A randomized study of fluorescence bronchoscopy versus white-light bronchoscopy for early detection of lung cancer in high risk patients

Review of Recent Advances in Fluorescence Bronchoscopy in Early Localization of Central Airway Lung Cancer

“…Kennedy et al [26] reported results on 55 high-risk subjects undergoing bronchoscopy examinations randomized for both the order of the modality and for two bronchoscopists blinded as to the findings of the other. Fifty-five percent of the subjects had high-grade dysplasia or worse and 78 of 391 biopsies (20%) had high-grade dysplasia or worse.…”

“…Bronchoscopists conducting trials based on subsequent biopsy samples will find it relatively easy to find the previous sites but difficult to interpret changes in fluorescence unless the original area was extensive. Limited experience also suggests some small sites of preneoplasia or CIS may be removed by the biopsy procedure, confounding the evaluation of study chemoprevention agents [26,32].…”

“…The specificity of LIFE, however, was lower than white light, 46% versus 78%. Combined white light and LIFE provided a sensitivity of 80% but a specificity of only 29% [26]. This could be a reflection of a lower threshold of classifying a lesion as visibly suspicious than that demonstrated by Venmans' group.…”

Risk of lung cancer in patients with preinvasive bronchial lesions followed by autofluorescence bronchoscopy and chest computed tomography

“…Times to local progression from severe dysplasia to CIS were (11, 28, 54 months), times to detection of CIS/LC centrally were (12, 17, 22, 30, 49, 49, 49 months), and times to detection of LC peripherally were (6,9,11,11,13,18,26,29,33, 46 months). Follow-up duration for patients with regression, stable disease and progression to CIS or LC (mean ± SD) were, 25 ± 18.4, 30 ± 25.4 and 26 ± 15.7 mo, respectively, with no significant difference (p = 0.46).…”

Optical Spectroscopy for the Classification of Malignant Lesions of the Bronchial Tree

“…Autofluorescence bronchoscopy has been reported to have a higher sensitivity than white light bronchoscopy for the detection of endobronchial (pre-)malignant lesions. [23][24][25] However, autofluorescence bronchoscopy is characterized by a low specificity with a high rate of false-positive findings, inducing unnecessary biopsies at a greater cost and a longer examination duration. 26,27 We find that both autofluorescence and white light reflectance spectroscopy increase the positive predictive value of autofluorescence imaging alone for the detection of bronchial tumors.…”