Thanks to a disbursement from the Moore Regional Hospital Foundation, state-of-the-art technology that provides a safer and more accurate diagnosis of lung cancer and other diseases of the chest will soon be available at FirstHealth Moore Regional Hospital.

Endobronchial ultrasound (EBUS) with electromagnetic navigation bronchoscopy is currently available only at major academic medical centers in North Carolina. The $235,000 disbursement to purchase the equipment for Moore Regional Hospital was recently approved by the Board of Trustees of the Moore Regional Hospital Foundation.

"Our foundation is committed to funding improvements to Moore Regional Hospital that enhance FirstHealth's core purpose, to care for people," says Howie Pierce, chair of the foundation's Grant Review Committee. "With this new technology, we will have the opportunity to care for people who previously had fewer options for diagnosis and treatment. I can't think of a more appropriate use of foundation resources."

According to Dr. Michael Pritchett, a board certified pulmonologist with FirstHealth's Chest Center of the Carolinas and Pinehurst Medical Clinic, the new technology gives Moore Regional "a significant technological leg-up" in its ability to diagnose diseases of the chest.

"We can use these tools together to improve the process of diagnosing, staging and treating lung cancer and other diseases," he says.

Because of the difficulty in reaching the outer or peripheral areas of the lungs, lung disease can be especially difficult to diagnose and stage. (Staging measures the extent of the disease and determines treatment options and prognosis.)

More than half of lung targets are not accessible by conventional technology because of the narrowing branches of the bronchial airways and due to difficulties with equipment orientation and maneuverability.

Because of this, a biopsy is many times done from the outside by sticking a needle between the ribs and into the lungs. This carries an increased chance of causing the lung to collapse, which may require more invasive treatments and a hospital stay.

EBUS, which uses sound waves to look through the airways, provides a safer and less invasive way of sampling lymph nodes in the chest, Pritchett says. It also offers an excellent view of the large blood vessels close by and allows physicians to access nodes not previously felt to be safe to biopsy.

It can also access lymph nodes that are out of reach of the usual surgical approach.

Electromagnetic navigation allows the physician to access all areas of the lungs and chest using a "GPS-like" navigation system based on a CT scan of the patient's chest. The process provides real-time images in three-dimensional format, allowing physicians to diagnose peripheral lesions, biopsy lymph nodes and prepare to treat the problem in one procedure.

"These technologies are safer, less invasive and offer improved accuracy compared to the current strategies," Pritchett says. "They also increase the likelihood of diagnosing lung cancer at an earlier stage when there are potentially curative treatments and the prognosis is much more favorable."

Currently, more than half of the people diagnosed with lung cancer die within one year of being diagnosed.

"This is because lung cancer is usually diagnosed at an advanced stage and that's something we want to try to change," Pritchett says.

A common procedure to biopsy lymph nodes in the chest to determine the stage of disease is a surgery called mediastinoscopy, which requires a small incision to be made in the neck just above or next to the breastbone. A scope is inserted through the opening to provide access to the lymph nodes.

While this method achieves great success in sampling the lymph nodes, it is invasive, has limited reach and requires general anesthesia. However, EBUS procedures are done in an outpatient setting with light sedation and local anesthesia. They can also reach lymph nodes that cannot be reached with the surgical approach.

Complications are rare in EBUS procedures, which are performed by a pulmonologist or a thoracic surgeon, and patients generally recover quickly and go home the same day.

Both Pritchett and Dr. Andy Kiser, a cardiothoracic surgeon, have been trained to do the procedures at Moore Regional.

"Endobronchial ultrasound and electromagnetic navigation bronchoscopy will allow us to be on the cutting edge of the diagnosis and staging of diseases of the chest," Pritchett says.

The Moore Regional Hospital Foundation Board of Trustees has also approved the following disbursements:

n $57,000 to the Cancer CARE Fund for medication, transportation and other assistance to cancer patients

n $25,000 to FirstHealth's Clinical Trials program for stroke patients

n $4,538 to Women and Children's Services for the purchase of a birthing simulator for staff training

n $2,281 to the Behavioral CARE Fund for clinical education

n $4,500 to the operating room for clinical education

n $44,800 to patient care administration to provide a part-time registered nurse to coordinate Magnet Nursing activities on the Richmond Memorial campus as a preliminary to Magnet redesignation

For additional information on the Moore Regional Hospital Foundation or to support health care in this community, call the Foundation of FirstHealth at (910) 695-7500.