Iriscope®, a new mini-camera to evaluate small peripheral lung nodules

O. Taton*^a (Dr), B. Bondue^a (Prof), D. Leduc^a (Prof)

^a Hôpital Erasme, Université Libre de Brussels, Brussels, Belgium, Bruxelles, BELGIUM

* olivier.taton@erasme.ulb.ac.be

Background

With the increasing use of CT scans, numerous pulmonary nodules are detected. As a majority of them are benign, development of efficient non-surgical diagnostic procedure is mandatory. However, a direct endobronchial view of small peripheral pulmonary nodules is currently unavailable. Therefore, Iriscope®, an ultra-thin video-endoscopic probe of 1.7 mm, was developed to be inserted in the working channel of the bronchoscope to achieve a direct view of peripheral (outer third) nodules unreachable by videobronchoscopes.

We report here the first case describing the direct endobronchial view and appearance of a peripheral non solid nodule of 16 mm by Iriscope® during an electromagnetic navigation bronchoscopy (ENB) guided by cone beam CT (CBCT).

Case report

A 55 year old woman, with a heavy smoking history, underwent a screening low dose chest CT scan in 2019. A non solid nodule of 14 mm was identified in the outer third of the right upper lobe. During the next two years of follow-up, the nodule size and the FDG uptake increased (from 14 to 16 mm and SUV from 1.2 to 5).

The patient underwent transbronchial cryobiopsy guided by Iriscope®, ENB and CBCT. After the navigation catheter was assumed to be in the correct position according to the CBCT, an abnormal endobronchial lesion (whitish plaque) was observed by Iriscope® when it was inserted through the extended working channel.

The pathological diagnosis was adenocarcinoma confirmed by surgery (T1bN0M0).

Conclusions

For the first time, a ultra-thin video-endoscopic probe (Iriscope®) allows to achieve a direct endobronchial view of a small peripheral malignant nodule. Additional small peripheral nodules have to be evaluated by the Iriscope® in order to better define normal and pathological images as well as the beneficial impact of this new technology on the diagnostic efficiency of small peripheral pulmonary nodules.

Disclosure of funding source(s):

Lys Medical (Waterloo, Belgium) developed and provided the Iriscope®. Benjamin Bondue and Dimitri Leduc received consultancy fee and have stock options in Lys Medical Society.