December 16, 2021

AI used to identify patients at risk for lung cancer


by Matt Batcheldor

The Vanderbilt Lung Institute is the first location in Tennessee to debut Optellum Virtual Lung Nodule Clinic comprehensive management software that, using artificial intelligence, can identify and track patients at risk for lung cancer — even if they have never been in for a cancer screening.

That’s because the Optellum software continuously looks for radiology reports in patients’ electronic medical records to detect specific lung nodules that may be lung cancers.

Otis Rickman, DO

By using machine learning, the software analyzes the nodule (radiomics) and applies a lung cancer risk score based on the size and location of the nodule and the patient’s risk factors.

The system is not limited to just reviewing lung cancer screenings. For example, a scan that a patient had received for abdominal pain can be reviewed for suspicious lung growths.

“Lung nodules are very common in Tennessee; so is lung cancer,” said Otis Rickman, DO, director of Interventional Pulmonology for the Vanderbilt Lung Institute. “Most lung nodules that are detected are actually not lung cancer; they’re something else. But you never want to miss a lung cancer. They can have a cancer that’s growing in their chest, and they don’t know.”

In addition to the machine learning feature, the software has a comprehensive notification system that ensures patients receive necessary follow-ups. A nurse (Nikki Baldi, RN) will serve in a new role as lung nodule navigator to ensure patients have no interruptions in their continuum of care.

The Vanderbilt Lung Institute, along with the Vanderbilt-Ingram Cancer Center, and the Lung Cancer Screening Program led by the Department of Radiology and Radiological Sciences, offers comprehensive care to prevent, detect and treat cancer, including a smoking cessation program, lung cancer screening, advanced diagnostic bronchoscopy, thoracic surgery, thoracic oncology and radiation oncology. Vanderbilt researchers work on all these areas to improve cancer care.

“There’s nowhere else in Tennessee that has that comprehensive suite of care,” Rickman said. “It sets us apart.”

The Optellum software adds just one more element to that comprehensive care, Rickman said. Another is a new Intuitive Surgical, ION bronchoscopy robot, which began use in November 2021, that allows surgeons to perform more precise lung biopsies and better diagnose lung cancers. This technology complements Vanderbilt’s Davinci robotic lung cancer surgery program.

“The robot is very small, so we can get out to the edges of the lungs where we couldn’t get before,” Rickman said. “And then once we get there, the robot will stay put. In a traditional bronchoscopic approach, a surgeon’s hand could slip or move. You could be off by a few millimeters, and that’s the difference between making a diagnosis and not making a diagnosis.”

The ION robot serves as a diagnostic robot, which complements the therapeutic Da Vinci robot that thoracic surgeons use to remove cancers.

Lung cancer kills more people each year than any other cancer, and early detection is crucial to treatment and survival. Moreover, lung nodules are especially present in Tennessee due to a fungus called histoplasmosis, Rickman said. Most are not cancer, but it’s critical to detect the ones that are.

“That’s what this Optellum software will do,” Rickman said. “We are making a difference. Survival has improved. We think that has a lot to do with screening and early diagnosis.”