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The Birmingham VA Health Care System recently implemented the Ion Endoluminal System, a robotic-assisted platform for minimally invasive biopsy in the lung. The Birmingham VA became the

first in the VA Southeast Network (VISN 7) to include the technology in November 2023. “The Ion system is unique in many ways,” said Dr. Joseph Thachuthara-George, Birmingham VA Director of

Bronchoscopy. “It uses a shape sensing technology that does not interfere with external devices in the procedure room whereas our older system used electromagnetic technology that can

potentially interfere with external devices.” HOW IT WORKS The Ion uses a picture archiving and communication system (PACS) and integrated software to retrieve patient CT scans and generates

3D images that identify areas that could require further medical attention. During a bronchoscopy, the Ion’s controller navigates to a target along a health care provider’s pre-planned

path. A maneuverable 3.5 mm catheter is used to access segments of a patient’s lungs that were previously unreachable during a standard biopsy. “Since the Ion bronchoscope is smaller in

diameter, it can be steered in any direction,” said Thachuthara-George. “Our traditional system consisted of a curved catheter that could move forward or backward but needed to be rotated to

align with the nodule. The Ion system is more precise, has better stability, and the instruments are more flexible.” Ion’s manufacturer, Intuitive, states that it offers: - More reach -

More stability - More precision - Seamless integration The Ion bronchoscope is used to biopsy the lung tumor if a tumor is detected. Its technology revolutionizes the speed and accuracy with

which lung disease or cancer can be detected. THE IMPORTANCE OF EARLY DETECTION Research has shown that when found early, lung cancer is most easily and effectively treated. The cancer is

at a stage where surgery or stereotactic body radiation therapy can be offered with the goal of a cure. “When lung cancer is diagnosed early, the patient has a better chance of survival, as

it can be either removed via surgery or radiosurgery (radiation),” said Thachuthara-George. “Although it doesn’t speed up the treatment when it is diagnosed early, the patient has a chance

of a better prognosis.” Survival rates for stage one lung cancer diagnoses currently range from 68% to 97% at five years from the diagnosis, depending on the size of the tumor. Stage two

average survival rates range from 32% to 65%, depending on the extent of the spread. Stage three survival rates drop to 24% to 41% at five years from diagnosis, depending on the location and

number of tumors. Stage four, which in many cases the cancer has spread to other parts of the body, survival rates are very low, with less than 10%.  The Birmingham VA performs an average

of 16,000 computed tomography (CT) scans yearly. Results of the CT scan will determine if a biopsy is recommended. PROVIDING EXCELLENT CARE TO AMERICA’S VETERANS The Ion Endoluminal System

allows the Birmingham VA to continue setting the standard for patient care and advance medical research.  “We will soon implement a cone beam CT scan, which is capable of 2D and 3D X-ray

imaging, that integrates with our Ion system,” said Thachuthara-George. “This integration will help us improve the accuracy of our biopsy procedures, which is a key step in how lung cancer

is diagnosed.” In November 2023, in recognition of Lung Cancer Awareness Month, the Birmingham VA demonstrated its new to Veterans during a lung cancer awareness event. The event highlighted

the expertise of its clinicians and the advance technologies available to Veterans in Northern and Central Alabama. U.S. Army Veteran Roy Littrell traveled from the Muscle Shoals, Alabama

area to attend the lung cancer awareness event and view a demonstration of the Ion Endoluminal System. “The implementation of this system not only proves that the Birmingham VA stays on the

cutting-edge of technology, but it also expresses the genuine concern the staff has for its Veterans’ health and quality of life,” said Littrell.