Montefiore Einstein’s new Bronchoscopy Suite is up and running, fully equipped with the most advanced diagnostic and therapeutic technologies, which will have a major impact on screening for lung cancer and other lung diseases.
It is very much needed.
Lung cancer is the leading cause of cancer deaths in both men and women, with an estimated 200,000 new cases diagnosed each year. But it was only relatively recently that there were formal screening guidelines for lung cancer, moving from annual x-ray to CT scans for high-risk patients. Last year the U.S. Preventive Task Force Services updated its guidelines calling for annual CT screenings for lung cancer in adults between the ages of 50 and 80 who have a 20-pack a year smoking history and currently smoke or quit within the past 15 years.
Chirag D. Shah, M.D.
This has resulted in a dramatic demand for bronchoscopies to evaluate lung abnormalities found on CT imaging.
“The CT scans are picking up lung abnormalities much earlier – an amazing advance for the early treatment of lung cancer – so a lot more patients are being referred to us,” says Chirag Shah, M.D., associate professor in the department of medicine (pulmonary medicine) and director of bronchoscopy and outpatient pulmonary programs. “During the last decade, our practice has seen a tripling of patients who need diagnostic and therapeutic interventions. This year we are on track to perform approximately 1,400 advanced procedures.”
The Bronchoscopy Suite is housed at the Montefiore Moses campus within the general endoscopy suite. It includes:
- Cutting-edge bronchoscopy equipment from Olympus, including endoscopic ultrasound allowing physicians to “see” tissue in the lungs they want to biopsy in real time.
- Minimally invasive robotics-based technology that enables physicians to secure tissue samples for biopsy from deep within the lung where most nodules are found.
- Incorporation of real-time endobronchial ultrasound (linear and radial).
- An advanced x-ray system utilizing 3-D fluoroscopy – the first at Montefiore Einstein and the first suite in New York to house this dedicated technology.
- Electromagnetic navigational bronchoscopy, using high resolution CT scans to create virtual maps to lung nodules.
- 4K monitors throughout the room that enables physicians to see multiple sources of information.
- A rigid bronchoscopy system using high resolution cameras that allows for the most advanced airway securing and debulking procedures in an endoscopy suite – the first integration of traditional operating room technology in New York.
Montefiore Einstein’s Bronchoscopy Suite is designed as a flexible space, one that uses an advanced software infrastructure to integrate imaging and various hardware, creating an environment to perform a variety of invasive procedures. The suite is a separate space, so procedures are done in an outpatient setting rather than in an operating room, which makes the suite much more patient-friendly.
It solidifies Montefiore Einstein’s commitment to offering patients the most advanced integrative approach to lung cancer screening and management. If an abnormality is detected on a CT scan, a team of interventional pulmonologists, in conjunction with colleagues from thoracic surgery, decide about the best approach to comprehensively evaluate the patient. This approach is among the most efficient “nodule to treatment” management in New York City, far exceeding the national standards set by the National Comprehensive Cancer Network.
The Bronchoscopy Suite is an important link in the chain and helps coordinate lung cancer screening for the entire Montefiore Health System. The radiology service, located within the cancer center, screens the patient via CT scan. If there is a mass detected, the patient is referred to interventional pulmonology for advanced testing with bronchoscopy. If that shows the mass is malignant, the patient is then referred to a thoracic cancer specialist. This seamless approach will help patients get the care they need under one roof without delay.
“This is a real boon to how we provide care,” says Shah. “It greatly enhances our ability to identify even the smallest lesions, which is key to improving health outcomes, especially with a disease like lung cancer. It’s taking interventional pulmonology to a whole new level, and it enables us to treat our patients in the best way possible.”
Posted on: Friday, May 13, 2022