Abstract
Current routine diagnosis of premalignant lesions of the central airways is hampered due to a limited sensitivity (white light bronchoscopy) and resolution (computer tomography (CT), positron emission tomography (PET)) of currently used techniques. To improve the detection of these subtle mucosal abnormalities, novel optical imaging bronchoscopic techniques have been developed over the past decade. In this review we highlight the technological developments in the field of endoscopic imaging, and describe their advantages and disadvantages in clinical use.
Highlights
Lung cancer is the second most common cancer in men and women and the leading cause of cancer related death
non-small-cell lung cancer (NSCLC) is subdivided in 3 different major histological classes: squamous cell carcinoma (SCC), adenocarcinoma, and undifferentiated large cell carcinoma [2]
It was shown that SCC develops sequentially: from normal to metaplasia, dysplasia, carcinoma in situ (CIS), and eventually invasive carcinoma [4]
Summary
Lung cancer is the second most common cancer in men and women and the leading cause of cancer related death. NSCLC is subdivided in 3 different major histological classes: squamous cell carcinoma (SCC), adenocarcinoma, and undifferentiated large cell carcinoma [2]. Fifty years ago Auerbach et al discovered that preinvasive lesions of different grades of severity were associated with lung tumors of squamous cell histology. This observation led to the hypothesis that SCC arises from these preinvasive changes [3]. Since the epithelial changes associated with premalignancy are very subtle, no current routine imaging technique is sensitive enough to detect these lesions. Novel endoscopic imaging techniques have been developed over the past decade to increase its sensitivity. In this paper we describe the technical aspects of these imaging and point measurement techniques, discuss the underlying biological mechanisms resulting in the optical contrast for each technique, and discuss the clinical use of these novel optical techniques
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