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One option is a bronchoscopic approach, which is where we go down through the mouth, into the airways. And that’s obviously going to be more easy to reach those nodules that are centrally located in the chest. Whereas the ones that are more peripheral, oftentimes those will be more easily approached from the outside by a radiologist, but it’s not that cut and dry. There are other things that we consider, which is, which lobe is the nodule in? How close is it to a fissure, which is the line between the lobes? Also the integrity of the lung that’s around that nodule. You have to think if there is a lot of damaged lung surrounding a nodule, you may approach it differently to avoid those areas of damaged lung. Things like the ribs, the scapula, which are the bones that are surrounding the lung, that can have an impact as well. So it can be tricky, particularly with a very small lung nodule.
