Today, advanced imaging technologies are detecting a higher percentage of nodules in the lungs.  The majority of these nodules are located in the peripheral areas of the lungs where the traditional bronchoscope cannot reach.  Though most lung nodules are benign, it is very important to identify those which show malignancy early, when cancer treatment is most successful.  Previously used procedures are invasive and may leave patients with a high risk of pneumothorax (collapsed lung).  However, a newly offered procedure at Licking Memorial Hospital (LMH) is safer and less invasive. 
 
Asegid Kebede, M.D., now offers Electromagnetic Navigational Bronchoscopy^® (ENB), which allows access to the small airway passages in the periphery of the lungs that previously were difficult to reach.  The process provides navigation through technology similar to a Global Positioning System (GPS) unit.  “ENB uses virtual bronchoscopy and real time 3-dimensional Computerized Tomography (CT) images that enable us to localize these peripheral lung nodules,” said Dr. Kebede.  “It is basically a 3D roadmap to the patient’s lung.  ENB identifies the exact spot where the lesion is located in order to collect a biopsy.” 
 
The most common reason for having an ENB procedure includes abnormal findings on a chest X-ray or CT scan showing a spot on the lung.  ENB provides a less invasive pathway to peripheral lung nodules, even for patients with procedure-restricting conditions. 
 
According to Dr. Kebede, tissue diagnosis is essential for patients with a high probability of lung cancer, including those with compromised lung function.  The minimally invasive outpatient procedure has a marginal risk of pneumothorax (2 to 3 percent) and its published diagnostic yield rates range from 67 to 86 percent.  “The benefit of ENB is potentially detecting lung cancer earlier and enhancing treatment options for patients,” said Dr. Kebede. 

The technology uses the i•Logic™ System from superDimension^®, which enhances the ability to collect tissue samples from very small nodules earlier and more safely than other methods.  In addition, i•Logic can also be used for radiosurgical marker placement for guiding external beam radiation therapy and to place markers near the pleural surface for video-assisted thoracoscopic surgery (VATS) pulmonary procedures.  To learn more about ENB, contact the LMH Pulmonology Department at (220) 564-1805.