Color Fluorescence Ratio for Detection of Bronchial Dysplasia and Carcinoma In situ
Open Access
- 15 July 2009
- journal article
- research article
- Published by American Association for Cancer Research (AACR) in Clinical Cancer Research
- Vol. 15 (14), 4700-4705
- https://doi.org/10.1158/1078-0432.ccr-08-1644
Abstract
Background: Autofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead to excessive biopsy and increased procedural time. Onco-LIFE, a device that combines fluorescence and reflectance imaging, allows numeric representation by expressing red-to-green ratio (R/G ratio) within the region of interest. The aim of the study was to determine if color fluorescence ratio (R/G ratio) added to autofluorescence bronchoscopy could provide an objective means to guide biopsy. Methods: Subjects at risk for lung cancer were recruited at two centers: VU University Medical Centre (Amsterdam) and BC Cancer Agency (Canada). R/G ratio for each site appearing normal or abnormal was measured before biopsy. R/G ratios were correlated with pathology, and a receiver operating characteristic curve of R/G ratio for high-grade and moderate dysplasia was done. Following analysis of the training data set obtained from two centers, a prospective validation study was done. Results: Three thousand three hundred sixty-two adequate biopsies from 738 subjects with their corresponding R/G ratios were analyzed. R/G ratio 0.54 conferred 85% sensitivity and 80% specificity for the detection of high-grade and moderate dysplasia, area under the curve was 0.90, and 95% confidence interval was 0.88 to 0.92. In another 70 different sites that were assessed, κ measurements of agreement of R/G ratios with visual scores and pathology were 0.66 (P < 0.0001) and 0.61 (P < 0.0001), respectively. R/G ratio combined with visual score improved specificity to 88% (95% confidence interval, 0.73-0.96) for high-grade and moderate dysplasia. Conclusion: Color fluorescence ratio can objectively guide the bronchoscopist in selecting sites for biopsy with good pathologic correlation.Keywords
All Related Versions
This publication has 32 references indexed in Scilit:
- Cancer Statistics, 2008CA: A Cancer Journal for Clinicians, 2008
- Autofluorescence bronchoscopy for lung cancer surveillance based on risk assessmentThorax, 2007
- Survival of Patients with Stage I Lung Cancer Detected on CT ScreeningNew England Journal of Medicine, 2006
- Early detection of bronchial lesions using newly developed videoendoscopy-based autofluorescence bronchoscopyLung Cancer, 2006
- Effective detection of bronchial preinvasive lesions by a new autofluorescence imaging bronchovideoscope systemLung Cancer, 2005
- A comparison of video and autofluorescence bronchoscopy in patients at high risk of lung cancerEuropean Respiratory Journal, 2005
- Management and outcome of patients undergoing thoracic surgery in a regional chest medical centreEuropean Journal of Anaesthesiology, 2001
- Management and outcome of patients undergoing thoracic surgery in a regional chest medical centreEuropean Journal of Anaesthesiology, 2001
- Lung Cancer: Current Concepts and ProspectsCA: A Cancer Journal for Clinicians, 1983
- Changes in Bronchial Epithelium in Relation to Cigarette Smoking, 1955–1960 vs. 1970–1977New England Journal of Medicine, 1979