Lung and Pulmonary Tumors

At the CyberKnife Institute at Mercy Hospital we make it possible to treat patients and tumors inappropriate for invasive surgery, or more effectively treated with the advanced technology of the Cyberknife. The capabilities of the CyberKnife to track the tumor’s true location during treatment and continually adjusts for movements of the body, is a unique technology that permits Radiosurgery on tumors anywhere in the body. The CyberKnife’s Synchrony System provides unprecedented accuracy that also extends to the treatment of tumors which move with respiration, due to the Cyberknife’s technology that “learns” and matches patients’ respiratory patterns, and accounts for them, allowing the precise dose to always be targeted at the tumor, making Cyberknife highly effective for lung and pulmonary tumors.

CyberKnife differs from radiation therapy, which irradiates both normal and cancerous tissues. CyberKnife delivers an ablative dose to the tumor with submillimeter accuracy and minimal exposure of normal tissue. As a result, we can treat inoperable patients, shrink tumors for less radical resections, destroy radioresistant tumors and treat patients previously treated with radiation. In addition, patients experience short, painless treatments with far fewer side effects, limited (if any) downtime and an immediate return to activities.

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CyberKnife radiosurgery represents a conformal ablative radiation technique that offers a potent new treatment alternative for patients with primary or recurrent bronchogenic carcinoma or pulmonary metastases. The advanced tracking capability of the CyberKnife Synchrony system enables radiation conformality around the tumor volume approaching that of a surgeon’s scalpel. The treatment is safe to administer to patients that are not healthy enough to withstand definitive surgery, and offers a new option to patients with recurrent disease, who may have previously had little if any additional effective treatment option available to them.

With CyberKnife, the range of tumors treatable with stereotactic Radiosurgical ablation is unprecedented.

The CyberKnife SuperDimension System

The CyberKnife Instutite at Mercy Hospital has the most advance Lung/Thorsac capabilities available, through the cutting edge tool called the SuperDimension Bronchus System. Using the SuperDimension system, with the CyberKnife imaging system, all lung abnormalities that show up on X-rays and CT-scans are within reach of a bronchoscope. Therefore, this new minimally invasive approach to biopsy replaces the need for high-risk invasive procedures, such as intrathoracic needle biopsy and open surgery. This advanced technology of SuperDimension sets the stage for an earlier diagnosis, and an earlier diagnosis improve success rates in treatment.

Because SuperDimension is the first technology to make a minimally invasive biopsy possible anywhere in the lungs, Doctors may have little, if any, reason to “wait and see” what happens to a spot on a CT scan. Therefore, patients who have COPD (chronic obstructive pulmonary disease) or who have gone through cancer surgery, chemotherapy, or radiation therapy may not be in a position to tolerate intrathoracic needle biopsy or major surgery for a spot that may turn out to be normal, (Estimates are that 45 percent of needle biopsies result in a collapsed lung), SuperDimension avoids this risk.

The SuperDimension procedure starts with treatment planning, and the recalibration of the patient’s CT-scan to the SuperDimension software. The interventional pulmonologist then performs a computerized “virtual bronchoscopy.” Steering through the three-dimensional image of the patient’s tracheobronchial tree with its tiny peripheral branches, the physician places electronic markers at precise points leading to the lesion(s) and at the lesion itself. The markers are recorded onto the CT-scan, providing a 3-D, CT-roadmap.

With the patient lying on a low-frequency electromagnetic bed, the procedure begins. Following a routine bronchoscopy, a special channel in the bronchoscope is loaded with a disposable guide that has 360-degree steering capacity and an electromagnetic sensor. As the physician advances the catheter and steers the disposable guide, the sensor’s exact location is viewed in real-time on the 3-D, electromagnetic map of the patient’s lungs — the computerized CT-image.

Once the lesion is reached, the catheter’s steering component is retracted, leaving the working channel at the level of the lesion. An ultrasound device is inserted, allowing the physician to visualize the actual lesion and airway. The working channel is manipulated to get as close as possible to the abnormal tissue and tiny surgical instruments are passed through for a quick biopsy.

The SuperDimension procedure takes 5–20 minutes with the patient under conscious sedation.