Biopsy of a Subpleural Lung Mass using VirtuTRAX^™

CONSIDERATION FOR USE

In this clinical case, the lesion is approached using a microconvex probe, with a trajectory that is almost parallel to the ultrasound beam. In such a case, the needle is hardly visible with ultrasound alone.

The VirtuTRAX system displays the exact needle position throughout the approach. Moreover, VirtuTRAX shows the precise location of the tip of the co-axial needle (from where the biopsy sample will be taken) within the mass, which improves the operator’s confidence in the procedure. Overall, the use of VirtuTRAX simplifies a procedure which could have been tricky using stand-alone ultrasound guidance.

REQUIRED EQUIPMENT FOR EXAMINATION

• Toshiba Aplio 500 Platinum ultrasound system
• Toshiba Smart Fusion with Smart Navigation
• CIVCO VirtuTRAX Instrument Navigator

Figure 1
Fusion imaging helps visualize and identify the lung mass (noted with the white arrows).

Figure 2
The length of the needle is calibrated. The VirtuTRAX system is fixed to the biopsy needle. Calibration is performed in close proximity to the electromagnetic field generator.

Figure 3
Ultrasound software demonstrates biopsy needle advancement using the VirtuTRAX guidance system. The system clearly shows when the needle is located inside the lung mass.

Figure 4
The semi-automatic biopsy needle (black arrow) is introduced within the co-axial system (white arrows) and is advanced toward the target.

Figure 5
VirtuTRAX shows the tip of the co-axial system. The tip of the semiautomatic biopsy needle is seen 2cm deeper in the axis of the VirtuTRAX trajectory (arrow). The biopsy is correctly targeted.