Improving the specificity of fluorescence bronchoscopy for the analysis of neoplastic lesions of the bronchial tree by combination with optical spectroscopy: preliminary communication

Abstract

Detection of malignancies of the bronchial tree in an early stage, such as carcinoma in situ (CIS), augments the cure rate considerably. It has been shown that the sensitivity of autofluorescence bronchoscopy is better than white light bronchoscopy for the detection of CIS and dysplastic lesions. Autofluorescence bronchoscopy is, however, characterized by a low specificity with a high rate of false positive findings. In the present paper we propose to combine autofluorescence bronchoscopy with optical spectroscopy to improve the specificity of autofluorescence imaging, while maintaining the high sensitivity. Standard autofluorescence bronchoscopy was used to find suspect lesions in the upper bronchial tree, and these lesions were subsequently characterized spectroscopically using a custom made fiberoptic probe. Autofluorescence spectra of the lesions as well as reflectance spectra were measured. We will show in this preliminary report that the addition of either of these spectroscopic techniques decreases the rate of false positives findings, with the best results obtained when both spectroscopic modalities are combined.