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Diagnostic Evaluations

Bronchoscopy

In this procedure, a thin, lighted tube connected to a camera (called a bronchoscope) is inserted through the patient’s mouth or nose and into the lungs. The bronchoscope helps examine the bronchial path, including the trachea (windpipe), bronchi (tubes inside the lungs) and lungs.

Oncologists typically use bronchoscopy to:

  • Locate and identify suspected tumors
  • Evaluate the extent of the cancer
  • Identify the cause of symptoms (e.g., difficulty breathing)
  • Reveal and treat obstructions in the airway
  • Collect sample lung tissue or fluid for lab analysis
  • Perform certain treatment procedures (e.g., brachytherapy)

Bronchoscopy procedures may find cancerous cells that other surgical and imaging tools may not detect. For lung cancer patients, bronchoscopies often reduce the risks of more invasive lung biopsies.

Some types of bronchoscopy procedures include those listed below.

Autofluorescence bronchoscopy/fluorescence bronchoscopy

Autofluorescence bronchoscopy, also known as blue-light bronchoscopy, is used to find and diagnose tumors in the lung early on.

During the procedure, a bronchoscope (a thin, lighted tube connected to a camera) is inserted through the mouth or nose into the lungs to examine the airways. Under fluorescence, healthy tissues appear green and abnormal tissues appear reddish-brown. Once abnormal tissues are identified, a small sample of the tissue may be removed for further analysis.

This technology lets doctors identify areas of abnormality in the bronchial tubes that may not be visible under white-light examination. It also helps detect cancerous tumors in early stages.

When a tumor is identified early (e.g., while it is still confined to the lung), other procedures may be possible, such as surgery, radiation therapy, laser ablation, photodynamic therapy and brachytherapy.

Navigational bronchoscopy

Navigational bronchoscopy is used to help doctors find and reach tumors located in the periphery of the lungs, where smaller bronchi are not wide enough to allow passage of a normal bronchoscope. With navigational bronchoscopy, doctors may find lung tumors, take biopsies and administer treatment.

Navigational bronchoscopy, which combines advanced imagine techniques with electromagnetic navigation, is used to:

  • Find and biopsy suspicious masses
  • Suction excess fluid or mucus from the airway or chest
  • Control bleeding in the airway
  • Treat tumor in the airway using HDR brachytherapy
  • Place airway stents
  • Place catheters in vital areas of the lungs

Navigational bronchoscopy is minimally invasive compared to percutaneous lung biopsy procedures. It also requires less time for recovery and may be performed on an outpatient basis.