DETECTION OF DYSPLASIA AND CARCINOMA INSITU WITH A LUNG IMAGING FLUORESCENCE ENDOSCOPE DEVICE

The performance of a novel bronchoscopic fluorescence imaging system w as compared with conventional white light bronchoscopy with a data bas e of 328 biopsy-confirmed sites from 53 patients and 41 volunteers. Th e 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 detecti ng dysplasia and carcinoma in situ. The fluorescence system uses a non linear discriminant function combining the red and green image intensi ty values to form a pseudoimage that, when displayed on an RGB monitor , allows the detection arid delineation of abnormal areas. In 15% of t he patients with lung cancer, synchronous carcinoma in situ was found in addition to the large invasive cancer. Of the current smokers in th is study, 40% had moderate dysplasia and 12% had severe dysplasia. For the ex-smokers 25% had moderate dysplasia, 6% had severe dysplasia, a nd 13% had carcinoma in situ. Fluorescence imaging may become an impor tant adjunct to conventional bronchoscopic examination to improve our ability to diagnose and stage lung cancer more accurately.