GPS system works like this: First, the patient\u2019s lungs are imaged with endobrachial ultrasound, or EBUS. The crisp, highly-detailed pictures are loaded into the ENB computer, which creates a 3-D map of the patient\u2019s lungs. Then the patient lies on a special low-frequency electromagnetic bed and is sedated for comfort.<\/p>\n

As in a normal bronchoscopy, doctors insert a long, thin, lighted tube through the mouth and into the airways, but the ENB also has an extended wire with a locatable guide at its tip.\u00a0As it travels\u00a0over the electromagnetic bed, the precise whereabouts of the locatable guide inside the lungs can be seen on a bedside computer screen, much as your car\u2019s location shows up in real time as a moving dot on your GPS or phone\u2019s mapping app.<\/p>\n

Using the lung and locatable guide images, doctors then slowly and carefully \u201cdrive\u201d the ENB tip to its final destination.<\/p>\n

In February 2014, Yant reported to Poudre Valley Hospital for his outpatient ENB procedure. Because it was the technology\u2019s UCHealth Northern Colorado debut, a number of medical professionals observed iy. \u201cThe room was packed with people,\u201d he recalled.<\/p>\n

\u201cI thought it was pretty exciting for him to be the first,\u201d said Rose, Yant\u2019s wife. \u201cAnd it was a simple procedure. We were back home a few hours later.\u201d<\/p>\n

\u201cWhen we combine ENB with EBUS ultrasound, we have a fantastic technology,\u201d DePriest said. \u201cWe can accurately target a peripheral lung mass as well as the lymph nodes. A pathologist standing by in the procedure room can then tell us immediately if a mass or the lymph nodes are cancerous. In Roy\u2019s case, only the lung tumor was malignant, so we knew he was a surgical candidate.\u201d<\/p>\n

Doctors of different but related specialties often work together to help UCHealth patients, DePriest said. The multidisciplinary clinic where he practices includes a thoracic surgeon, a radiologist, pulmonologists, research coordinators and a lung-patient navigator. The staff and physicians gather to discuss in detail the case of every patient on that week\u2019s docket. They put their heads together and ask questions like: Do we have the right tissue samples? What are the best treatment options for this patient? How is the patient feeling physically? The vetted answers help ensure each patient receives the best care.<\/p>\n

\u201cWhen a person walks into something like lung cancer — that sounds like a death sentence,\u201d DePriest said. \u201cBut when multiple experts are weighing in on each patient\u2019s case, and we can bring the consensus recommendation to the patient, they know that an entire team is helping figure out the best approach.\u201d<\/p>\n

A few weeks after Yant\u2019s ENB procedure, UCHealth thoracic surgeon Michael Stanton, MD,\u00a0removed the upper lobe of Yant\u2019s left lung. The Fort Collins resident didn\u2019t require chemotherapy or radiation, and now he\u2019s back to golfing, fishing and volunteering at the American Legion.<\/p>\n

\u201cI feel good now,\u201d he said.<\/p>\n

\n

What\u2019s ENB for?<\/strong><\/p>\n

Deployed in early 2014 at Poudre Valley Hospital, Electromagnetic Navigation Bronchoscopy, or ENB, offers patients many benefits:
\n\u2022 A new approach to detecting lung cancer earlier.
\n\u2022 Availability to a wide range of patients, including those who suffer from poor lung function or have had cancer surgery, chemotherapy, and\/or radiation therapy.
\n\u2022 Enables physicians to take tissue samples from lung masses in areas that are inaccessible with traditional bronchoscope.
\n\u2022 Can be used to place fiducial markers for guiding external beam radiation therapy.
\n\u2022 Can be used to place markers near the lung\u2019s surface for video-assisted thoracic surgery, or VATS.<\/p>\n","protected":false},"excerpt":{"rendered":"

The spot on Roy Yant\u2019s lung X-ray was in the far corner of his left upper lobe \u2014 a notoriously challenging place to biopsy. The 70-year-old doesn\u2019t use GPS himself, and he never imagined he\u2019d be the first patient in northern Colorado to benefit from a new GPS-like technology designed to navigate tiny lung airways […]<\/p>\n","protected":false},"author":2164,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[471,24,177],"class_list":["post-5016","post","type-post","status-publish","format-standard","hentry","category-innovative-care","tag-bronchoscopy","tag-northern-colorado","tag-pulmonology"],"acf":[],"yoast_head":"\nCloser look - UCHealth Today<\/title>\n<meta name=\"description\" content=\"The spot on Roy Yant\u2019s lung X-ray was in the far corner of his left upper lobe \u2014 a notoriously challenging place to biopsy. 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