Hackensack University Medical Center One of First Hospitals in Northeast to Roll out Ion Navigational Bronchoscopy Imaging Software Upgrade

Next-generation Ion software addresses CT body divergence to give real-time nodule location confirmation

December 11, 2024

CT body divergence is a fundamental challenge in navigational bronchoscopy for lung biopsies, where accurate diagnosis of potential lung cancer is paramount. The static CT scan performed prior to the biopsy may not always align in real-time with the patient’s actual airways and lung tissue during the procedure. Depending on the location and size of the target, being off by even 1 mm can result in a missed target.

Hackensack University Medical Center’s commitment to using technology to enhance patient care led them to become the first hospital in New Jersey to obtain the Ion robotic bronchoscopy platform in 2020. It allows thoracic surgeons and pulmonologists to navigate the lungs’ intricate tissue and vast network of narrow and delicate airways to access hard-to-reach nodules. The latest Ion integrated cone beam CT software update is now in limited rollout to select hospitals, including Hackensack University Medical Center, and allows for direct communication between the real-time 3D imaging fluoroscope and the Ion system software.

“It’s amazing to see how quickly the technology in this field has advanced,” said Geoffrey Pelz, M.D., Thoracic surgeon at Hackensack University Medical Center. “When we started, we only had live x-rays and an ultrasound probe that had to be removed during the actual biopsy to confirm the location. If a nodule was too small or not solid, it could not be seen on the imaging.”

In June of 2023, they added 3D fluoroscopy capable of performing a live CT scan to confirm the biopsy needle in the target.

“The 3D OEC was a game changer; we could now identify in real-time that we are in the target. However, it may still require multiple scans and repositionings of the needle to get there, which adds radiation exposure for the patient and staff, anesthesia time, and risk of bleeding or lung collapse,” Dr. Pelz explained.

The new software update allows the 3D fluoroscope to directly communicate with the Ion software and immediately import the images. The doctor can then retarget the nodule directly, overcoming any CT body divergence. Once the target is repositioned, it eliminates the uncertainty of how much to change the angle of the needle and saves time and reduces the number of additional scans that are required.

“We're able to reliably reach smaller targets in more difficult areas of the lung. It allows us to potentially identify and diagnose lung cancers earlier and operate on them sooner, resulting in more lung-sparing surgeries, which in turn leads to shorter hospital stays, quicker recovery, preserved lung function and improved quality of life.” said Dr. Pelz.

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