Inside Body Vision Process
Dana Halperin - April 19, 2021

Following two recent publications in the Journal of Bronchology and Interventional Pulmonology, one in July 2020 and another in October 2020, Body Vision gained interest and inquiries from Pulmonologists and key opinion leaders worldwide. We are often asked, “How is your technology different from Electromagnetic Navigation Bronchoscopy (ENB), and what are the benefits of using Body Vision in my practice?”

 

These questions are important and have been a key component of our mission since day one. Body Vision is not just a navigation system but also an advanced, real-time, imaging modality. Contrary to pre-existing technologies on the market that rely on a random biopsy sample approach, Body Vision technology makes lesions and pathways visible and offers real-time, tool-in-lesion confirmation. This approach is revolutionizing pulmonary practice from blind biopsy to evidence-based biopsy.

 

Other navigation systems extend the bronchoscopy working channel or sheath to the proximity of the lesion. However, extending the working channel is only an intermediate goal of a procedure. The main purpose is to get a tissue sample from the area of the suspicious lesion. Until our advanced imaging technology, no product enabled physicians, working in the conventional bronchoscopy suite, to confidently get to the pulmonary lesion, confirm their tool in the lesion and take an evidence-based sample from that lesion in real time.


The Procedure

The lung diagnostic procedure empowered by Body Vision includes two phases.

1) Pre-procedure Planning

2) Artificial Intelligence Navigation Bronchoscopy

 

Pre-Procedure Planning

The first phase is pre-procedure planning. In this phase, the goal is to mark any suspicious lesions on CT and plan the potential pathway to each. This may occur at any time per the doctor’s choice, before or after the patient enters the procedure room. Here are the steps to planning the optimal pathway:

 

1) Upload the preoperative CT.

2) The lesion is identified, and the lesion and lesion boundaries are marked.

 

 

3) Powered by Artificial Intelligence, the LungVision™ System learns the anatomical structure of the lung and identifies potential pathways to the lesion. The physician chooses the preferred pathway and LungVision™ highlights the pathway from the entrance of the trachea to the lesion.

 




4) Once the pre-procedure planning phase is complete, in preparation for the Artificial Intelligence Navigation Bronchoscopy procedure, the physician and his/her team learn the future procedure through a simulated virtual bronchoscopy visualization.

 

5) Once planning is complete, the procedure is ready to begin.

 

Artificial Intelligence Navigation Bronchoscopy

Artificial Intelligence Navigation bronchoscopy can be performed in the standard bronchoscopy suite. The Body Vision system is compatible with a wide range of C-arms and scopes. According to the physician’s choice, It can be used with or without a radial EBUS probe. Its nimble and seamless design allows easy room-to-room mobility if desired. By design, it does not have any sensors so its smooth operation does not interfere with any equipment in the bronchoscopy suite. Once the patient and staff are ready the procedure begins.



Artificial Intelligence Navigation bronchoscopy is comprised of the following steps:


1) Navigation

The purpose of this step is to place the distal tip of LungVision™ sheath, a part of the disposable procedural kit, into the lesion.

 

The navigation step starts with a quick C-Arm setup. This step enables physicians to use any conventional C-Arm to produce a tomographic reconstruction of the actual lesion in 3D.

Then the actual lesion and the pre-planned pathway become visible and are displayed on the conventional fluoroscopic view. Initially, virtual bronchoscopy guides the navigation of the bronchoscope. Once the bronchoscope reaches its physical limits when its outside diameter is larger than the airways leading to the periphery of the lungs, the disposable LungVision™ Procedural Kit is used to extend the working channel and reach the lung lesion under the guidance of advanced, real-time imaging. Then the real-time augmented Fluoroscopy view including the highlighted target, pathway, and adjunctive airways, guides the placement of the distal tip of the LungVision™ sheath into the actual lesion.

 

2) Tool-in-lesion Confirmation

Once the LungVision™ sheath is at the target lesion location, it’s time to insert a biopsy tool. Before the sampling, it’s recommended to confirm that the biopsy tool is indeed inside the lesion in all planes of the 3D space through Body Vision’s CABT™ technology. With CABT™ tool-in-lesion confirmation in 3D space, the user can see the biopsy tooltip and actual lesion spatial relationship. With the help of this advanced imaging, physicians can study and improve the position and directionality of their biopsy tool relative to the actual lesion on tomography view. With this approach the question of accuracy becomes obsolete. There is no CT-to-Body divergence because the actual lesion is revealed with a conventional C-Arm without the use of preoperative CT. With Body Vision technology, what you see is what you get.

 

CABT™ technology allowing real-time, tool-in-lesion confirmation in 3 planes.


CABT™ tool-in-lesion confirmation is also available in 3D view.


 LungVision™ technology is highly compatible and provides physicians with the flexibility to use any instrument of their choice. If desired, physicians may choose to use a Radial EBUS probe inside the LungVision™ sheath, before inserting the biopsy tool. This is not a mandatory step but is an option for lesion verification without a biopsy tool. Physicians are also able to use advanced LungVision™ imaging with radial EBUS side by side.

 

3) Managed Biopsy Process

Once the tip of the biopsy tool is confirmed inside the lesion in real-time, biopsy samples are taken from the actual lesion area. With LungVision™ the biopsy process is well managed and there is no longer any need for random biopsy samples in different locations around a virtual lesion. The LungVision™ procedural kit makes most off-the-shelf, biopsy tools compatible with LungVision™ technology to collect specific samples from within the lesion. Making diagnostic calls from small lesions is challenging, so confidently knowing that the sample is taken from the suspicious lesion itself is imperative for a definitive diagnosis.



BodyVision technology enables a real-time, evidence-based solution from the scope in to scope out for pulmonary doctors and their team. We are committed to fulfilling the unmet clinical need of small pulmonary lesion diagnostics while supporting timely and reliable clinical outcomes with a comprehensive system at low operational costs.


If you are considering an advanced bronchoscopy system for your practice, be sure to read our blog, Determining Success of a Navigation System, where Body Vision partner, Dr. Michael Pritchett, shares the unmatched level of confidence that our platform provides.