Autofluorescence for the diagnosis of visceral pleural invasion in non-small-cell lung cancer

Takizawa, Hiromitsu; Kondo, Kazuya; Kawakita, Naoya; Tsuboi, Mitsuhiro; Toba, Hiroaki; Kajiura, Koichiro; Kawakami, Yukikiyo; Shoji, Shuichi; Tangoku, Akira; Morishita, Atsushi; Nakagawa, Yasushi; Hirose, Toshiyuki

doi:10.1093/ejcts/ezx419

Cited by 20 publications

(13 citation statements)

References 22 publications

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“…In previous studies, we reported that the use of an autofluorescence endoscopy system improved the diagnostic accuracy rate of VPI (17). VPI is deemed present when the green autofluorescence light is diminished or disappears.…”

Section: Discussionmentioning

confidence: 97%

“…Based on these facts, it is suggested that sublobar resection should not be performed for cases with suspected VPI even for lung cancer of 2 cm or smaller (3). However, it is difficult to accurately diagnose VPI before and during surgery (17).…”

Section: Discussionmentioning

confidence: 99%

“…Previously, we focused on the reduction or disappearance of autofluorescence in the pleura with lung cancer invasion. We reported the usefulness of pleural autofluorescence observation using a fluorescent endoscopy system for intraoperative diagnosis of VPI in lung cancer (17).…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of visceral pleural invasion using confocal laser endomicroscopy during lung cancer surgery

Sawada¹,

Takizawa²,

Aoyama³

et al. 2021

J Thorac Dis

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Background: Visceral pleural invasion (VPI) in lung cancer is a significant prognostic factor; however, it is difficult to diagnose preoperatively or intraoperatively. In this study, we examined the possibility of intraoperative diagnosis of VPI using confocal laser endomicroscopy (CLE). Methods: Among patients with primary lung cancer who underwent surgery between April 2018 and August 2019, those in whom the tumor was in contact with the pleura on chest computed tomography and whose pleural changes were intraoperatively confirmed were enrolled in this study. In the 35 patients who underwent lung resection (6 cases with visceral pleural infiltration), the area where pleural change was noted was observed and a short video was recorded using CLE. Based on the video images, three evaluators determined the defect ratio (0%, 25%, 50%, 75%, and 100%) of the autofluorescence-positive structure.The area under the receiver operating characteristic curve was used to evaluate the diagnostic performance for VPI. In 15 cases (3 cases with VPI), a validation study was performed for intraoperative VPI according to the cutoff value of the defect ratio of the autofluorescence-positive structure. Results:The areas under the receiver operating characteristic curve for the defect ratio of the autofluorescence-positive structure were 0.86-0.91 for the three readers. Using defect ratio of autofluorescence-positive structure cutoff of ≥50% as predictor of VPI, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 83.3-100.0%, 57.7-73.1%, 35.3-41.7%, 95.0-100.0%, and 75.0-78.1%, respectively, for the three readers. In the validation study, the sensitivity was 100%, the specificity was 83.3%, and the diagnostic accuracy rate was 86.7%. Conclusions:The diagnosis of VPI through CLE is simple, non-invasive, and has high diagnostic accuracy rates. This method may be applicable for determining surgical procedures.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Diagnosis of visceral pleural invasion using confocal laser endomicroscopy during lung cancer surgery

Sawada¹,

Takizawa²,

Aoyama³

et al. 2021

J Thorac Dis

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“…4 Unfortunately, the conventional intraoperative diagnosis of VPI is time-consuming and prone to inaccuracies, with a reported accuracy of only 56.5%. 5 Consequently, the current gold standard, relying on postoperative pathological diagnosis, 2 introduces a delay in determining an appropriate surgical plan, highlighting the need for a reliable preoperative predictive method for VPI status to ensure precise treatment of lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Nomogram Using Intratumoral and Peritumoral Radiomics For the Preoperative Prediction of Visceral Pleural Invasion in Clinical Stage IA Lung Adenocarcinoma

Wang,

Lyu,

et al. 2023

Preprint

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Purpose To investigate the value of intratumoral and peritumoral radiomics nomograms for preoperatively predicting the presence of visceral pleural invasion (VPI) in patients diagnosed with clinical stage IA lung adenocarcinoma (LUAD) . Methods A total of 404 patients from our hospital were randomly assigned to a training set (n = 283) and an internal validation set (n = 121) using a 7:3 ratio, while 81 patients from two other hospitals constituted the external validation set. We extracted 1218 CT-based radiomics features from the gross tumor volume (GTV) as well as the gross peritumoral tumor volume (GPTV), which included peritumoral regions at 5mm, 10mm, and 15 mm to construct a radiomics model. Additionally, we developed a nomogram based on relevant CT features and the radscore derived from the optimal radiomics model. Results The GPTV10 radiomics model exhibited superior predictive performance compared to GTV, GPTV5, and GPTV15, with AUC values of 0.855, 0.842, and 0.842 in the three respective sets. In the clinical model, the solid component size, pleural indentation sign, solid attachment sign, and vascular convergence sign were identified as independent risk factors among the CT features. The predictive performance of the nomogram, which incorporated relevant CT features and the GPTV10-Radscore, outperformed both the radiomics model and clinical model alone, with AUC values of 0.894, 0.828, and 0.876 in the three respective sets. Conclusions Our nomogram, integrating radiomics features and CT morphological features, exhibits good performance in predicting VPI status in LUAD.

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“…These methods include uorescence spectroscopy (FS) which has been validated as a diagnostic tool during various pathologies, e.g. diastolic dysfunction, 16 non-small-cell lung carcinoma, 17 ischemic heart disease, 18 diabetes mellitus 19 and many others. The method is based on the analysis of the autouorescent substances occurring in the sample (e.g.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive diagnostic methods for diabetes mellitus from tear fluid

et al. 2019

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Autofluorescence for the diagnosis of visceral pleural invasion in non-small-cell lung cancer

Abstract: The sensitivity, specificity and accuracy of visceral pleural invasion diagnosis was improved through the additional use of the autofluorescence mode compared with the white-light mode alone.

Cited by 20 publications

References 22 publications

Diagnosis of visceral pleural invasion using confocal laser endomicroscopy during lung cancer surgery

Diagnosis of visceral pleural invasion using confocal laser endomicroscopy during lung cancer surgery

Nomogram Using Intratumoral and Peritumoral Radiomics For the Preoperative Prediction of Visceral Pleural Invasion in Clinical Stage IA Lung Adenocarcinoma

Noninvasive diagnostic methods for diabetes mellitus from tear fluid

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