Interventional Pulmonology: Diagnostic Tests
Learn More About Interventional Pulmonology at Eastern: Chat with Us | Email Us
Developing a pulmonary treatment plan
When you arrive at CTCA at Eastern Regional Medical Center, you will have a multidisciplinary team of cancer experts caring for you. If pulmonary medicine is part of your care, you’ll meet with Dr. Lund and his team. “We have patients who travel from all over the world to come here,” says Morrow.
Before you begin treatment, your care team will work with you to develop a personalized treatment plan that best suits your needs. This plan is based on an understanding of the location and stage (extent) of the cancer, as well as the existence of metastasis.
The treatment of metastatic cancer depends on where the cancer started. There is a common misconception that when cancer metastasizes to the lung, it is considered lung cancer and requires lung cancer treatment. However, a cancer that spreads to the lung is still the original cancer and should be treated accordingly.
Also, sometimes patients can develop more than one cancer, or a generalized lung problem. Treatment will vary for each of these circumstances. “Each cancer is treated differently. Therapy depends on a good diagnosis of the type of tumors you have. Our doctors are very thorough. We biopsy it so we know what we are dealing with, and then we implement an individualized treatment plan,” says Morrow.
Moreover, an accurate diagnosis is essential in determining which cancer treatments will be best suited to you. Dr. Lund and the rest of your care team at Eastern will use advanced diagnostic procedures and tests to develop your individualized treatment plan.
Diagnostic tests/procedures
The following are some of the diagnostic tests/procedures the pulmonology team performs:
- Biopsy: The removal and examination of a small piece of tissue for diagnostic, staging and/or treatment purposes. A biopsy can determine which type of cancer is present and whether the cancer began at the site of the biopsy sample, or started somewhere else in the body and spread to the site of the biopsy sample. For instance, a biopsy of a tumor in the lung may reveal breast cancer cells.
Examples of biopsies include endobronchial (to obtain a sample tissue inside the bronchus), transbronchial (to obtain a sample tissue further away from the main divisions of the bronchi), and needle aspiration (to extract cells or tissue from the lung or airway using a thin needle).
Flow cytometry: A technique used to examine the cells of a biopsy sample. The cells being examined are treated with special laboratory antibodies and are passed in front of a laser beam.
Pulmonary Function Testing (PFT): A test in which you breathe in and out through a tube connected to machines to help determine how well your lungs are working. Your doctor may perform this test to help determine if surgical removal of part of the lung is an option for you.
CT scans: An x-ray procedure which uses a computer to generate three-dimensional, cross-sectional images of the body to reveal where the tumors are and what they look like. The pulmonary team offers virtual bronchoscopy CT scans, which use 3D reconstruction imaging to navigate directly to a tumor (similar to the way a GPS navigates a driver) to evaluate the airway and look for an obstruction. The team also provides spiral computed tomography, a method of CT scanning in which a continuous spiraling motion takes detailed 3D pictures of the body with speed and accuracy.
Ultrasounds: An imaging technology that uses high-energy sound waves to construct precise images of organs and tissues within the body. While chest x-rays are commonly performed when patients are coughing, ultrasounds are performed on patients who have fluid in the lungs.
In July 2008, CTCA at Eastern Regional Medical Center acquired endobronchial ultrasound technology. In this imaging test, a bronchoscope is fitted with an ultrasound transducer at its tip and is passed down into the windpipe to look at the area between the lungs. A hollow needle is then passed through the bronchoscope, using ultrasound guidance, to obtain a biopsy.
- Nuclear medicine imaging: Tests which involve administering very small amounts of radioactive substances by injection, inhalation, or pill to examine the level of function of the lungs, and to help diagnose various conditions. Quantitative ventilation-perfusion scans use inhaled and injected radioactive material to measure breathing and circulation of blood in areas of the lungs. The test helps determine if the area is still well-profused with blood, which is important because a patient’s condition can worsen if surgery is performed on a patient with no blood flow in that area.
- Medical plueroscopy: A procedure which involves making a small incision in the pleural space between the lungs and chest wall and using a thoracoscope (a thin, tube-like instrument) to view the inside of the chest. This method, which the hospital introduced in July 2008, can help diagnose tumors inside the chest lining.
In addition, the department also helps diagnose and manage complications of cancer treatments. For instance, some chemotherapeutic agents can cause scarring in the lung. The pulmonology team will evaluate and treat the complications or side effects of chemotherapy and/or radiation therapy. The team will also differentiate between complications of the therapy, progression of cancer, and the possibility that the condition is something else.