The clinical value of lung imaging fluorescence endoscopy for detecting synchronous lung cancer

Some patients with non-small cell lung cancer (NSCLC) will also have a sync hronous malignant lesion. The lung imaging fluorescence endoscopy (LIFE) ha s proven better than conventional white light bronchoscopy (WLB) for visual izing premalignant lesions or early stages of lung cancer. In this study, t he additional value of LIFE in diagnosing synchronous lung cancers as well as the impact of these findings on definite therapy was analyzed. Seventy-t wo patients with recently diagnosed NSCLC or pulmonary lesions highly suspe ct of lung cancer were studied. Patients underwent WLB, followed by LIFE. A part from the primary lesions, additional abnormal and suspicious lesions s een at WLB and LIFE were scored separately and biopsied. Sixty-nine patient s had NSCLC and three patients had small cell lung carcinoma. Apart from th e primary lesion, one up to six additional endobronchial lesions were visua lized in 48 patients by WLB and/or LIFE. High-grade dysplastic lesions were detected in ten patients, three of whom were eligible for surgery of the p rimary tumor after completion of the investigations. Three other patients ( 4.3%) had synchronous cancers (NSCLC). In one patient, the lesion was visua lized by LIFE and by WLB. The other two malignant lesions were detected onl y by LIFE. In these three latter patients, diagnostic work-up and definite treatment was changed. as a result of detection of synchronous lesions. In conclusion, LIFE has additional value in detecting synchronous malignant le sions in patients with primary lung cancer. The detection of these lesions changed diagnostic work-up and definite treatment plan. Therefore, LIFE sho uld be used in the work-up of patients with primary lung cancer. (C) 2001 E lsevier Science Ireland Ltd. All rights reserved.