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New AF scope helps Sinai doctor diagnose lung cancer early on
Every time Edit Molnar, R.N., tried to stop smoking, she ultimately found the urge to have a cigarette too powerful to resist.
But the new D-Light Autofluorescence (AF) Bronchoscopy System test at Sinai Hospital has given her all the motivation she needs to quit for good.
The state-of-the-art, early detection AF scope enables doctors for the first time to see lung cancer in its earliest stages. In Edit's case, William Krimsky, M.D., was able to show her on a computer screen lung tissue he suspected might turn out to be cancerous.
"It was amazing. I felt like the physician had an extra set of eyes in there," Molnar says.
The flexible bronchoscope, a pencil-thin fiberoptic endoscope, allows Krimsky to see the bronchial system. After a patient is sedated, he passes the scope gently through the patient's nose or mouth, then through the trachea and into the lower airways of the lungs. A tiny camera projects the image onto a computer monitor.
With the flip of a switch, Krimsky, a pulmonolgist in the Division of Pulmonary and Critical Care Medicine at Sinai Hospital, can switch from white light to fluorescent light, illuminating lesions and abnormal tissue that are not otherwise visible. The entire procedure can be recorded on a DVD and replayed later for the patient.
"What we've found is abnormal cells absorb and reflect light differently," Krimsky says.
The AF scope gives physicians an opportunity to offer very early diagnosis and, consequently, early treatment and an improved prognosis for many patients. Lung cancer is the leading cause of cancer deaths in developed countries, but the rate of survival increases if the disease is detected early on.
Krimsky says patients he's seen range in age between 40 and 70. Most have a history of smoking. The procedure takes about 30 minutes and is covered by most insurance plans with little or no cost to the patient.
It took several more weeks, but Molnar feels she's finally getting over her addiction. She'll have another test down the road to monitor her condition, but the AF scope has given her hope that if she develops cancer, she can beat it.
"Every day I get up and say, 'It's going to be a non-smoking day!'"
New PET/CT technology debuts at Sinai
Contrary to popular opinion, the new PET/CT scan at Sinai Hospital doesn't have anything to do with dogs, cats or goldfish.
The PET/CT scan gives doctors the ability to see inside the human body quickly and non-invasively so they can pinpoint abnormalities, such as cancer and blockages that can cause heart disease. It can also help identify the
initial stages of Alzheimer's disease.
The Department of Nuclear Medicine at Sinai has been using the PET/CT (positron emission tomography and computed tomography) for about three months. It combines two scans to give doctors one clear picture. "The PET scan uses radioactive glucose that's injected into the patient and absorbed by irregular cells," says Paul Clark, senior nuclear medical technologist. "Images that detect the radiation show the size and shape of those cells so they can be analyzed. The analysis includes level of their activity, which indicates if a mass is benign or malignant."
The CT scan shows a section of tissues and organs in the body from various positions and in vast detail. It doesn't have the capability of showing if a disease is active, but the PET/CT gives physicians a highly sophisticated diagnostic and staging tool.
"Because this technology provides many views of the body simultaneously, it saves time and reduces stress for patients. For example, if a doctor suspects lung cancer, the PET/CT scan not only shows if there's a mass in the lung but whether it has spread to other areas," Clark adds.
The PET/CT scan works best with head and neck, lung, bone, breast, thyroid, and colorectal cancers, as well as lymphoma and melanoma. The PET/CT scan is not ideal for brain cancer because the brain already has large amounts of glucose in it.
Doctors also use the scan to see if tumors have shrunk or grown and whether a change in treatment is required.
The scan takes about 30 minutes for patients. They lie on a stretcher, which slowly moves through a three-foot long tube. Results can be read quickly, within a day or two.
"This method can stop unnecessary surgeries," says Stuart A. Rabinowitz, M.D., Ph.D., director of Nuclear Medicine at Sinai. "Combining the anatomic information from the CT with the physiological data from the PET gives us the best of both worlds."
