Vanderbilt Interventional Pulmonary Research Lab (VIPR)
The Vanderbilt Interventional Pulmonary Research Lab (VIPR) includes IP faculty members (Fabien Maldonado, MD, Otis Rickman, DO, and Robert Lentz, MD), thoracic surgery faculty (Erin Gillaspie, MD), biomechanical engineering (Robert Webster, PhD), statistical support, (Heidi Chen, PhD), interventional pulmonary fellow (Jimmy Katsis, MD), research fellow (Michael Lester, MD) and a study coordinator (Lance Roller, MS).
Research activities include (1) Investigator-initialed pragmatic clinical trials, (2) Biomedical engineering research in collaboration with the Vanderbilt institute for Surgery and Engineering VISE), (3) Lung nodule research and (4) industry-sponsored trials. The lab receives funding from the National Institute of health, the Department of Defense and from our industry partners.
Investigator-initiated clinical trials
In collaboration with the Interventional Pulmonology Outcomes Group, the VIPR lab has led and participated in the following pragmatic clinical trials among which:
- Manometry VS. conventional thoracentesis (completed, published in Lancet Respiratory) - multicenter randomized controlled trial (RCT)
- GRAVITAS: gravity VS. suction drainage for therapeutic thoracentesis (completed, published CHEST) - multicenter RCT
- PRECISION-1: RCT comparing robotic, navigation and conventional bronchoscopy (completed, published in CHEST 2019)
- NEWTON: gravity VS suction drainage for indwelling pleural catheters (ongoing)-multicenter RCT
- VERITAS: navigation bronchoscopy VS CT-guided biopsy (funded, upcoming) - multicenter RCT
- FROSTBITE: Novel small cryoprobe VS conventional forceps for lung disease (upcoming) -multicenter RCT
Goal: Continue to develop a collaborative multicenter research infrastructure for efficient deployment of industry-sponsored and investigator-initiated trials in IP.
Biomedical engineering research in collaboration with VISE
In collaboration with the Vanderbilt Institute for Surgery and Engineering, the VIPR lab is working on innovative solutions in bronchoscopy and thoracoscopy to define the future of IP.
Selected projects include:
- Flexible bronchoscopy robot with steerable needles (funded by NIH-RO1)
- Rigid bronchoscopy with tentacle-like robots (funded by NIH R41)
- Selected grants:
- 1 R01 EB 024864-01
- 1 R41 HL 140709-01
Goals: to foster innovation, change the current paradigm in IP research and IP clinical practice, and reinforce Vanderbilt at the leader in IP translational research
Lung nodule - radiomics research
In collaboration with the CANARY lab (Mayo Clinic) and Pierre Massion’s lab, the VIPR lab is developing novel imaging techniques to characterize indeterminate lung nodules and working on integrating intelligent bronchoscopic ablation solutions for the future of lung cancer treatment.
- Selected projects include:
- Radiomic classifier for benign and malignant indeterminate pulmonary nodules (BRODERS classifier - Benign versus aggressive nODule Evaluation using Radiomic Stratification)
- Radiomic classification of lung adenocarcinoma using Computer-Aided Nodule Assessment and Risk Yield (CANARY)
- Optimization of navigation bronchoscopy using real-time imaging (digital tomosynthesis-guided electromagnetic navigation and cone-beam CT guided bronchoscopy)
The VIPR is involved in a number of industry-sponsored trials including pleural, biomarker and bronchoscopy research.
- The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial. Lentz RJ, Shojaee S, Grosu HB, Rickman OB, Roller L, Pannu JK, DePew ZS, Debiane LG, Cicenia JC, Akulian J, Walston C, Sanchez TM, Davidson KR, Jagan N, Ahmad S, Gilbert C, Huggins JT, Chen H, Light RW, Yarmus L, Feller-Kopman D, Lee H, Rahman NM, Maldonado F; Interventional Pulmonary Outcomes Group.Chest. 2020 Mar;157(3):702-711.
- A Prospective Randomized Comparative Study of Three Guided Bronchoscopic Approaches for Investigating Pulmonary Nodules: The PRECISION-1 Study.Yarmus L, Akulian J, Wahidi M, Chen A, Steltz JP, Solomon SL, Yu D, Maldonado F, Cardenas-Garcia J, Molena D, Lee H, Vachani A; Interventional Pulmonary Outcomes Group (IPOG). Chest. 2020 Mar;157(3):694-701.
- A Concentric Tube Robot System for Rigid Bronchoscopy: A Feasibility Study on Central Airway Obstruction Removal.Gafford JB, Webster S, Dillon N, Blum E, Hendrick R, Maldonado F, Gillaspie EA, Rickman OB, Herrell SD, Webster RJ 3rd.Ann Biomed Eng. 2020 Jan;48(1):181-191.
- Improved diagnostic yield for lung nodules with digital tomosynthesis-corrected navigational bronchoscopy: Initial experience with a novel adjunct. Aboudara M, Roller L, Rickman O, Lentz RJ, Pannu J, Chen H, Maldonado F. Respirology. 2020 Feb;25(2):206-213. doi: 10.1111/resp.13609. Epub 2019 Jul 2.
- Computed Tomography-Based Score Indicative of Lung Cancer Aggression (SILA) Predicts the Degree of Histologic Tissue Invasion and Patient Survival in Lung Adenocarcinoma Spectrum. Varghese C, Rajagopalan S, Karwoski RA, Bartholmai BJ, Maldonado F, Boland JM, Peikert T. J Thorac Oncol. 2019 Aug;14(8):1419-1429. doi: 10.1016/j.jtho.2019.04.022. Epub 2019 May 4.
- Routine monitoring with pleural manometry during therapeutic large-volume thoracentesis to prevent pleural-pressure-related complications: a multicentre, single-blind randomised controlled trial. Lentz RJ, Lerner AD, Pannu JK, Merrick CM, Roller L, Walston C, Valenti S, Goddard T, Chen H, Huggins JT, Rickman OB, Yarmus L, Psallidas I, Rahman NM, Light RW, Maldonado F. Lancet Respir Med. 2019 May;7(5):447-455. doi: 10.1016/S2213-2600(18)30421-1. Epub 2019 Feb 13.