Clinical Benefits of Narrow Band Imaging Bronchoscopy in Central Lung Cancer

Park, Jin Kyeong; Jo, Young Sun; Jang, Sae Jin; Park, Young Soo; Choi, Chang

doi:10.4046/trd.2010.68.1.16

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…We should certainly keep investigating the further potential of AFB in early lung cancer detection, but we should also investigate its potential benefits in everyday clinical practice. There is more and more data confirming that AFB is entering daily practice in respiratory endoscopy suites 46–55 …”

Section: Clinical Application Results and Indicationsmentioning

confidence: 99%

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Diagnostic value of autofluorescence bronchoscopy in lung cancer

et al. 2013

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The role of autofluorescence bronchoscopy (AFB) was primarily investigated in regard to the detection of precancerous lesions of bronchial mucosa. Most of the results confirmed higher sensitivity for the detection of precancerous bronchial lesions, when compared to white light bronchoscopy (WLB) alone. However, it is commonly known that the specificity of AFB remains low. Our findings agree in terms of the detection of premalignant bronchial lesions and early lung cancer, but regarding the detection of synchronous lesions or in the evaluation of lung cancer extension, the specificity of AFB is significantly higher. There is still an ongoing debate in the scientific community whether or not autofluorescence should be used as a screening tool for lung cancer. Results of the majority of published series did not support the general use of AFB as a screening tool for lung cancer; however, these results suggest its use in groups of patients with a high risk of lung cancer. Despite this, some authors still do not recommend its use even in high-risk cases. In recent years, the indications for AFB have been widening and this tool may find its place in routine bronchoscopy. With new indications for AFB, such as the evaluation of tumor extension or follow up after surgical resection, bronchoscopists may make use of this tool more often. A sharp learning curve and a clear distinction between healthy and pathologically altered mucosa make this technology acceptable for inexperienced bronchoscopists. We also investigate new hardware and software improvements in AFB. The addition of backscattered light analysis, ultraviolet spectra, fluorescence-reflectance or dual digital systems could improve the diagnostic yield of this technology.

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Section: Clinical Application Results and Indicationsmentioning

confidence: 99%

“…There is more and more data confirming that AFB is entering daily practice in respiratory endoscopy suites. [46][47][48][49][50][51][52][53][54][55]…”

Section: Clinical Application Results and Indicationsmentioning

confidence: 99%

Diagnostic value of autofluorescence bronchoscopy in lung cancer

et al. 2013

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Relation between vascular patterns visualized by narrow band imaging (NBI) videobronchoscopy and histological type of lung cancer

et al. 2012

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Narrow Band Imaging (NBI) videobronchoscopy is a new technique for visualization of microvascular changes in bronchial mucosa. The primary aim of this study was to evaluate relation between vascular patterns visualized by NBI and histology of lung cancer. We prospectively evaluated 65 patients with suspected lung cancer scheduled for bronchoscopy. NBI followed conventional WL videobronchoscopy. After identification of endoscopically visible tumor, NBI was used to determine predominant type of pathological vascular pattern (dotted, tortuous, abrupt-ending blood vessels-Shibuya descriptors). All the lesions were biopsied and histologically confirmed. There were 81.5 % male and 18.5 % female patients evaluated in the study. Lung cancer was confirmed in all patients; 63.1 % were diagnosed with squamous cell lung cancer (SCC), 24.6 % had adenocarcinoma, 9.2 % had small-cell (SCLC) and 3.1 % large-cell lung cancer (LC). Dotted blood vessels were significantly (p < 0.000) associated with adenocarcinoma, identified in 68.4 % adenocarcinoma and 31.6 % SCC. Tortuous blood vessels were identified in 72 % SCC, 8 % adenocarcinoma, 12 % SCLC and 8 % of LC. Tortuous blood vessels were significantly (p < 0.000) associated with SCC. Abrupt-ending vessels were identified in 81 % SCC, 14.3 % SCLC and 4.8 % adenocarcinoma and were significantly associated (p < 0.000) with SCC. Dotted visual pattern of blood vessels identified during NBI videobronchoscopy is highly suggesting adenocarcinoma histology of lung cancer. Tortuous and abrupt-ending blood vessels visualized under NBI videobronchoscopy significantly suggest squamous cell histology of lung cancer. Large-scale studies should be designed in order to determine true relation between visual appearance and histology in lung cancer.

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Autofluorescence imaging videobronchoscopy in the detection of lung cancer: from research tool to everyday procedure

Zarić

Perin²,

Becker

et al. 2011

Expert Review of Medical Devices

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Autofluorescence imaging videobronchoscopy (AFI) is one of the new systems of autofluorescence bronchoscopy designed for thorough examination of bronchial mucosa. The integration of autofluorescence and videobronchoscopy provides clear images of normal and pathologically altered bronchial mucosa. Major indications for AFI include evaluation of early-stage lung cancer and detection of precancerous lesions. However, in recent years, the indications for AFI are widening, and this tool might find its place in routine daily bronchoscopic practice. With new indications for AFI, such as evaluation of tumor extension or follow-up after surgical resection, this tool might be more often used by bronchoscopists. A sharp learning curve and clear distinction between healthy and pathologically altered mucosa make this technology acceptable for young and inexperienced bronchoscopists. One of the major disadvantages of AFI is low specificity in the detection of premalignant lesions and early-stage lung cancer. This disadvantage could be overcome with the appearance of new and improved technologies in autofluorescence, such as the addition of backscattered light analysis, ultraviolet spectra, fluorescence-reflectance or dual digital systems. Quantitative image analysis is also one of the ways to improve objectivity and minimize observer errors. However, one of the most appropriate solutions would be the addition of AFI to narrow band imaging, and merging the two technologies into one videobronchoscope.

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Clinical Benefits of Narrow Band Imaging Bronchoscopy in Central Lung Cancer

Cited by 4 publications

References 15 publications

Diagnostic value of autofluorescence bronchoscopy in lung cancer

Diagnostic value of autofluorescence bronchoscopy in lung cancer

Relation between vascular patterns visualized by narrow band imaging (NBI) videobronchoscopy and histological type of lung cancer

Autofluorescence imaging videobronchoscopy in the detection of lung cancer: from research tool to everyday procedure

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