New Diagnostic Tool Aids Lung Cancer Treatment

Bronchoscopy has long been an essential tool for thoracic surgeons diagnosing and staging lung cancer. The device is a thin, flexible tube that allows physicians to peer into the airways of patients while performing biopsies. But for the past year, NYU Medical Center experts have had access to even better technology, the OLYMPUS BF TYPE UC160F-OL8, that combines both video and fiber optic technologies with ultrasound capabilities for an up-to-the-minute picture of the lymph nodes.

"Thanks to brand new machinery, surgeons can see the needle going into lymph nodes in real time. It's no longer done blindly, and can potentially save patients from having an invasive procedure," explains Harvey I. Pass, MD, Professor of Surgery and Cardiothoracic Surgery, and Chief of Thoracic Surgery and Thoracic Oncology at NYU Medical Center. He reports that, according to Olympus, NYU's Division of Thoracic Surgery is one of the most experienced groups in New York City at this time.

Alongside Dr. Pass, the team includes physicians Costas Bizekis, MD, Michael D. Zervos, MD, Bernard K. Crawford, MD, and Jessica S. Donington, MD, all whom are Assistant Professors of Cardiothoracic Surgery. The technology is also currently used at Bellevue Hospital Center, which is affiliated with the NYU School of Medicine.

In the operating room, thoracic surgeons insert a fine needle into suspicious lymph nodes to remove only a few cells. Pathologists can then do instant readings on these cells, leading to instant diagnosis by the clinical team that also includes pulmonologists. Patients are spared the more traditional procedure, called mediastinoscopy, in which incisions are made at the top of the breast bone or the chest to physically remove lymph nodes for staging.

Though the Olympus machine is well-established and no longer considered experimental, surgeons still face a learning curve when acquiring the specialized skills necessary to perform the procedure properly. The NYU Thoracic Surgery team is now at the point where, if the lymph node has a known location, it can be diagnosed with 95 percent accuracy, notes Dr. Pass.

In addition, endobronchial ultrasound is proving to be a useful tool for conducting genomics and proteomics studies on genes and proteins. "We can get tissue in a kinder, gentler fashion that can be used for translational research," Dr. Pass says, referring to the trend for basic scientific findings to quickly move from the lab to the hospital, where they can benefit patients.

For more information on real-time endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA), please contact Dr. Pass at the NYU Clinical Cancer Center at (212) 731-5415.