World's first Stereotaxis® magnetic lung procedure may herald a new era in early lung cancer diagnosis

A 64-year-old Iowa woman is the world's first person to undergo a lung procedure involving a revolutionary electromagnetic surgery system called Stereotaxis®.

Marlene Monkelien, a part-time pie baker and postal worker from Pomeroy, underwent the procedure in September 2005 at University of Iowa Hospitals and Clinics. She had earlier been diagnosed with non-malignant nodules in her lungs.

Her voluntary participation in the procedure was the first of several transitional steps that will be taken before an actual lung nodule biopsy is performed by Stereotaxis. The system employs super conducting magnetic assemblies, advanced computer technology, magnetically tipped catheters, and a joystick that doctors use to navigate the catheters.

Geoffrey McLennan, M.D., project leader, said Stereotaxis could represent a major advance in the ability to diagnose lung cancer earlier, enabling treatment to begin sooner.

McLennan noted that Stereotaxis is potentially safer and more accurate than traditional forms of biopsy. Biopsies taken through a needle in the chest can potentially collapse a lung or spread the cancer. Bronchoscopes (small tubes inserted through the mouth or nose) have only a 50 to 70 percent chance of getting a sample.

Because hard-to-reach areas of the body can be reached more easily, Stereotaxis may allow physicians to perform procedures that were previously impossible. UI Heart and Vascular Center cardiologists, for instance, already use the system for some forms of heart disease.

Scott Ferguson, M.D., a pulmonary and critical-care specialist, said it could be two to three years before the system is FDA-approved for lung biopsies.

Other members of the team included David Riker, M.D.; Kim Sprenger, R.N.; Kurt Wolf, R.T.; and Scott Nibaur, R.T.R., R.C.I.S.

Early diagnosis the key

The great promise of Stereotaxis® reflects a current reality: while up to half of all smokers have detectable nodules, only 1 to 2 percent of those patients have cancer. Because of this low percentage, along with the operation's risk and expense, doctors don't remove every nodule, often waiting months to monitor growth. The potential benefit of early detection is lost if an early diagnosis isn't made.