Bronchoscopy

Widespread use of fiber-optic (endoscopic) technologies has allowed doctors to conduct timely and effective diagnostic procedures to patients for various types of malignancies. Endoscopic bronchoscopy is one of the main methods of minimally invasive diagnosis of lung cancer in Israel. The special value of this method is the ability to obtain tissue samples of suspected tumor foci (biopsy).

The technique allows to also conduct minimally invasive treatments aimed at relieving symptoms in patients with lung cancer.

Endoscopic method bronchoscopy

During the procedure, a flexible optical device, a bronchoscope is introduced to the bronchi of the patient under general anesthesia.

The bronchoscope, which combines optical fiber devices, increases the transmission of visual information to a computer monitor, and it also utilizes manipulators that allow for minimally invasive procedures. In recent years, thanks to the development of high technology, bronchoscopy combined with additional diagnostic procedures (endoscopic ultrasound and imaging), has significantly expanded the indications for this study.

Indications for bronchoscopy in Israel

The main indication for bronchoscopy in Israel is the differential diagnosis of volume processes (tumors) of the lungs. Modernization study facilitates a more accurate diagnosis not only of lesions located within the lumen of the bronchi but also pathology propagating in the lung parenchyma, its peripheral areas and mediastinum. The feasibility of a minimally invasive biopsy of the suspicious area makes bronchoscopy indispensable in the diagnosis of lung cancer in Israel. The study can not only detect the presence of malignancy but also ascertain its histologic type and stage distribution, which is essential for planning an effective treatment of lung cancer.

Modern techniques of bronchoscopy in the diagnosis of lung cancer in Israel

The most suitable bronchoscopy technique is determined by the results of preliminary studies (X-ray, CT, MRI, and ultrasound). At this stage, it is important to diagnose whether the pathological process affecting the central or the bronchi is located in the peripheral areas of the lung. Depending on the location and the size of the tumor during the study, different techniques are used and combinations thereof. Modern methods of bronchoscopy are successfully used at leading medical centers in Israel, among which it is important to note the following:

• Bronchoscopy under direct visual control. This method is used in the diagnosis of pathological processes located in the bronchi. After the introduction of the endoscope, optical professionals can consider in detail the mucous membrane of the bronchial tree, detect pathological changes and implement biopsy suspicious for cancer suspicious spots
• Bronchoalveolar lavage (BAL) – washing the pulmonary tree technique with saline followed by the aspiration of the fluid and a cytological examination for the presence of malignant cells. This technique is important in the case of visually undetectable tumors
• Endobronchial ultrasound (EBUS) became possible with the development of high-tech small size sensors, the introduction of which is carried out using a bronchoscope. This technique allows a detailed examination of processes located in the lung parenchyma. The indispensable technique for the assessment of mediastinal lymph nodes with the ability to accurately aim the manipulator for minimally invasive biopsy
• Transbronchial aspiration needle under the control of an endoscope or ultrasound (TBNA) – this method allows obtaining safe material for histological lesions located within the bronchi, and for portions, which are located beneath the mucosa. The combination of this technique with endobronchial ultrasonography and computed tomography during the procedure allows for a biopsy of the peripheral areas of the lung, pulmonary gate, and mediastinum

Innovative techniques and scientific developments in the field of bronchoscopy in lung cancer are continuously developed for a technology that improves the accuracy and diagnostic yield of bronchoscopy.

Among the methods of passing the last stage of the investigation must be emphasized:

• Confocal laser fluorescence microscopy (CLFM)
• Autofluorescence bronchoscopy (AFB) – allows to accurately determine the malignant processes and precancerous lesions of the mucous membrane
• Narrow-band imaging (NBI) – a technique that allows you to define the minimum vascular changes characteristic of malignant process
  These and many other high-tech methods join the arsenal of studies that allow us to diagnose lung cancer in the early stages.