Diagnostic test for lung conditions

Diagnosing lung diseases when they are at an early stage is vital to effective treatment. Our dedicated specialists treat adults and children with a range of lung conditions and symptoms including:  

• asthma   
• chronic lung infection  
• chronic obstructive pulmonary disease (COPD)  
• fungal lung diseases  
• interstitial lung disease  
• lung cancer 
  

To aid the diagnosis of lung conditions in adults and children, we use a wide range of tests and scans as part of our innovative, world-leading heart and lung care.

Lung function tests

We offer a range of lung function tests (also referred to as pulmonary function tests) to evaluate how well your or your child’s lungs work. All tests are painless and should not take longer than an hour. Depending on the lung test results, you or your child may need a blood test or exercise test to aid accurate diagnosis.   

Tests available with our lung specialists include:

Spirometry

A spirometry test (also known as a spiro lung function test) involves blowing into a device called a spirometer to show how well you or your child breathes in and out. You will be asked to breathe in fully and then blow out as hard and fast as you can.  

Lung volume

A lung capacity test requires breathing into a device similar to a spirometer, whilst sitting in a glass box with a clip on your nose (to prevent air escaping). This allows us to gauge breathing capacity.  

Gas transfer

During a gas transfer test, you will breathe in a harmless gas, hold it in for 10 seconds and then breathe out the gas into a mouthpiece. We will then test the gas to detect how much oxygen is in the lungs.  

FeNO testing

Fractional exhaled nitric oxide (FeNO) testing involves measuring the concentration of nitric oxide in the exhaled breath. It is used to identify inflammation in the lungs. FeNO can help diagnose asthma in adults and children. 

FeNO measurement is recommended as an option to support asthma management in people who are symptomatic despite using inhaled corticosteroids.  

Arterial blood gas sampling

Blood-gas analysis is a useful test involving a small amount of blood being taken from the base of your ear lobe.  It is needed for the clinician to understand whether or not there are any physical or metabolic changes affecting your condition. This is often supported with background information on the clinical condition collected by routine lung function tests.

Exercise test to diagnose lung conditions

An exercise test allows us to monitor changes to your or your child’s heart rate and breathing whilst you exercise.  

We will ask you to walk on a treadmill, whilst breathing into a mouthpiece with a soft clip on your nose. This will enable our specialists to measure how much air you breathe during exercise.  

An electrocardiogram (ECG) will be used to monitor your heart rate, whilst a blood pressure cuff will be used to measure your blood pressure. Meanwhile, a small peg on your finger will also be used to detect the level of oxygen in your blood.

Imaging tests to diagnose lung conditions

Consultants at Guy’s and St Thomas’ Specialist Care provide a range of imaging tests to build a more detailed picture of your or your child’s lungs.

Chest X-ray 

A chest X-ray is just like a normal X-ray. It allows us to get a picture of the lungs, heart, large arteries, ribs and diaphragm. You or your child will be asked to hold your breath during the X-ray. 

Computed tomography (CT) scan

A CT scan is a special imaging test that allows us to build detailed pictures of your heart and lungs. You will lie on a bed as it moves through a scanner and will be asked to hold your breath whilst the scan is taken.  

CT scans are sometimes offered with contrast medium (a special dye), which is usually administered as an injection. Contrast helps to create a clear differentiation of body tissue during imaging, but is not required for all CT scans.

NAEOTOM Alpha CT scanner

The NAEOTOM Alpha CT This creates outstanding image detail while reducing the amount of radiation typically required for imaging. 

As a dual-source CT machine, the NAEOTOM Alpha operates twice as fast as conventional CT scanners, providing precise, high-quality images of the organ’s structure, leading to a diagnosis of a range of chronic lung conditions.

Nuclear medicine and PET 

Nuclear medicine can be used in the diagnosis of heart or lung conditions by injecting a special substance with radioactive properties into the blood. Known as a ‘tracer,’ this substance helps to highlight the part of the body being scanned.  

We can scan children aged 6 years and older. We do not currently provide scans with contrast or tracer to children.

Bronchoscopy to diagnose lung conditions

A bronchoscopy is a procedure where a doctor can look at the trachea (windpipe), the bronchi (branches of the airways) and into some areas of the lungs with a video bronchoscope. This enables samples to be obtained for the diagnosis of a variety of lung conditions ranging from lung cancer and infection through to lung fibrosis.  

The diagnostic tests include:  

• ‘wash’ or bronchoalveolar lavage (BAL)  
• transbronchial needle aspiration (TBNA)  
• endobronchial biopsy  
• transbronchial lung biopsy 
  

Bronchoscopies can be used for both children and adults to investigate lung conditions and confirm diagnoses. Bronchoscopies are typically carried out under general anaesthetic to ensure that you remain completely still for the procedure.

Endobronchial ultrasound guided transbronchial fine needle aspiration (EBUS-TBNA)

This procedure uses a special bronchoscope with ultrasound scanning built into it. This allows the area beyond the air passages to be evaluated and samples from lymph glands and other areas adjacent to the airways to be obtained under ultrasound control.

Ion robotic-assisted lung cancer biopsy

A new robotic-assisted technology, the Ion endoluminal system (also referred to as ‘Ion’), enables respiratory specialists to obtain biopsies (tissue samples) from very small lung nodules that are typically hard to access. By utilising the Ion endoluminal system, with cone beam CT scanning and its advanced 3D roadmap capability, our consultants became the first in the country to carry out robotic-assisted biopsies for lung cancer. 

This approach offers high accuracy in sampling tissue from nearly any lung nodule, including those that are more challenging to reach. Ion’s advanced features mean that lung nodules as small as 6mm can be detected, allowing for timely treatment and potentially improving survival outcomes.

Complementary services for lung conditions

Effective treatment of lung conditions requires a multidisciplinary approach.  

Here’s an example of the additional services we provide to accelerate and enhance recovery:

Diet and nutrition advice

Our expert dieticians will work with you to create tailored plans for weight loss, managing food allergies and simple ways to make essential, effective diet and lifestyle changes that complement your or your child’s treatment and therapy. 

Physiotherapy

Our highly-trained physiotherapists work alongside dieticians, consultants and therapists to ensure your or your child’s physical wellbeing is looked after. Physiotherapy services include exercise regimes, breathing exercises, airway clearance, pain management and rehabilitation programmes.  

Psychology

Our psychologists offer a range of therapies to treat psychological problems associated with long term or acute illness. There is strong evidence from research studies linking effective treatment of mental health conditions with significantly improved physical health outcomes.  

Bone density scan (DEXA scan)

If you have received a lung transplant, you will need to undergo an annual bone density scan known as a dual-energy X-ray absorptiometry (DEXA) scan for the first two years, following surgery. This is to monitor your bone health, as patients may experience a loss in bone mineral density (BMD) after a transplant. This can make you more susceptible to fractures and osteoporosis.