Interventional Pulmonology Unit (IPU)

The Interventional Pulmonology Unit at Liverpool Hospital provides state-of-the-art expertise in the diagnosis and management of complex airway, lung, and pleural diseases. With advanced facilities and a highly skilled faculty, the unit is at the forefront of patient care, education, and research in Australia.

Clinical Services

Our unit offers a full spectrum of interventional procedures, ensuring accurate diagnosis, effective treatment, and improved patient outcomes.

Standard services include:

• Endobronchial ultrasound (EBUS) biopsy – minimally invasive diagnosis and staging of lung cancer.
• Flexible bronchoscopy – evaluation and treatment of airway disorders.
• Rigid bronchoscopy – advanced management of complex airway conditions.
• Central airway debulking – state-of-the-art techniques for obstructing airway tumours.
• Navigation bronchoscopy – precise biopsy of peripheral pulmonary nodules.
• Lung cancer diagnosis and staging – multidisciplinary evaluation with cutting-edge technology.
• Endoscopic lung volume reduction – minimally invasive therapy for advanced COPD.
• Transbronchial lung cryobiopsies – high-yield diagnostic approach for interstitial lung disease.
• Thoracentesis and chest tube insertion – safe management of pleural effusions and pneumothorax.
• Indwelling pleural catheters – long-term management of recurrent pleural effusions.
• Ultrasound-guided pleural biopsies – modern diagnostic tools for pleural pathology.

Research and Innovation

The Liverpool Hospital Interventional Pulmonology Unit actively participates in national and international clinical studies, contributing to the advancement of respiratory medicine.

Current and recent research includes:

• Next-generation sequencing of lung cancers.
• Novel approaches to the diagnosis and treatment of interstitial lung disease.
• Innovative strategies in the management of pleural diseases.
• Airway stenting for patients with complex airway obstruction.

Education and Training

Our faculty are leaders in interventional pulmonology education, delivering programs across Australia that promote competence in advanced bronchoscopic and pleural procedures. We are committed to training the next generation of respiratory physicians through workshops, national conferences, and hands-on teaching.

Patient Information Sheets

Bronchoscopy
Endobronchial Ultrasound (EBUS)
Transbronchial Cryobiopsy

Meet Our Team:

Associate Professor Jonathan Williamson

Lead Interventional Pulmonologist, IP Unit, Liverpool Hospital
Associate Professor Jonathan Williamson established the Interventional Pulmonology Unit at Liverpool Hospital in 2010 and has overseen its growth into a major referral centre for advanced airway, pleural, and lung cancer interventions. He completed his medical and specialty training locally at Royal North Shore Hospital, St Vincent’s Hospital Sydney, and Sir Charles Gairdner Hospital in Perth, followed by a fellowship at the Thoraxklinik, Heidelberg, Germany.

A/Prof Williamson has introduced numerous innovations to the service and remains actively involved in national and international clinical trials. His primary interests include navigation bronchoscopy, next-generation sequencing for lung cancers, and therapeutic strategies for central airway obstruction. Today, the Liverpool Interventional Pulmonology Unit is recognised as one of the leading referral centres for complex airway interventions across Sydney and regional New South Wales.

Dr Matthew Ing

Interventional Pulmonologist
Dr Matthew Ing trained in interventional pulmonology at Liverpool Hospital and Sir Charles Gairdner Hospital in Perth. He has a strong interest in pleural disease and the use of bronchoscopy for diagnosis, staging, and management of central airway obstructing lesions.

Dr Ing is currently completing a Master of Philosophy in Pleural Disease and has ongoing involvement in national and international clinical trials investigating the optimal use of indwelling pleural catheters. His combined clinical and research expertise ensures patients benefit from the latest evidence-based approaches to pleural disease and lung cancer care.

Dr Melissa Baraket

Advanced Bronchoscopist
Dr Melissa Baraket is a senior respiratory physician at Liverpool Hospital who trained in Sydney. She has several years of experience in flexible bronchoscopy and endobronchial ultrasound (EBUS), with a strong commitment to collaborative care. Dr Baraket works closely with her colleagues to ensure excellence in both diagnosis and treatment, contributing to the unit’s reputation as a leader in interventional pulmonology.

Publications from the Interventional Pulmonology Unit, Liverpool Hospital (2021–2025)

2025

• TSANZ Practical Guide for Clinicians in the Management of Screen- and Incidentally-Detected Nodules (Respirology, 2025)
  A national consensus guideline, co-authored by A/Prof Jonathan Williamson, providing a comprehensive framework for evaluating and managing pulmonary nodules identified through screening and incidental imaging. It emphasises timely referral pathways and evidence-based diagnostic algorithms.
• BREATHE Trial – Airway Scaffolds for Emphysema-Related Hyperinflation (AJRCCM, 2025)
  An international, multicentre study reporting six-month outcomes of bronchoscopically placed airway scaffolds in severe emphysema. Williamson and colleagues demonstrated clinically meaningful improvements in lung function and hyperinflation, providing a novel therapeutic avenue for COPD.

2024

• Treatment of Bronchopleural Fistula with Watanabe Spigots (Respir Case Rep, 2024)
  A case series showcasing the utility of endobronchial spigots in managing complex bronchopleural fistulas.
• Removal of Ruptured Pulmonary Hydatid Cyst During Conscious Sedation Bronchoscopy (Respirol Case Rep, 2024)
  Case report and literature review demonstrating minimally invasive bronchoscopic management of a rare parasitic pulmonary lesion.
• Recurrent DEK::AFF2 Fusion Squamous Cell Carcinoma (Pathology, 2024)
  Identifies a novel genetic fusion associated with squamous carcinoma, prompting clinicians to consider emerging molecular subtypes in diagnosis.
• Tracheobronchial Stents – An Expanding Prospect (Intern Med J, 2024)
  Review article highlighting indications, evolving technology, and outcomes of stent use in complex airway obstruction.
• Multigene Panel Next-Generation Sequencing in NSCLC (IMJ, 2024)
  Demonstrated the clinical utility of NGS for routine identification of actionable genomic alterations in newly diagnosed metastatic NSCLC.
• EBUS-TBNA Samples for Comprehensive Sequencing (Cancers, 2024)
  Proved feasibility of using EBUS-derived samples for whole genome/exome sequencing, supporting integration of bronchoscopic tissue in precision oncology.
• KRAS G12C Mutation in NSCLC (Pathology, 2024)
  Describes histopathological and molecular correlates of this increasingly targetable mutation, refining diagnostic and therapeutic pathways.

2023

• Central Airway Squamous Metaplasia After Radiation (Respir Med Case Rep, 2023)
  Report highlighting a post-radiation airway change mimicking tumour recurrence, reinforcing the importance of biopsy confirmation.
• Mediastinal Cryobiopsy (Lancet Respir Med, 2023)
  Invited commentary evaluating safety and appropriate indications for cryobiopsy of mediastinal lesions.
• Cryo-Radial Bronchoscopy vs. CT-Guided Biopsy (IMJ, 2023)
  Randomised study demonstrating comparable diagnostic yield but superior safety of cryobiopsy with radial EBUS compared to transthoracic biopsy for peripheral pulmonary nodules.

2022

• BRadSTAT Tool for Bronchoscopy-Radiology Skills (Respiration, 2022)
  Developed and validated an assessment tool to evaluate bronchoscopists’ radiological interpretation skills, contributing to training and credentialing frameworks.
• Global SARS-CoV-2 Bronchoscopy Database (J Bronchol Interv Pulmonol, 2022)
  International collaboration reporting safety and outcomes of bronchoscopy in COVID-19 patients, guiding practice during the pandemic.
• Exploratory Cryo-Radial Study (IMJ, 2022)
  Early data supporting the role of cryo-radial bronchoscopy as a safer, effective alternative to transthoracic biopsy in selected patients.
• Genomic Sequencing in Cancer (ESMO Open, 2022)
  Compared whole-genome sequencing, exome sequencing, and mutation panels, providing insights into detection of actionable mutations and the future of precision oncology.

2021

• Clinical Practice Guide for Respiratory Support in COVID-19 (NSW Agency for Clinical Innovation, 2021)
  Statewide guideline for managing respiratory support in adults with COVID-19, with broad clinical uptake.
• Interventional Bronchoscopy for COPD (MJA, 2021)
  Perspective article on bronchoscopic therapies for COPD, framing future directions beyond pharmacological therapy.
• Localized Tracheobronchial Amyloidosis (Respirol Case Rep, 2021)
  Case report outlining tailored bronchoscopic management of this rare disease.
• 3D-Printed Airway Models for Stent Implantation (Interact CardioVasc Thorac Surg, 2021)
  Innovative use of patient-specific airway models to guide complex stent placement, bridging interventional pulmonology and bioengineering.
• Cryobiopsy for ILD (AJRCCM, 2021)
  Findings from the COLDICE trial, confirming the value of cryobiopsy in diagnosing interstitial lung disease with histopathological confidence.

Overall Themes and Impact

Over the past five years, the Liverpool Hospital IP Unit has contributed significantly across four domains:

1. Lung Cancer – advancing tissue acquisition (EBUS, cryobiopsy) and precision oncology through integration of genomic sequencing.
2. Airway Intervention – pioneering airway stenting, debulking, and novel bronchoscopic techniques such as dye marking and scaffold placement.
3. COPD and Pleural Disease – innovating in endoscopic lung volume reduction, collateral ventilation reversal, and indwelling pleural catheter research.
4. Education and Global Collaboration – developing tools (BRadSTAT), publishing practice guidelines, and leading multicentre collaborations in interventional pulmonology.