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Bonhomme O, Heinen V, Louis R, Corhay JL, Duysinx B. [Probe based confocal laser endomicroscopy in thoracic endoscopy]. Rev Mal Respir 2024; 41:145-155. [PMID: 38030554 DOI: 10.1016/j.rmr.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Probe based confocal laser endomicroscopy (pCLE) is a new endoscopic imaging technology. It uses mini probes which can be introduced through the working channels of endoscopes. Whenever applied on the tissue of interest, they allow imaging of tissue at a cellular level. STATE OF ART In the filed of pleuropulmonary malignancies, pCLE showed mostly its ability to guide biopsies samplings. Those results need to be validated in larger prospective studies. In interstitial lung diseases, pCLE provides information complementary to other clinical and paraclinical data. The valuability of these informations need to be investigated further, prospectively in randomized trials. In obstructive pulmonary diseases, pCLE is able to investigate the structural and functional relationships between pulmonary structures. pCLE showed good ability in the identification of acute cellular rejection after lung transplantation. PERSPECTIVES AND CONCLUSION For the time being, pCLE is not part of routine clinical practice. The data available need to be validated in larger randomized prospective trials, before it can be recommended as a guiding tool for biopsies or as a diagnostic tool for pathologic process. New fluorophores are now available. They are specific of some molecular sequences, allowing the enhancement of specific targets within the sample studied.
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Affiliation(s)
- O Bonhomme
- Pneumologues, CHU de Liège, 4000 Liège, Belgique.
| | - V Heinen
- Pneumologues, CHU de Liège, 4000 Liège, Belgique
| | - R Louis
- Pneumologues, CHU de Liège, 4000 Liège, Belgique
| | - J-L Corhay
- Pneumologues, CHU de Liège, 4000 Liège, Belgique
| | - B Duysinx
- Pneumologues, CHU de Liège, 4000 Liège, Belgique
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2
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Matache RS, Stanciu-Gavan C, Pantile D, Iordache AM, Bejgăneanu AO, Șerboiu CS, Nemes AF. Clinical and Paraclinical Characteristics of Endobronchial Pulmonary Squamous Cell Carcinoma-A Brief Review. Diagnostics (Basel) 2023; 13:3318. [PMID: 37958213 PMCID: PMC10647737 DOI: 10.3390/diagnostics13213318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Endobronchial squamous cell carcinoma is one of the most common types of tumors located inside the tracheobronchial tree. Patients often present in advanced stages of the disease, which most often leads to a targeted therapeutic attitude of pneumonectomy. Practicing lung parenchyma-preserving surgery led us to undertake this review. MATERIALS AND METHODS We used three search platforms-SCIENCE, MEDLINE, and PubMed-in order to identify studies presenting case reports, investigations, and reviews on endobronchial squamous cell carcinoma. We identified the clinical and paraclinical features of endobronchial squamous cell carcinoma. All the selected articles were in English and addressed the clinical criteria of endobronchial squamous cell carcinoma, autofluorescence bronchoscopy in endobronchial squamous cell carcinoma, imaging features of endobronchial squamous cell carcinoma, blood tumor markers specific to lung squamous cell carcinoma, and histopathological features of endobronchial squamous cell carcinoma. RESULTS In total, 73 articles were analyzed, from which 48 articles were selected as bibliographic references. We present the criteria used for the identification of endobronchial squamous cell carcinoma in order to highlight its main characteristics and the most reliable technologies that can be used for the detection of this type of cancer. CONCLUSIONS The current literature review highlights the clinical and paraclinical characteristics of endobronchial squamous cell carcinoma. It aims to open new paths for research and early detection with respect to the frequent practice of lung parenchymal preservation surgery.
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Affiliation(s)
- Radu Serban Matache
- Department of Thoracic Surgery, “Marius Nasta” Institute of Pneumophtiziology, 050159 Bucharest, Romania;
| | - Camelia Stanciu-Gavan
- Department of Thoracic Surgery, “Doctor Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Daniel Pantile
- Department of Thoracic Surgery, “Doctor Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Adrian Mihail Iordache
- Department of Thoracic Surgery, “Doctor Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | | | - Crenguța Sorina Șerboiu
- Department of Cellular, Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, University Emergency Hospital, 050098 Bucharest, Romania
| | - Alexandra Floriana Nemes
- Department of Neonatology, Louis Turcanu Clinical Emergency Hospital for Children, 300011 Timisoara, Romania
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Kobayashi M, Kurimoto N, Tanino R, Shiratsuki Y, Okuno T, Nakao M, Hotta T, Tsubata Y, Nagasaki M, Nishisaka T, Isobe T. Comparison of Ultra-Magnifying Endocytoscopic and Hematoxylin-Eosin-Stained Images of Lung Specimens. Diagnostics (Basel) 2023; 13:diagnostics13051003. [PMID: 36900147 PMCID: PMC10000767 DOI: 10.3390/diagnostics13051003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Endocytoscopy enables real-time observation of lesions at ultra-magnification. In the gastrointestinal and respiratory fields, endocytoscopic images are similar to hematoxylin-eosin-stained images. This study aimed to compare the nuclear features of pulmonary lesions in endocytoscopic and hematoxylin-eosin-stained images. We performed an endocytoscopy to observe resected specimens of normal lung tissue and lesions. Nuclear features were extracted using ImageJ. We analyzed five nuclear features: nuclear number per area, mean nucleus area, median circularity, coefficient of variation of roundness, and median Voronoi area. We conducted dimensionality reduction analyses for these features, followed by assessments of the inter-observer agreement among two pathologists and two pulmonologists to evaluate endocytoscopic videos. We analyzed the nuclear features of hematoxylin-eosin-stained and endocytoscopic images from 40 and 33 cases, respectively. Endocytoscopic and hematoxylin-eosin-stained images displayed a similar tendency for each feature, despite there being no correlation. Conversely, the dimensionality reduction analyses demonstrated similar distributions of normal lung and malignant clusters in both images, thus differentiating between the clusters. The diagnostic accuracy of the pathologists was 58.3% and 52.8% (κ-value 0.38, fair), and that of the pulmonologists was 50% and 47.2% (κ-value 0.33, fair). The five nuclear features of pulmonary lesions were similar in the endocytoscopic and hematoxylin-eosin-stained images.
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Affiliation(s)
- Misato Kobayashi
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Noriaki Kurimoto
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
- Correspondence: ; Tel.: +81-853-20-2580
| | - Ryosuke Tanino
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Yohei Shiratsuki
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Takae Okuno
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Mika Nakao
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Takamasa Hotta
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Yukari Tsubata
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Makoto Nagasaki
- Division of Pathology, National Hospital Organization Hamada Medical Center, Hamada 697-8511, Japan
| | - Takashi Nishisaka
- Department of Pathology and Laboratory Medicine, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan
| | - Takeshi Isobe
- Division of Medical Oncology & Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
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Shiratsuki Y, Kurimoto N, Amano Y, Hamaguchi S, Kobayashi M, Okuno T, Hotta T, Tsubata Y, Isobe T. Ultra-magnifying Imaging of Thoracoscopic Biopsy Specimens Using Ex vivo Endocytoscopy in Three Patients with Mesothelioma. Intern Med 2022; 61:3251-3257. [PMID: 36328587 PMCID: PMC9683823 DOI: 10.2169/internalmedicine.9173-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We performed endocytoscopy (ECS) for the ex vivo evaluation of mesothelioma in specimens biopsied during medical thoracoscopy in three patients. We evaluated 19 biopsy specimens based on the density of nuclei and irregularity in the nuclei shape using ECS and compared them with the histopathological findings. All 10 specimens considered malignant based on ECS were diagnosed as malignant based on histopathology. The nine specimens evaluated as non-malignant based on ECS consisted of six specimens diagnosed as malignant based on histopathology and three diagnosed as non-malignant based on histopathology. ECS was feasible and had some utility for ex vivo ultra-magnifying imaging of thoracoscopic biopsy specimens from patients with mesothelioma.
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Affiliation(s)
- Yohei Shiratsuki
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Noriaki Kurimoto
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Yoshihiro Amano
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Shunichi Hamaguchi
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Misato Kobayashi
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Takae Okuno
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Takamasa Hotta
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Yukari Tsubata
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
| | - Takeshi Isobe
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, Japan
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Diez-Ferrer M, Torrejon-Escribano B, Baixeras N, Tebe C, Cubero N, Lopez-Lisbona R, Dorca J, Rosell A. Comparing Probe-Based Confocal Laser Endomicroscopy With Histology. Are We Looking at the Same Picture? Arch Bronconeumol 2021; 57:778-780. [PMID: 35698992 DOI: 10.1016/j.arbr.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/20/2021] [Indexed: 06/15/2023]
Affiliation(s)
- Marta Diez-Ferrer
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona,Spain.
| | - Benjamin Torrejon-Escribano
- Unit of Advanced Optical Microscopy, Scientific and Technological Centers (CCiTUB) University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Baixeras
- Department of Pathology, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona, Spain
| | - Cristian Tebe
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL). L'Hospitalet de Llobregat, Barcelona,Spain; Department of Basic Medical Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Noelia Cubero
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona,Spain
| | - Rosa Lopez-Lisbona
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona,Spain
| | - Jordi Dorca
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona,Spain
| | - Antoni Rosell
- Thorax Institute, Hospital Germans Trias i Pujol-IGTP-UAB, Badalona, Barcelona, Spain
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Kramer T, Wijmans L, de Bruin M, van Leeuwen T, Radonic T, Bonta P, Annema JT. Bronchoscopic needle-based confocal laser endomicroscopy (nCLE) as a real-time detection tool for peripheral lung cancer. Thorax 2021; 77:370-377. [PMID: 34172559 PMCID: PMC8938671 DOI: 10.1136/thoraxjnl-2021-216885] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/21/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Diagnosing peripheral lung cancer with the bronchoscope is challenging with near miss of the target lesion as major obstacle. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic tumour visualisation at the needle tip (smart needle). AIM To investigate feasibility and safety of bronchoscopic nCLE imaging of suspected peripheral lung cancer and to assess whether nCLE imaging allows real-time discrimination between malignancy and airway/lung parenchyma. METHODS Patients with suspected peripheral lung cancer based on (positron emission tomography-)CT scan underwent radial endobronchial ultrasound (rEBUS) and fluoroscopy-guided flexible bronchoscopy. After rEBUS lesion detection, an 18G needle loaded with the CLE probe was inserted in the selected airway under fluoroscopic guidance. The nCLE videos were obtained at the needle tip, followed by aspirates and biopsies. The nCLE videos were reviewed and compared with the cytopathology of the corresponding puncture and final diagnosis. Five blinded raters validated nCLE videos of lung tumours and airway/lung parenchyma twice. RESULTS The nCLE imaging was performed in 26 patients. No adverse events occurred. In 24 patients (92%) good to high quality videos were obtained (final diagnosis; lung cancer n=23 and organising pneumonia n=1). The nCLE imaging detected malignancy in 22 out of 23 patients with lung cancer. Blinded raters differentiated nCLE videos of malignancy from airway/lung parenchyma (280 ratings) with a 95% accuracy. The inter-observer agreement was substantial (κ=0.78, 95% CI 0.70 to 0.86) and intra-observer reliability excellent (mean±SD κ=0.81±0.05). CONCLUSION Bronchoscopic nCLE imaging of peripheral lung lesions is feasible, safe and allows real-time lung cancer detection. Blinded raters accurately distinguished nCLE videos of lung cancer from airway/lung parenchyma, showing the potential of nCLE imaging as real-time guidance tool.
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Affiliation(s)
- Tess Kramer
- Respiratory Medicine, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
| | - Lizzy Wijmans
- Respiratory Medicine, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
| | - Martijn de Bruin
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
| | - Ton van Leeuwen
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
| | - Teodora Radonic
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
| | - Peter Bonta
- Respiratory Medicine, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
| | - Jouke T Annema
- Respiratory Medicine, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, The Netherlands
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7
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Diez-Ferrer M, Torrejon-Escribano B, Baixeras N, Tebe C, Cubero N, Lopez-Lisbona R, Dorca J, Rosell A. Comparing Probe-Based Confocal Laser Endomicroscopy With Histology. Are We Looking at the Same Picture? Arch Bronconeumol 2021; 57:S0300-2896(21)00042-9. [PMID: 33722423 DOI: 10.1016/j.arbres.2021.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Marta Diez-Ferrer
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona, Spain.
| | - Benjamin Torrejon-Escribano
- Unit of Advanced Optical Microscopy, Scientific and Technological Centers (CCiTUB) University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Baixeras
- Department of Pathology, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona, Spain
| | - Cristian Tebe
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL). L'Hospitalet de Llobregat, Barcelona, Spain; Department of Basic Medical Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Noelia Cubero
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona, Spain
| | - Rosa Lopez-Lisbona
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona, Spain
| | - Jordi Dorca
- Department of Respiratory Medicine, Hospital de Bellvitge-IDIBELL-University of Barcelona, Barcelona, Spain
| | - Antoni Rosell
- Thorax Institute, Hospital Germans Trias i Pujol-IGTP-UAB, Badalona, Barcelona, Spain
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8
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Nguyen P, Lee P, Kurimoto N. Interventional pulmonology: Moving forward. Respirology 2020; 25:1008-1009. [PMID: 32767533 DOI: 10.1111/resp.13923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Phan Nguyen
- The Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Pyng Lee
- Division of Respiratory and Critical Care Medicine, The National University Hospital, Singapore
| | - Noriaki Kurimoto
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, Izumo, Japan
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9
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Shanthikumar S, Steinfort DP, Ranganathan S. Interventional bronchoscopy in children: Planning the path ahead. Pediatr Pulmonol 2020; 55:288-291. [PMID: 31816189 DOI: 10.1002/ppul.24596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Shivanthan Shanthikumar
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Respiratory Diseases, Murdoch Children's Research Institute, Melbourne, Australia
| | - Daniel P Steinfort
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parkville, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Respiratory Diseases, Murdoch Children's Research Institute, Melbourne, Australia
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Goorsenberg A, Kalverda KA, Annema J, Bonta P. Advances in Optical Coherence Tomography and Confocal Laser Endomicroscopy in Pulmonary Diseases. Respiration 2019; 99:190-205. [PMID: 31593955 DOI: 10.1159/000503261] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022] Open
Abstract
Diagnosing and monitoring pulmonary diseases is highly dependent on imaging, physiological function tests and tissue sampling. Optical coherence tomography (OCT) and confocal laser endomicroscopy (CLE) are novel imaging techniques with near-microscopic resolution that can be easily and safely combined with conventional bronchoscopy. Disease-related pulmonary anatomical compartments can be visualized, real time, using these techniques. In obstructive lung diseases, airway wall layers and related structural remodelling can be identified and quantified. In malignant lung disease, normal and malignant areas of the central airways, lung parenchyma, lymph nodes and pleura can be discriminated. A growing number of interstitial lung diseases (ILDs) have been visualized using OCT or CLE. Several ILD-associated structural changes can be imaged: fibrosis, cellular infiltration, bronchi(ol)ectasis, cysts and microscopic honeycombing. Although not yet implemented in clinical practice, OCT and CLE have the potential to improve detection and monitoring pulmonary diseases and can contribute in unravelling the pathophysiology of disease and mechanism of action of novel treatments. Indeed, assessment of the airway wall layers with OCT might be helpful when evaluating treatments targeting airway remodelling. By visualizing individual malignant cells, CLE has the potential as a real-time lung cancer detection tool. In the future, both techniques could be combined with laser-enhanced fluorescent-labelled tracer detection. This review discusses the value of OCT and CLE in pulmonary medicine by summarizing the current evidence and elaborating on future perspectives.
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Affiliation(s)
- Annika Goorsenberg
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands,
| | - Kirsten A Kalverda
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jouke Annema
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Bonta
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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11
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Gupta A, Harris K, Dhillon SS. Role of bronchoscopy in management of central squamous cell lung carcinoma in situ. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:354. [PMID: 31516900 DOI: 10.21037/atm.2019.04.36] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Squamous cell carcinoma in situ (SCIS) is the pre-invasive stage of squamous cell carcinoma. Early detection and management of SCIS can prevent further progression. Although surgery and external beam radiation therapy are treatment options for SCIS, smaller lesions can be easily managed by bronchoscopic modalities like photodynamic therapy (PDT), cryotherapy, mechanical debulking with biopsy forceps, electrocautery and argon plasma coagulation (APC). Endobronchial brachytherapy (EBBT) and lasers may be judiciously utilized in selected cases. Although, previous studies of treatment modalities may have inadvertently included cases of invasive carcinomas, the advent of new technologies like radial probe endobronchial ultrasound (RP-EBUS) and optical coherence tomography (OCT) can help accurately determine the of depth of invasion. Superficial extent can also be better demarcated with techniques like auto-fluorescence bronchoscopy and narrow band imaging (NBI). New drugs for PDT with deeper penetration and less phototoxicity are being developed. These advances hopefully will allow us to perform superior clinical trials in future and improve our understanding of diagnosis and management of SCIS.
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Affiliation(s)
- Ankit Gupta
- Division of Pulmonary and Critical Care Medicine, Hartford Healthcare, Norwich, CT, USA
| | - Kassem Harris
- Interventional Pulmonology Section, Pulmonary Critical Care Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | - Samjot Singh Dhillon
- Pulmonary Critical Care and Sleep Medicine, Interventional Pulmonary, The Permanente Medical Group, Roseville and Sacramento, CA, USA
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12
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Shah PL. Sonic biopsy: A new tool for the assessment of peripheral pulmonary lesions. Respirology 2019; 24:933-934. [PMID: 31095802 DOI: 10.1111/resp.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Pallav L Shah
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.,National Heart & Lung Institute, Imperial College, London, UK
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13
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He R, Hu C, Niu R. Analysis of the Clinical Features of Tracheobronchial Fungal Infections with Tumor-Like Lesions. Respiration 2019; 98:157-164. [PMID: 31067555 DOI: 10.1159/000496979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/14/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Tracheobronchial fungal infections (TBFI) cause life-threatening complications in immunocompromised hosts but are rarely reported. Misdiagnosis and delayed antifungal treatment are associated with the high mortality rate of patients with TBFI. OBJECTIVES This study analyzed the bronchoscopic features of TBFI and their roles in the early diagnosis of TBFI. METHODS The demographic, clinical, radiologic, and bronchoscopic data of 53 patients diagnosed with TBFI in our department during a 15-year period were retrospectively analyzed. RESULTS Most of the TBFI patients were male, and mass was the most common radiologic abnormality. Obvious predilection in primary bronchus distributions was observed. 41.9% of the 43 Aspergillus tracheobronchitis (AT) patients, 70% of the 10 tracheobronchial mucormycosis (TM) patients, and 100% of the 3 endobronchial cryptococcosis patients had been misdiagnosed as having cancer on bronchoscopy because of the presence of tumor-like lesions. The most common features of AT were bronchial occlusion with a mass or mucosal necrosis, bronchial stenosis with mucosal hyperplasia, or uneven mucosa. The main descriptions of TM were bronchial stenosis or obstruction due to mucosal necrosis, uneven mucosa, or a mass. The endoscopic characteristics of endobronchial cryptococcosis included occlusion due to uneven mucosa or mass, or external compressive stricture. CONCLUSION Immunocompromised patients and immunocompetent patients with underlying disease displaying tumor-like lesions on bronchoscopy should be differentially diagnosed with cancer. Bronchial biopsy is indispensable for the early diagnosis of TBFI.
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Affiliation(s)
- Ruoxi He
- Department of Respiratory Medicine (National Key Clinical Specialty), Xiangya Hospital, Central South University, Changsha, China
| | - Chengping Hu
- Department of Respiratory Medicine (National Key Clinical Specialty), Xiangya Hospital, Central South University, Changsha, China
| | - Ruichao Niu
- Department of Respiratory Medicine (National Key Clinical Specialty), Xiangya Hospital, Central South University, Changsha, China,
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14
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Tsurudome I, Miyahara R, Funasaka K, Furukawa K, Matsushita M, Yamamura T, Ishikawa T, Ohno E, Nakamura M, Kawashima H, Watanabe O, Nakaguro M, Satou A, Hirooka Y, Goto H. In vivo histological diagnosis for gastric cancer using endocytoscopy. World J Gastroenterol 2017; 23:6894-6901. [PMID: 29085232 PMCID: PMC5645622 DOI: 10.3748/wjg.v23.i37.6894] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/12/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To examine usefulness of virtual biopsy using endocytoscopy by comparing the in vivo endocytoscopic and histopathological images of gastric cancers.
METHODS Endocytoscopy was performed in 30 patients with early gastric cancer. Of these, 26 patients showed well differentiated adenocarcinomas, while 4 patients showed poorly differentiated adenocarcinomas (including one signet ring cell carcinoma). Cancerous and non-cancerous areas were observed after double staining with 0.05% crystal violet and 0.1% methylene blue. The endocytoscopic images obtained were evaluated by an expert endoscopist and an expert pathologist without knowledge of patient clinical data, and endocytoscopic and histopathological diagnoses were compared.
RESULTS The endocytoscopic images of the cancerous area were assessed as evaluable in 25 (83.3%) and 27 (90%) patients by endoscopist A and pathologist B, respectively, and those of the non-cancerous area as evaluable in 28 (93.3%) and 23 (76.7%) patients by the endoscopist and pathologist, respectively. The sensitivity, specificity, and diagnostic accuracy of gastric cancer diagnosis using evaluable endocytoscopic images were 88.0% and 92.9%, and 90.6% by endoscopist A, and 88.9% and 91.3%, and 90.0% by pathologist B, respectively. Evaluation of the diagnostic concordance rate between the endoscopist and the pathologist by inter-observer agreement calculation revealed no significant difference between the two observers. The inter-observer agreement (κ-value) for endocytoscopic diagnosis was 0.745.
CONCLUSION Endocytoscopy is useful for the differentiation of cancerous from non-cancerous gastric mucosa, making it a promising tool for virtual biopsy.
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Affiliation(s)
- Issei Tsurudome
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Ryoji Miyahara
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Kohei Funasaka
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Kazuhiro Furukawa
- Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Japan
| | - Masanobu Matsushita
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Takeshi Yamamura
- Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Japan
| | - Takuya Ishikawa
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Eizaburo Ohno
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Hiroki Kawashima
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Osamu Watanabe
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya 466-8560, Japan
| | - Akira Satou
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya 466-8560, Japan
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Yoshiki Hirooka
- Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Japan
| | - Hidemi Goto
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
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