Detection of dysplasia and carcinoma in situ with a lung imaging fluorescence endoscope device.
The performance of a novel bronchoscopic fluorescence imaging system was compared with conventional white light bronchoscopy with a data base of 328 biopsy-confirmed sites from 53 patients and 41 volunteers. The two methods were found to have the same specificity (94%); however, the sensitivity of the fluorescence system (72.5%) was found to be 50% greater than that of the white light bronchoscopy (48.4%) in detecting dysplasia and carcinoma in situ. The fluorescence system uses a nonlinear discriminant function combining the red and green image intensity values to form a pseudoimage that, when displayed on an RGB monitor, allows the detection and delineation of abnormal areas. In 15% of the patients with lung cancer, synchronous carcinoma in situ was found in addition to the large invasive cancer. Of the current smokers in this study, 40% had moderate dysplasia and 12% had severe dysplasia. For the ex-smokers 25% had moderate dysplasia, 6% had severe dysplasia, and 13% had carcinoma in situ. Fluorescence imaging may become an important adjunct to conventional bronchoscopic examination to improve our ability to diagnose and stage lung cancer more accurately.
Cancer Imaging, B.C. Cancer Research Center, Vancouver, Canada.
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Lam
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MacAulay
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Hung
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LeRiche
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Profio
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Palcic
D000368:Aged; D001999:Bronchoscopy / Q000379:methods*; D002278:Carcinoma in Situ / Q000175:diagnosis*; D005336:Fiber Optic Technology; D005453:Fluorescence; D005470:Fluorometry / Q000295:instrumentation*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis*; D008875:Middle Aged; D012680:Sensitivity and Specificity