Bronchoscopy and Interventional Pulmonology

Minimally invasive diagnosis and treatment of lung cancer.

Interventional pulmonology involves the use of minimally invasive procedures to help us diagnose lung cancer. We can also use interventional pulmonology to relieve your pain and help you breathe easier during your treatment for lung cancer or other cancers that have spread to the lungs, such as breast cancer, kidney cancer and lymphoma.

Our interventional pulmonologists are an important part of our lung cancer team. Henry Ford Cancer has the only comprehensive interventional pulmonology program in Michigan, and we are one of a handful of programs in the world that has helped develop the advanced technology and minimally invasive lung procedures doctors worldwide use today.

Bronchoscopy

Bronchoscopy is a minimally invasive procedure that lets our interventional pulmonologists look inside your airways or lungs without surgery. It uses a long, flexible tube called a bronchoscope that has a light and camera at the end of it. Your doctor can use the bronchoscope to take video or photos of the suspected cancerous tissue. We can also take a sample (biopsy) of the tissue for testing and diagnosis.

We use several types of bronchoscopy to help us diagnose lung cancer. These include:

• Airway examination: We can look into small sections of your airways and collect samples of lung secretions.
• Bronchoalveolar lavage: Your doctor may use a saline solution to reach into distant areas of your airways, where the bronchoscope can’t reach. We’ll then collect this fluid and test it for cancer cells or other signs of disease.
• Cytologic brushing: Your doctor will pass a flexible brush through the bronchoscope to brush cells loose from a tumor. We can test these cells in our laboratory to make a diagnosis.
• Endobronchial biopsy: Your doctor will use a set of flexible forceps and the bronchoscope to perform a biopsy.
• Transbronchial biopsy: Even if your tumor isn’t visible through the bronchoscope, we can still take a sample. Using computed tomography (CT) scans taken before the bronchoscopy, your doctor can locate the tumor. We can also use fluoroscopy, a type of X-ray that takes video of moving structures inside the body, to navigate to your tumor.

Advanced bronchoscopy for diagnosing lung cancer

In addition to our standard bronchoscopy procedures, we offer advanced techniques that aren’t widely available . These techniques include:

• Electromagnetic navigation bronchoscopy (ENB): Similar to a car’s GPS system, EMB provides 3D virtual roadmaps of your lungs. It helps your doctor locate any tumors to take tissue samples. We were one of the first five sites in the world to perform the clinical development of this technology.
• Radial probe endobronchial ultrasound: This technique uses ultrasound and electromagnetic navigation to let us get information about areas of your airways that are too small and far away for us to see with standard bronchoscopy.
• Endobronchial ultrasound (EBUS) and endobronchial ultrasound and transbronchial needle aspiration (EBUS-TBNA): During EBUS, we can use a bronchoscope with an ultrasound probe to locate and take samples of abnormal tissues in your lungs. During EBUS-TBNA, your doctor uses ultrasound as a guide to take tissue samples through the airway walls with a needle. We were involved with the development of the equipment used in EBUS-TBNA, and our doctors are highly experienced with this technique.
• Robot-assisted bronchoscopy: This is the newest advanced diagnostic procedure available. Our doctors can navigate this robotic endoscope into your lung with improved reach, vision and control to reach distant locations. The robotic system’s enhanced stability improves our diagnostic capabilities. We were the only healthcare system in the world involved in the development of the technology for this technique, and we performed the first clinical studies of the systems used worldwide. We remain a worldwide reference and education site for robot-assisted bronchoscopy.
• Autofluorescence bronchoscopy: Using a special light we shine through the end of a bronchoscope, we can visualize your healthy tissue as green and any diseased tissue as red. Your doctor can then take a sample of any abnormal tissue for testing.

Lung cancer therapy with interventional pulmonology

In addition to helping diagnose lung cancer, our interventional pulmonologists can help you breathe better during your treatment. We work closely with medical oncologists, radiation oncologists, surgeons and other providers during your care. As part of your personalized treatment plan, these minimally invasive procedures improve your lung function so you can better tolerate your treatments and improve your chances of survival. Our treatment options include:

• Rigid bronchoscopy: This procedure lets us control your airway and use our specialized surgical tools in the airway.
• Laser: We use our surgical laser to destroy or damage tumor tissue, as well as to cut through and remove (debride) tissue.
• Argon plasma coagulation: This procedure uses a stream of argon gas to destroy the surface of tumors or to stop bleeding.
• Electrocautery: We use heat to destroy tumors, stop bleeding or cut out (resect) whole tumors.
• Cryotherapy: We freeze and thaw targeted tissue repeatedly to destroy tumors or remove obstructions in your airway.
• Photodynamic therapy: During this procedure, we use a specialized dye to make your tumor cells more sensitive to a laser while sparing healthy tissue.
• Stents: We use hollow tubes made of silicone or metal to keep your airways open or to close holes in airways.

Learn more about the services we offer in our Interventional Pulmonology Center and Bronchoscopy Suite.