MUSC first in state to test robotic bronchoscopy on peripheral lung cancer

January 14, 2019
Dr. Nick Pastis with robotic bronchoscopy
Dr. Nick Pastis looks at images captured by a robotic bronchoscope, the first device of its kind in the state.

Lung specialist Nick Pastis, M.D., has high hopes for the new robotic bronchoscopy machine he’s testing at the Medical University of South Carolina. “This could really be a game changer.”

MUSC is one of only eight sites across the country taking part in a feasibility study testing whether the robotic bronchoscope can get to lung spots that are otherwise hard or impossible to reach and do a biopsy to see if they’re cancerous. The device is the only one in South Carolina.

“It’s a novel way to provide better access to peripheral lung nodules, which are on the outer parts of the lungs,” Pastis said. “With Medicare’s approval of lung cancer screening, physicians are being inundated with multiple lung nodules. We’ve been looking for safer ways to evaluate and diagnose. The best way to treat lung cancer is to catch it early, and this is part of that process.”

Pastis, who is part of the pulmonary team at MUSC Health, said the procedure has already been approved by the Food and Drug Administration. “It has the opportunity to diagnose lesions in the periphery of the lungs with potentially a high success rate.”

He hopes it will serve as a badly needed new option. “Other than surgical biopsy and more risky needle biopsies done with radiology, we struggle to find an alternative that’s safe and effective. Bronchoscopy for peripheral nodule diagnosis has been a challenge.”

While doctors have been able to use endobronchial ultrasound since the early 2000s to detect cancer between the lungs, the area called the mediastinum, spots on the periphery have been tougher to tackle. “There are a lot more airways and turns,” Pastis said. “Your scope can’t go through the lung. It has to follow the airways. So you’re limited where you can get out to lesions.”

He said the robotic bronchoscope, which uses navigation software, could change that. “We feel like this scope has the potential to improve on what we do with bronchoscopy. It really anchors the scope in a distal position and it really gives fine articulation and reach out of the lung periphery that is superior to what we’ve seen before.”

The MUSC study, led by Pastis’ colleague Gerard Silvestri, M.D., a researcher at Hollings Cancer Center, is enrolling patients. "To qualify for this study, you’d have to have a lung nodule, a spot on the lung seen on a CAT scan between 1 and 5 centimeters, with suspicion that it could be cancer and not something else that would go away with antibiotics, like an infection,” Pastis said.

Lung cancer is the leading cancer-related cause of death in American adults. The American Cancer Society estimates more than 142,000 Americans will die from lung cancer this year.

MUSC Health has a lung cancer screening program. Pastis encourages people who meet the criteria for screening to get checked.

For information about the robotic bronchoscopy trial, email Michael Balassone or call 843-792-6696