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Biopsy and Diagnosis of 9mm Nodule in Right Middle Lobe

Biopsy and Diagnosis of 9mm Nodule in Right Middle Lobe

Case Details

Lesion Characteristics

Lesion Size (diameter): 9 mm

Lesion Location: Right Middle Lobe

Bronchus Sign: Yes

Visible on Fluoro: No

REBUS Verification: Concentric Rebus Confirmation


Case Information

Time to First Biopsy: 13 minutes

Full Procedure Time: 30 minutes

ROSE: No ROSE on-site

Definitive Diagnosis: Adenocarcinoma


Background

A 67-year-old woman, non-smoker. CT completed due to unexplained weight loss.


Planning


In Planning, the pre-operative CT was uploaded and the lesion and lesion boundaries were marked. The Body Vision System proposed different pathway options to reach the lesion and Dr. Abramovich chose the appropriate one.
In Planning, the pre-operative CT was uploaded and the lesion and lesion boundaries were marked. The Body Vision System proposed different pathway options to reach the lesion and Dr. Abramovich chose the appropriate one.


Virtual Navigation


Dr. Abramovich viewed and verified the virtual pathway via Body Vision's virtual bronchoscopy.
Dr. Abramovich viewed and verified the virtual pathway via Body Vision's virtual bronchoscopy.

CABT Registration



Using only a conventional C-arm, Body Vision produced a tomographic reconstruction of the lesion in 3D, thus enabling Dr. Ambramovich to see the real-time, accurate lesion location and overcome any concerns with CT-to-body divergence.
Using only a conventional C-arm, Body Vision produced a tomographic reconstruction of the lesion in 3D, thus enabling Dr. Ambramovich to see the real-time, accurate lesion location and overcome any concerns with CT-to-body divergence.



Tool-in-Lesion CABT


Here, Dr. Abramovich was able to confirm the tool was inside the lesion using Body Vision's real-time, CABT technology.
Here, Dr. Abramovich was able to confirm the tool was inside the lesion using Body Vision's real-time, CABT technology.


Biopsy


Dr. Abramovich successfully takes a biopsy sample from within the lesion using forceps.


Conclusion

Small nodules should be diagnosed even if the patient does not have risk factors. The Body Vision system is capable of assisting a definitive diagnosis by creating a reliable augmented fluoroscopy image and providing real-time, CABT tool-in-lesion confirmation in nodules as small as only a few millimeters.


About Dr. Amir Abramovich



Director, Interventional Pulmonology

Carmel Medical Center

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