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Creating 3D ‘road map’ to locate lung cancer cells

Procedure using VR and GPS-guided system allows docs to pinpoint cells more accurately 

The Straits Times (15 December 2017) - A new procedure that allows doctors to pinpoint cancer in the lungs more accurately and could lead to earlier diagnosis and treatment of Singapore’s No. 1 killer cancer has been made available here.

 

Dr Akash Verma and Senior Staff Nurse Chin Mee Choo with
equipment for navigational bronchoscopy. In the procedure, a
three-dimensional “road map” is created and it shows several routes
a doctor can take to insert a tube into the lung to the target site with
the suspected cancer cells. ST PHOTO: ONG WEE JIN
 

Called navigational bronchoscopy, it uses virtual reality and a GPSguided system to find and extract suspected cancer cells in the lungs, said Dr Akash Verma, who helped bring in the procedure.

The adjunct assistant professor at Tan Tock Seng Hospital (TTSH) and senior consultant in its department of respiratory and critical care medicine said yesterday that the hospital is the first here to adopt the procedure. It has been used in 33 patients so far, with no complications.

In the procedure, a three-dimensional “road map” is created and it shows several routes a doctor can take to insert a tube into the lung to the target site with the suspected cancer cells.

The on-screen map helps to guide the procedure, showing how close or far away the tube is – in centimetres – to the site. Once the spot is reached, tissue samples can be taken using biopsy forceps or a triple-needle brush inside the tube. There are several types of lung biopsy: traditional bronchoscopy, which does not have a virtual road map; transthoracic needle aspiration, also known as CT-guided biopsy; and wedge resection surgery.

But these procedures involve risks, such as of puncturing the lung. The main reason is that doctors do not have a route to follow within the organ, said Dr Akash.

1,500 Number of Singaporeans diagnosed with lung cancer each year. 

“The map makes it safer and more precise. If a white spot is indeed cancerous, we dye the lung so that surgeons can later open it up and know exactly where to work on.”

According to the Singapore Cancer Registry’s 2015 annual report, lung cancer is the No. 1 cause of cancer deaths in males, accounting for 27.1 per cent. For females, it is the No. 2 cause, at 16.6 per cent.

About 1,500 Singaporeans are diagnosed with lung cancer each year. As the symptoms do not show until the later stages, 85 per cent are diagnosed in the more advanced third and fourth stages.

Though a more precise diagnostic tool does not necessarily solve that problem, it improves the outlook for lung cancer patients, said Dr Akash, who learnt the procedure in the United States.

Two doctors at TTSH can do it and more will be trained.

The procedure helped locate the disease cells in Madam S.K. Ong in March. “I initially thought I had the 100-day cough, which came on and off since the middle of last year. But I got breathless when I climbed the stairs, so I had a check-up in March,” said the 55-year-old graphic designer, who does not smoke.

A lung biopsy done through navigational bronchoscopy showed she had Stage 4 lung cancer.

“My parents both had cancer but I assumed I wouldn’t get it because I had always been living healthily,” she said.


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Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction.