Detection of bronchial preneoplastic lesions and early lung cancer with fluorescence bronchoscopy: a study about its ambulatory feasibility under local anaesthesis

Endobronchial ultrasound and value of PET for prediction of pathological results of mediastinal hot spots in lung cancer patients

“…Oxygen (2 L/min) was administered with nasal prongs, and transcutaneous hemoglobin saturation and cardiac rhythm (Ohmeda Biox 3740; Louisville, CO) were continuously monitored. Anaesthesia of the airways was performed as previously described [11] with conscious sedation using intravenous midazolam and patients were managed on an outpatient basis. The technical description of ultrasound examination and real-time guided needle aspiration of lymph nodes using 22-gauge needle has previously been described [7][8][9].…”

Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

“…Oxygen (2 L?min -1 ) was administered with nasal prongs, and transcutaneous haemoglobin saturation and cardiac rhythm (Ohmeda Biox 3740; Ohmeda, Louisville, CO, USA) were monitored continuously during the whole procedure. Analgesia of the airways was performed as previously described [10], with conscious sedation using intravenous midazolam; patients were evaluated on a real outpatient basis. A 20-MHz radial mechanical transducer type ultrasonic probe (UM-BS20-26R; Olympus) in a flexible sheet equipped with a balloon at the tip (Maj-643R; Olympus), connected to a EBUS processor (EU-M20; Olympus) was inserted in the channel and used to localise the abnormal FDG-PET lymph nodes and to make precise their relationship with the tracheobronchial tree.…”

Autofluorescence Bronchoscopy and Endobronchial Ultrasound

“…Many subsequent literature studies (Level of evidence: III) including varying categories of patients with known/suspected lung cancer, or at high-risk of developing lung cancer, confirmed the superiority of AFB + WLB versus WLB in the detection of dysplasia and CIS, even though the relative sensitivity of AFL + WLB was usually found to be lower than that reported in the 1998 study by Lam et coll [10][11][12][13].…”

“…The investigators found that AFB + WLB had a relative sensitivity of 6.3 compared to WLB alone. The specificity of AFB was 66%.Many subsequent literature studies (Level of evidence: III) including varying categories of patients with known/suspected lung cancer, or at high-risk of developing lung cancer, confirmed the superiority of AFB + WLB versus WLB in the detection of dysplasia and CIS, even though the relative sensitivity of AFL + WLB was usually found to be lower than that reported in the 1998 study by Lam et coll [10][11][12][13].More recently, the first prospective, randomised, multicentric study compared WLB + AFB versus WLB in 1173 smokers with additional risk factors for lung cancer (Level of evidence: Ib) [4]. The results of this study confirmed the superiority of AFB over WLB in the detection of preneoplastic and early neoplastic lesions, but did not support the high expectations raised by many previous studies.…”

“…Second, the relative sensitivity of WLB + AFB versus WLB alone found in this study (1.42) was much lower than in many previous studies, and the superiority of AFB over WLB was statistically significant only for moderate/severe dysplasia and not for CIS. The specificity was 58% for WLB + AFB, and 62% for WLB alone.In conclusion, the experience with AFB accumulated so far suggests that [1,3,4,[10][11][12][13][14]: 1) this method is superior to WLB alone, especially in the detection of preneoplastic lesions (moderate to severe dysplasia); 2) it is quite clear that this depends mainly on the sensitivity of WLB. In those studies where the sensitivity was particularly low [Lam] the relative sensitivity of AFB + WLB versus WLB alone was markedly higher; 3) the prevalence of preneoplastic lesions in the population being studied is extremely important, and it has proved highly variable in studies into AFB published thus far.…”