Explore pulmonology diagnostic methods including pulmonary function tests and imaging.

Learn about accurate diagnosis for lung conditions. We offer spirometry, imaging, and advanced testing for adults and children at LIV Hospital.

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Mapping the Breath

When you cannot breathe, nothing else matters. The panic of air hunger or the exhaustion of a chronic cough drives patients to seek answers. But the lungs are complex organs, hidden behind the rigid cage of the ribs. In the past, diagnosing lung conditions often required open surgery or “wait and see” approaches.

Today, Pulmonology Diagnosis at Liv Hospital is a high-tech, minimally invasive discipline. We have replaced the scalpel with the bronchoscope and the stethoscope with the CT scanner. Our goal is to provide a Definitive Diagnosis—not just “It might be asthma,” but “It is Eosinophilic Asthma triggered by dust mites with 20% airway obstruction.”

Our Interventional Pulmonology Unit allows us to reach deep into the chest to biopsy lymph nodes, drain fluid, and inspect airways without making a single incision on your skin. This “inside-out” approach is safer, faster, and less painful than traditional methods.

Pulmonary Function Tests (PFTs)

Before we look inside the lungs, we measure how well they work. These tests are the foundation of all respiratory diagnosis.

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Spirometry

PULMONOLOGY

This is the most common test for Asthma and COPD.

  • The Procedure: You sit in a glass booth and breathe into a mouthpiece connected to a machine. You will be asked to take a deep breath and blow out as hard and fast as you can.
  • What it Measures:
    • FVC (Forced Vital Capacity): The total amount of air you can exhale.
    • FEV1 (Forced Expiratory Volume in 1 Second): How much air comes out in the first second.
  • The Diagnosis:
    • Obstructive (Asthma/COPD): Air comes out slowly (low FEV1) because airways are narrow.
    • Restrictive (Fibrosis): Total air is low (low FVC) because lungs are stiff and small.
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DLCO

PULMONOLOGY

Spirometry measures air flow; DLCO measures gas exchange.

  • The Procedure: You inhale a harmless gas mixture (containing a tiny amount of carbon monoxide) and hold your breath for 10 seconds.
  • The Science: We measure how much of the gas was absorbed into your blood.
  • The Insight: If DLCO is low, it means the alveoli (air sacs) are damaged (Emphysema) or thickened (Fibrosis), preventing oxygen from entering the bloodstream. This is often the first sign of Long COVID lung damage.

What is 6-Minute walk test?

Real life doesn’t happen in a chair. We measure your oxygen levels and heart rate while walking for 6 minutes. This tells us if you need supplemental oxygen at home.

Advanced Imaging

X-rays are often not enough. To see a tumor when it is curable (size of a pea), we need 3D clarity.

Low-Dose CT Screening (LDCT)

  • Who needs it? Smokers aged 50–80 with a “20 pack-year” history.
  • The Tech: It uses 90% less radiation than a standard CT scan. It takes 10 seconds.
  • The Benefit: It reduces lung cancer mortality by 20% by finding nodules before symptoms appear.

PET-CT (Metabolic Scan)

If a nodule is found, is it cancer or just a scar?

  • The Test: We inject a radioactive sugar tracer. Cancer cells eat the sugar and “light up” on the scan.
  • The Result: It tells us if the nodule is active (malignant) and if it has spread to lymph nodes (staging).

Interventional Bronchoscopy

This is the core of our diagnostic power. We use flexible tubes (scopes) to enter the airways.

Flexible Bronchoscopy

  • The Experience: Performed under Deep Sedation (TIVA). You are asleep and feel no gagging or pain.
  • The Scope: A thin tube with a camera enters through the mouth or nose. We inspect the vocal cords, trachea, and bronchi for tumors, blockages, or bleeding.
  • Bronchoalveolar Lavage (BAL): We squirt saline water into a segment of the lung and suck it back out. This “lung washing” captures bacteria, fungi, or cancer cells for analysis. It is crucial for diagnosing complex infections like Tuberculosis or Pneumocystis.

EBUS (Endobronchial Ultrasound)

The “Game Changer” for lung cancer staging.

  • The Problem: Lymph nodes sit outside the airway walls. A regular camera can’t see them.
  • The Solution: The EBUS scope has an ultrasound probe at the tip. We press it against the airway wall to see the lymph nodes behind it.
  • The Biopsy (TBNA): A tiny needle shoots out of the scope, through the wall, and into the node to suck out cells.
  • The Benefit: It replaces “Mediastinoscopy” (a surgery that required a cut in the neck). It is an outpatient procedure with >95% accuracy.

Electromagnetic Navigation Bronchoscopy (ENB)

For tumors deep in the periphery of the lung (where standard scopes can’t reach).

  • The GPS: We upload your CT scan to create a 3D virtual roadmap. Sensors on the patient’s chest track the probe in real-time, guiding the doctor to the exact millimeter of the tumor for biopsy.

Pleural Procedures

The lungs are wrapped in a double-layer sac called the pleura. Sometimes, fluid builds up here (Pleural Effusion), crushing the lung.

Thoracentesis (Tap)

  • The Procedure: Using ultrasound guidance, we insert a small needle into the back to drain the fluid.
  • Diagnostic: We send the fluid to the lab to check for protein (heart failure), bacteria (pneumonia), or cancer cells.
  • Therapeutic: Draining 1 liter of fluid instantly relieves shortness of breath.

Medical Thoracoscopy

If the fluid keeps coming back and the cause is unknown, we perform a mini-surgery.

  • The Tech: Under local anesthesia and sedation, we make a small “keyhole” incision and insert a camera (thoracoscope) into the chest cavity.
  • The Goal: We can see the lung surface directly and take biopsies of the pleura. This is often the only way to diagnose Mesothelioma or Tuberculosis pleurisy.

Sleep Diagnostics

Sleep Apnea is a physical blockage of the airway, but it requires physiological proof.

Level 1 Sleep Study (In-Lab)

You spend the night in our luxury sleep suite. It is soundproofed and designed like a hotel room, not a hospital ward.

  • Sensors: We monitor:
    • EEG: Brain waves (are you in deep sleep or REM?).
    • Airflow: Is air entering your nose?
    • Chest/Abdomen Belts: Are your muscles trying to breathe?
    • Oximetry: Is your oxygen dropping?
    • ECG: Is your heart skipping beats?
  • The Result: We calculate your AHI (Apnea-Hypopnea Index).
    • <5: Normal.
    • 5–15: Mild.
    • 15–30: Moderate.
    • >30: Severe (You stop breathing 30+ times an hour).

Home Sleep Apnea Test (HSAT)

For patients with high suspicion of simple obstructive apnea, we can provide a portable kit to wear in your own hotel bed. It measures fewer channels but is more convenient.

Allergy and Immunology Testing

Asthma is often just the symptom; allergy is the cause.

  • Skin Prick Test: We apply drops of common allergens (dust, pollen, mold, cat dander) to your arm and scratch the skin. If a red bump (wheal) appears in 15 minutes, you are allergic.
  • Specific IgE Blood Test: A blood test to measure the precise level of antibodies to specific triggers. Crucial for patients who cannot stop taking antihistamines for the skin test.
  • FeNO (Fractional Exhaled Nitric Oxide): You blow into a handheld device. High nitric oxide levels indicate “Eosinophilic” (allergic) inflammation in the airways, predicting if you will respond well to steroid inhalers.

How We Ensure Comfort and Safety

Diagnostic procedures can be scary. We prioritize your experience.

  1. Sedation for All: We do not believe in “awake” bronchoscopy. An anesthesiologist is present to ensure you are deeply sedated and comfortable.
  2. Rapid Pathology: For international patients, we use “Rapid On-Site Evaluation” (ROSE). A pathologist is in the bronchoscopy suite to check the biopsy immediately. If we have the answer, we stop. No need for repeat procedures.
  3. Single-Session Care: We try to combine tests. For example, we can do the EBUS and the Colonoscopy (if needed for cancer staging) under the same sedation session to save you time.

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FREQUENTLY ASKED QUESTIONS

How can I improve my indoor air quality?

Keep humidity levels between 30-50%, change HVAC filters regularly, use a vacuum with a HEPA filter, and avoid using strong chemical fragrances or smoking indoors.

Yes, a healthy diet maintains a healthy weight, reduces pressure on the diaphragm, and provides antioxidants that help protect lung tissue from inflammation and damage.

Yes, most people with asthma can and should exercise; using a rescue inhaler 15 minutes before activity and warming up properly can prevent exercise induced symptoms.

In addition to standard childhood vaccines, adults with lung conditions need the annual flu shot, the pneumococcal conjugate vaccine (PCV20 or PCV15/PPSV23), and the COVID-19 vaccine.

Stress can cause your breathing to become shallow and rapid (hyperventilation), which can make you feel short of breath and worsen conditions like asthma or COPD. Learning deep-breathing exercises helps counteract this.

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