Radial EBUS(Endobronchial ultrasound)- a newer modality to diagnose early lung cancer
Endobronchial ultrasound (EBUS) is a minimally invasive but highly effective procedure used to diagnose lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest or lump in the lungs which are beyond the reach of conventional bronchoscopy.
There are two types of EBUS- Linear EBUS and Radial EBUS. Linear EBUS allows physicians to obtain tissue or fluid samples from the lymph nodes or tumours surrounding lungs and heart without conventional surgery. Radial EBUS helps in identifying and sampling peripheral small lung tumours/lung infections.
A 70 year old male presented to our hospital with complaints of weight loss of 6 kgs over 2 months and cough for 2 days. Chest X-ray was done which showed a nodular lesion in the left upper zone. Subsequently, a CT scan of the chest was done which showed a 2.8cm tumour in the left upper lobe suspicious of lung cancer. This lesion could not be biopsied using conventional routine bronchoscope. Hence, we decided to biopsy the lung tumour with the help of Radial EBUS.
Fig: Tumour in the left lung being biopsied with the help of radial EBUS
With the help of special mapping technique, the tumour was mapped to peripheral sub-sub-segment of upper lobe of the left lung. Dr.Baranitharan, Consultant Interventional Pulmonologist at the GKNM hospital, Coimbatore biopsied the tumour using radial EBUS and the pathology report confirmed a type of lung cancer called Non-Small cell lung cancer. The whole procedure was done under mild sedation only. Subsequent PET scan done to stage the tumour did not show any evidence of cancer spread to other organs, hence confirming early stage lung cancer(Stage I). Patient subsequently underwent surgery(lobectomy) for the removal of the tumour under Dr.Chandrasekar, Consultant Cardiothoracic Surgeon, GKNM hospital and is doing well post operatively.
Ours is the first centre to do Radial EBUS in Coimbatore and the second in Tamilnadu state.