Diagnostic Testing

Common tests for pulmonary conditions and sleep disorders.

Diagnostic Testing

Diagnostic tests are performed to help your physician detect, identify, confirm, or rule out possible health conditions. They can also be used to monitor progression of diseases or evaluate the effectiveness of a treatment plan.  Diagnostic tests can also help identify medical conditions before they worsen. There are many different types of diagnostic tests. Below are some of the most common ones we use to identify pulmonary conditions and sleep disorders.

ENDOBRONCHIAL ULTRASOUND BRONCHOSCOPY

Endobronchial ultrasound (EBUS) is a minimally invasive procedure used in the diagnosis of lung cancer, infections, and other lung disease. Our physicians are trained to use specialized bronchoscopic equipment that has additional ultrasound capabilities. This uses sound waves to visualize enlarged lymph nodes or other lesions near the main airways in lungs in real time. These lesions can then be biopsied with a high degree of safety and success.

EBUS is most commonly used to assess lymph nodes in the chest to evaluate for cancer metastasis. The preparation for EBUS bronchoscopy and recovery is similar to that of traditional bronchoscopy. Often, EBUS is performed with the support of an anesthesiologist to provide sedation and support breathing during the procedure.

FIBEROPTIC BRONCHOSCOPY

Fiberoptic bronchoscopy (bron-kos-ko-pi) is a visual exam of the breathing passages of the lungs (called “airways”). This test is done when it is important for your doctor to see inside the airways of your lungs, or to get samples of mucus or tissue from the lungs. Bronchoscopy involves placing a thin tube-like instrument called a bronchoscope (bron’ko-sko-p) through the nose or mouth and down into the airways of the lungs. The tube has a mini-camera at its tip, and is able to carry pictures back to a video screen or camera.

LUNG FUNCTION STUDIES: METHACHOLINE OR CHALLENGE TEST

Challenge tests or challenge studies, are types of tests that measure if your lung function changes after you breathe in specific chemicals. In the United States, the most common chemical used in this test is methacholine. The chemical histamine may also be used in the test. In general, a challenge study may be done to see if you have asthma or how well your asthma medicine is working

NAVIGATIONAL BRONCHOSCOPY

Navigational bronchoscopy is a procedure that may be used to reach small lesions in the lung. This minimally invasive technique involves creation of a 3D virtual “roadmap” of the lungs from the patient’s CT scan. This enables the physician to steer a bronchoscope with a specialized set of catheters through the lungs to reach the targeted lesion. Most often, navigational bronchoscopy is used to biopsy small peripheral lung lesions, that were previously difficult to biopsy. This can enable early diagnosis of lung cancer. This technique may also be used to place markers next to cancerous lesions to precisely deliver radiation therapy while reducing radiation exposure to surrounding healthy tissue. The preparation for navigational bronchoscopy and recovery is similar to that of traditional bronchoscopy. Often, navigational bronchoscopy is performed with the support of an anesthesiologist to provide sedation and support breathing during the procedure.

PULMONARY FUNCTION TESTS

Pulmonary function tests (PFTs) are breathing tests to analyze how well your lungs are working. The most common PFTs are spirometry (spy-RAH-me-tree), diffusion studies, and body plethysmography (ple-thiz-MA-gra-fee). Sometimes only one test is done, other times all tests will be scheduled, often on the same day. Diffusion studies help us determine how well oxygen is brought into the body and how well carbon dioxide is removed.

  • Do not smoke for at least 4 hours before the test.
  • Do not drink alcohol for at least 4 hours before the test.
  • Do not exercise 30 minutes before the test.
  • Do not wear tight clothing that makes it difficult to take a deep breath.
  • Do not eat a large meal 2 hours before the test.

THORACENTESIS

Thoracentesis (thor-a-sen-tee-sis) is a procedure that is done to remove a sample of fluid from around the lung. The lung is covered with a tissue called the pleura. The inside of the chest is also lined with pleura. The space between these two areas is called the pleural space. This space normally contains just a thin layer of fluid, however, some conditions such as pneumonia, cancer, or congestive heart failure may cause excessive fluid to develop (pleural effusion). To remove this fluid for evaluation (testing) or to reduce the amount of fluid, thoracentesis is done.

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