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Senyei G, Nobari M, Miller R, Harrell B, Cheng GZ. Learning Curve of Real-Time Imaging with C-Arm Based Tomography for Peripheral Lung Nodule Biopsy. Life (Basel) 2023; 13:life13040936. [PMID: 37109465 PMCID: PMC10141185 DOI: 10.3390/life13040936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
The number of procedures required to attain proficiency with new bronchoscopic biopsy technologies for peripheral pulmonary lesions (PPLs) is uncertain. A prospective, single-center study evaluated learning curves of two operators performing PPL biopsies using a novel, real-time, intraoperative tomographic imaging system in consecutive procedures in adults with CT-detected PPLs. Operators were considered “proficient” when they asked three or fewer questions of the manufacturer’s clinical representative with no subsequent navigations in which they asked more than three questions. A total of 31 procedures were performed on 31 patients (Operator 1: 18, Operator 2: 13). Proficiency was achieved after an average of 10 procedures (Operator 1: 12, Operator 2: 8). From the learning curve to the post-learning curve period, the number of questions (median [IQR]: 23 [9.5–41.5] versus 0 [0–1], p < 0.001) and radiation dose (median [IQR]: 19.5 mGy/m2 [1.9–43.5] versus 1.5 mGy/m2 [0.7–3.3], p = 0.05) decreased significantly; procedure time decreased (median [IQR]: 12 min [7–20] versus 8 min [3–15], p = 0.29); and diagnostic yield increased significantly (13/20 cases [65%] to 11/11 cases [100%]), (p = 0.03). Based on this unique, clinically relevant method of assessing learning curve, proficiency with the Body Vision system was achieved at approximately the tenth procedure. These findings require validation in larger, diverse populations.
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Affiliation(s)
- Grant Senyei
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Matthew Nobari
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Russell Miller
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA 92037, USA
- Department of Pulmonary Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Brody Harrell
- California State University, San Bernadino, CA 92407, USA
| | - George Z. Cheng
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA 92037, USA
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2
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Bansal S, Bechara RI, Patel JD, Mehta HJ, Ferguson JS, Witt BL, Murgu SD, Yasufuku K, Casal RF. Safety and Feasibility of Photodynamic Therapy for Ablation of Peripheral Lung Tumors. J Bronchology Interv Pulmonol 2023; 30:135-143. [PMID: 35968968 PMCID: PMC10063184 DOI: 10.1097/lbr.0000000000000889] [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: 02/18/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Newer navigational bronchoscopy technologies render peripheral lung lesions accessible for biopsy and potential treatment. We investigated whether photodynamic therapy (PDT) delivered via navigational bronchoscopy is feasible and safe for ablation of peripheral lung tumors. METHODS Two studies evaluated PDT in patients with solid peripheral lung tumors followed by clinical follow-up (nonresection study, N=5) or lobectomy (resection study, N=10). Porfimer sodium injection was administered 40 to 50 hours before navigational bronchoscopy. Lesion location was confirmed by radial probe endobronchial ultrasonography. An optical fiber diffuser was placed within or adjacent to the tumor under fluoroscopic guidance; laser light (630 nm wavelength) was applied at 200 J/cm of diffuser length for 500 seconds. Tumor response was assessed by modified Response Evaluation Criteria in Solid Tumors at 3 and 6 months postprocedure (nonresection study) and pathologically (resection study). RESULTS There were no deaths, discontinuations for adverse events, or serious or grade ≥3 adverse events related to study treatments. Photosensitivity reactions occurred in 8 of 15 patients: 6 mild, 1 moderate, 1 severe (elevated porphyrins noted in blood after treatment). Among 5 patients with clinical follow-up, 1 had complete response, 3 had stable disease, and 1 had progressive disease at 6 months follow-up. Among 10 patients who underwent lobectomy, 1 had no evidence of tumor at resection (complete response), 3 had 40% to 50% tumor cell necrosis, 2 had 20% to 35%, and 4 had 5% to 10%. CONCLUSION PDT for nonthermal ablation of peripheral lung tumors was feasible and safe in this small study. Further study is warranted to evaluate efficacy and corroborate the safety profile.
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Affiliation(s)
- Sandeep Bansal
- Interventional Pulmonology, The Lung Center, Penn Highlands Healthcare, DuBois, PA
| | - Rabih I. Bechara
- Interventional Pulmonology, Medical College of Georgia School of Medicine, Augusta University, Augusta, GA
| | - Jiten D. Patel
- Pulmonary Medicine, Providence Sacred Heart Medical Center and Children’s Hospital, Spokane, WA
| | - Hiren J. Mehta
- Interventional Pulmonology, University of Florida, Gainesville, FL
| | - J. Scott Ferguson
- Interventional Pulmonology, School of Medicine and Public Health and the Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Benjamin L. Witt
- Association of Regional Utah Pathologists (ARUP) Laboratories, University of Utah, Salt Lake City, UT
| | - Septimiu D. Murgu
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| | - Kazuhiro Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Roberto F. Casal
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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3
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Hocanlı İ, Uzer F, Çil B, Kırhan İ, Günak F. Diagnostic value of adenosine deaminase in bronchoalveolar lavage fluid for patients with lung cancer. Int J Clin Pract 2021; 75:e14918. [PMID: 34564933 DOI: 10.1111/ijcp.14918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/30/2021] [Accepted: 09/23/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Lung cancer is both the most common seen malignity and cause of cancer-related deaths worldwide. Adenosine deaminase (ADA) is a hydrolytic enzyme that catalyses the conversion of adenosine to inosine in the purine metabolism pathway. Studies examining ADA levels in bronchoalveolar lavage (BAL) fluids of patients with lung malignancy are very limited in the literature. Our aim examine the clinical significance of ADA levels in BAL fluids of patients with lung malignancy. METHODS A total of 89 patients undergoing fiberoptic bronchoscopy (FOB) with different indications from December 2017 to December 2018 were included in this study. The patients were divided into two groups as malignancy and non-malignancy groups. Demographic, laboratory data and ADA levels in bronchoalveolar lavage (BAL) were compared between the two groups. In addition, ADA levels in BAL were compared among the histopathological subtypes of patients in the malignant group. RESULTS The mean age of the patients was 58.2 ± 14.5 years with 86% of male gender. ADA enzyme levels were statistically higher in the malignant patient group compared with the non-malignant group (37.2 [17.6-71] vs 17.1 [9-35.3], P < .001). When the patients in the malignant group were compared in terms of ADA levels according to their histopathological types, a statistically significant difference was obtained in small cell carcinoma patients (49 [12.5-75.3], P = .005). CONCLUSION ADA levels in BAL may be a diagnostic biomarker in lung malignancies. In patients where a biopsy cannot be taken or histopathological typing cannot be performed because of tissue insufficiency, ADA levels in BAL can be an auxiliary parameter in making malignancy / histopathological diagnosis accompanied by radiological and clinical findings.
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Affiliation(s)
- İclal Hocanlı
- Mehmet Akif İnan Training and Research Hospital, Departman of Chest Diseases, Şanlıurfa, Turkey
| | - Fatih Uzer
- Akdeniz University, Faculty of Medicine, Department of Chest Diseases, Antalya, Turkey
| | - Barış Çil
- Mardin Public Hospital, Clinic of Chest Diseases, Mardin, Turkey
| | - İdris Kırhan
- Harran University, Faculty of Medicine, Department of İnternal Medicine, Sanliurfa, Turkey
| | - Faruk Günak
- Mehmet Akif İnan Training and Research Hospital, Departman of Chest Diseases, Şanlıurfa, Turkey
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4
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Rodriguez-Diaz E, Kaanan S, Vanley C, Qureshi T, Bigio IJ. Toward optical spectroscopy-guided lung biopsy: Demonstration of tissue-type classification. JOURNAL OF BIOPHOTONICS 2021; 14:e202100132. [PMID: 34245106 DOI: 10.1002/jbio.202100132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/08/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
The diagnostic yield of standard tissue-sampling modalities of suspected lung cancers, whether by bronchoscopy or interventional radiology, can be nonoptimal, varying with the size and location of lesions. What is needed is an insitu sensor, integrated in the biopsy tool, to objectively distinguish among tissue types in real time, not to replace biopsy with an optical diagnostic, but to verify that the sampling tool is properly located within the target lesion. We investigated the feasibility of elastic scattering spectroscopy (ESS), coupled with machine learning, to distinguish lung lesions from the various nearby tissue types, in a study with freshly-excised lung tissues from surgical resections. Optical spectra were recorded with an ESS fiberoptic probe in different areas of the resected pulmonary tissues, including benign-margin tissue sites as well as the periphery and core of the lesion. An artificial-intelligence model was used to analyze, retrospectively, 2032 measurements from excised tissues of 35 patients. With high accuracy, ESS was able to distinguish alveolar tissue from bronchi, alveolar tissue from lesions, and bronchi from lesions. This ex vivo study indicates promise for ESS fiberoptic probes to be integrated with surgical intervention tools, to improve reliability of pulmonary lesion targeting.
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Affiliation(s)
| | - Samer Kaanan
- Providence Mission Hospital, Mission Viejo, California, USA
| | | | | | - Irving J Bigio
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
- Department of Electrical & Computer Engineering, Boston University, Boston, Massachusetts, USA
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5
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Gorospe L, Ayala-Carbonero AM, Montelongo-Martín A, Mirambeaux-Villalona RM, Arrieta P, Muñoz-Molina GM, Fra-Fernández S, Benito-Berlinches A, Lumbreras-Fernández B, Alarcón-Rodríguez J. Percutaneous Biopsy of a Paraaortic Mediastinal Mass Using a Contralateral Parasternal Approach: A New Alternative Safe Access. Arch Bronconeumol 2021; 57:499-501. [PMID: 35698962 DOI: 10.1016/j.arbr.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/24/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Luis Gorospe
- Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | | | | | | | - Paola Arrieta
- Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Sara Fra-Fernández
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
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6
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Yasukawa M, Kawaguchi T, Kimura M, Tojo T, Taniguchi S. Implications of Preoperative Transbronchial Lung Biopsy for Non-small Cell Lung Cancer Less than 3-cm. In Vivo 2021; 35:1027-1031. [PMID: 33622898 DOI: 10.21873/invivo.12346] [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: 11/03/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Transbronchial lung biopsy (TBLB) has been recommended for patients with suspected lung cancer. However, its diagnostic value is limited to small lesions, and some studies have indicated that biopsy might be related to metastasis and/or dissemination. This study aimed to evaluate the outcomes after preoperative TBLB for non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS Data were reviewed from 371 patients with resected pN0 NSCLC less than 3-cm. Patients were divided into two groups: TBLB and Non-TBLB. Recurrence-free survival (RFS) curves were plotted using the Kaplan-Meier method. Cox regression analyses were used to evaluate the hazard ratio (HR) with the endpoint RFS. RESULTS The 5-year RFS rates were 75.5% in the TBLB group and 91.4% in the Non-TBLB group (p<0.001). Poor RFS was independently associated with TBLB (HR=2.491, 95%CI=1.337-4.640; p=0.004). CONCLUSION Preoperative TBLB may adversely affect RFS among NSCLC patients with small size tumours.
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Affiliation(s)
- Motoaki Yasukawa
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan; .,Department of Surgery, Osaka Kaisei Hospital, Osaka, Japan
| | - Takeshi Kawaguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Michitaka Kimura
- Department of Thoracic Surgery, Saiseikai Chuwa Hospital, Nara, Japan
| | - Takashi Tojo
- Department of Thoracic Surgery, Saiseikai Chuwa Hospital, Nara, Japan
| | - Shigeki Taniguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan
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7
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A Randomized Controlled Trial on Optimal Sampling Sequence in Radial Guide Sheath Endobronchial Ultrasound Lung Biopsy. J Bronchology Interv Pulmonol 2021; 27:205-211. [PMID: 32101915 DOI: 10.1097/lbr.0000000000000651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND An optimal sampling sequence in radial guide sheath endobronchial ultrasound lung biopsy (R-EBUS) is unclear. This prospective single-center pilot randomized controlled trial aimed to determine if the initial method and sequence of sampling affect the diagnostic accuracy of the procedure. METHODS Consecutive patients undergoing R-EBUS for lesions >15 mm with a bronchus sign were randomly assigned (1:1:1) to biopsy first (group A), brushings first (group B) or combination (group C). The primary outcome was a positive diagnosis from any sampling method. RESULTS Fifty-four patients were randomized. The overall diagnostic yield of the procedure was 77.8% (95% confidence interval: 66%-89%), with no difference between groups. A higher rate of positive cytology from brushings was seen if the biopsies were performed before brushings (77.8% in group A vs. 44.4% in group B, P=0.03). The rate of positive cytology from washings was higher if the washings were obtained just after the brushings (61.1% in group A vs. 11.1% in group B, P=0.02). There was no difference in the rate of positive biopsy histology in the groups (P=0.27). All 3 sampling modalities were more likely to be positive in group A (50.0% vs. 11.1% in group B and 22.2% in group C, P=0.04). Complications rate was low and not significantly different between groups. CONCLUSION The overall rate of a positive R-EBUS procedure was not affected by the initial sampling method or sequence. However, all 3 sampling modalities were more likely to be positive if biopsies were performed first, followed by brushings and washings.
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8
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Pritchett MA. Prospective Analysis of a Novel Endobronchial Augmented Fluoroscopic Navigation System for Diagnosis of Peripheral Pulmonary Lesions. J Bronchology Interv Pulmonol 2021; 28:107-115. [PMID: 32732491 PMCID: PMC8132897 DOI: 10.1097/lbr.0000000000000700] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/23/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Navigational bronchoscopy has improved upon traditional bronchoscopy to identify suspicious pulmonary lesions, but wide variability exists in the diagnostic yield of various modalities. The aim of this study was to measure localization accuracy and diagnostic yield of a novel endobronchial augmented fluoroscopic navigation system (first-generation LungVision system) for peripheral pulmonary lesions (PPLs). METHODS This prospective single-center study included adults undergoing guided bronchoscopy to evaluate PPLs. Preprocedure computed tomography (CT) images were obtained, and planning software calculated a pathway to the lesion. A flexible bronchoscope was used to navigate along the pathway overlaid on the intraprocedural fluoroscopic image. When real-time display indicated the catheter tip had reached the lesion, cone-beam computed tomography (CBCT) was used to measure the actual location of the tip. Biopsy and rapid on-site cytopathologic evaluation were performed. RESULTS Fifty-one patients were included in the analysis. The median lesion diameter was 18.0 mm (range: 7.0 to 48.0 mm). Localization success was 96.1%. The average distance between lesion location as shown by LungVision augmented fluoroscopy and actual location measured by CBCT was 5.9 mm (range: 2.1 to 10.0 mm). Diagnostic yield at the index procedure was 78.4%. Diagnostic accuracy assessed at 12 months follow-up was 88.2%. Average CT-to-body divergence was 14.5 mm (range: 2.6 to 33.0 mm) from preprocedure CT to intraprocedural CBCT images. CONCLUSION Augmented fluoroscopy for navigation and biopsy of PPLs with the LungVision system showed a high localization success rate and corresponding high diagnostic yield. Navigation and biopsy with real-time visualization can improve diagnostic yield for PPLs.
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Affiliation(s)
- Michael A Pritchett
- FirstHealth Moore Regional Hospital and Pinehurst Medical Clinic, Pinehurst, NC
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9
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Tao M, Zhang N, Wang H, Ma H, Gao H, Wang Z. Bronchial arterial embolization may reduce the risk of severe bleeding in central airway obstruction due to renal cell carcinomas during bronchoscopic procedures. Ther Adv Respir Dis 2020; 14:1753466620976012. [PMID: 33272105 PMCID: PMC7720307 DOI: 10.1177/1753466620976012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hemorrhage is a life-threatening complication during bronchoscopic intervention in patients with central airway obstruction (CAO) due to metastatic renal cell carcinoma (RCC). Whether pre-bronchoscopic bronchial arterial embolization (BAE) can reduce the risk of severe bleeding in CAO patients due to metastatic RCC remains unclear. METHODS A total of 31 CAO patients due to metastatic RCC were included retrospectively and divided into a BAE group (receiving pre-bronchoscopic BAE) and non-BAE group in this study. Based on computed tomography (CT) and bronchoscopic findings, tumor debulking was used to reconstruct the airway during interventional bronchoscopy. The primary outcome was the incidence of severe bleeding during bronchoscopic procedures. Bleeding-related complications, Karnofsky performance score (KPS) and dyspnea score were also analyzed over a 1-month observation period. RESULTS There were no significant differences between the two groups in baseline characteristics, including patients' features, tumor morphology under CT scannings, tumor site, and obstruction degree under bronchoscopic examination. Procedure-related bleeding occurred in all 31 patients. Pre-bronchoscopic BAE significantly reduced the incidence of moderate and major bleeding when compared with that in the non-BAE group. The incidence of poor visualization and hypoxia was also reduced significantly in the BAE group. There was no significant difference in KPS and dyspnea score between the BAE and non-BAE groups at 1 month follow up. CONCLUSION Pre-bronchoscopic BAE might be a feasible option to reduce the risk of severe bleeding for CAO patients due to metastatic RCC during bronchoscopic intervention. Interventional bronchoscopy was a safe and effective procedure for CAO due to metastatic RCC.The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Meimei Tao
- Department of Oncology, Emergency General Hospital, Beijing, China
| | - Nan Zhang
- Department of Oncology, Emergency General Hospital, No. 29 Xibahe Nanli, Chaoyang District, Beijing, 100028, China
| | - Hongwu Wang
- Department of Oncology, Emergency General Hospital, Beijing, China
| | - Hongming Ma
- Department of Oncology, Emergency General Hospital, Beijing, China
| | - Hong Gao
- Department of Oncology, Emergency General Hospital, Beijing, China
| | - Zhina Wang
- Department of Oncology, Emergency General Hospital, Beijing, China
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10
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Gorospe L, Ayala-Carbonero AM, Montelongo-Martín A, Mirambeaux-Villalona RM, Arrieta P, Muñoz-Molina GM, Fra-Fernández S, Benito-Berlinches A, Lumbreras-Fernández B, Alarcón-Rodríguez J. Percutaneous Biopsy of a Paraaortic Mediastinal Mass Using a Contralateral Parasternal Approach: A New Alternative Safe Access. Arch Bronconeumol 2020:S0300-2896(20)30307-0. [PMID: 33067024 DOI: 10.1016/j.arbres.2020.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/27/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Luis Gorospe
- Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, España.
| | | | | | | | - Paola Arrieta
- Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, España
| | | | - Sara Fra-Fernández
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, España
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11
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Liu Z, Ning Z, Lu H, Cao T, Zhou F, Ye X, Chen C. Long non-coding RNA RFPL3S is a novel prognostic biomarker in lung cancer. Oncol Lett 2020; 20:1270-1280. [PMID: 32724368 PMCID: PMC7377115 DOI: 10.3892/ol.2020.11642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/07/2019] [Indexed: 01/10/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) are functional components of the human genome. Recent studies have demonstrated that lncRNAs play essential roles in tumorigenesis, and are involved in cell proliferation, apoptosis, migration and invasion in several types of tumor, including lung cancer. However, the clinical relevance of lncRNA expression in lung cancer remains unknown. The aim of the present study was to investigate the expression pattern of RFPL3 antisense (RFPL3S) and its associations with clinicopathological characteristics in patients with lung cancer. Whether RFPL3S can act as a potential prognostic biomarker for lung cancer was also investigated. RFPL3S expression in tumor samples and cells was assessed using the Oncomine database and the Cancer Cell Line Encyclopedia, respectively. Based on Kaplan-Meier Plotter analyses, the prognostic values of RFPL3S were further evaluated. It was revealed that RFPL3S was highly expressed in lung cancer tissues when compared with normal tissues and was significantly associated with pN factor, pTNM stage and Ki-67 labeling index. In the survival analyses, increased RFPL3S expression was associated with poor survival and was inversely associated with first progression in all patients. These results indicate that RFPL3S may be of clinical significance and may act as a prognostic biomarker in lung cancer.
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Affiliation(s)
- Zhonghua Liu
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Zhiqiang Ning
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Hailin Lu
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Tinghua Cao
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Feng Zhou
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Xia Ye
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Chao Chen
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
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12
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Solidoro P, Corbetta L, Patrucco F, Sorbello M, Piccioni F, D'amato L, Renda T, Petrini F. Competences in bronchoscopy for Intensive Care Unit, anesthesiology, thoracic surgery and lung transplantation. Panminerva Med 2019; 61:367-385. [DOI: 10.23736/s0031-0808.18.03565-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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13
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Zhao Z, Jordan S, Tse ZTH. Devices for image-guided lung interventions: State-of-the-art review. Proc Inst Mech Eng H 2019; 233:444-463. [DOI: 10.1177/0954411919832042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lung cancer is the leading cause of cancer-related death. According to the American Cancer Society, there were an estimated 222,500 new cases of lung cancer and 155,870 deaths from lung cancer in the United States in 2017. Accurate localization in lung interventions is one of the keys to reducing the death rate from lung cancer. In this study, a total of 217 publications from 2006 to 2017 about designs of medical devices for localization in lung interventions were screened, shortlisted, and categorized by localization principle and reviewed for functionality. Each study was analyzed for engineering characteristics and clinical significance. Research regarding interventional imaging equipment, navigation systems, and surgical devices was reviewed, and both research prototypes and commercial products were discussed. Finally, the future directions and existing challenges were summarized, including real-time intra-procedure guidance, accuracy of localization, clinical application, clinical adoptability, and clinical regulatory issues.
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Affiliation(s)
- Zhuo Zhao
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Sophie Jordan
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Zion Tsz Ho Tse
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, GA, USA
- 3T Technologies LLC, Atlanta, GA, USA
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14
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Sumathipala Y, Shafiq M, Bongen E, Brinton C, Paik D. Machine learning to predict lung nodule biopsy method using CT image features: A pilot study. Comput Med Imaging Graph 2018; 71:1-8. [PMID: 30448741 DOI: 10.1016/j.compmedimag.2018.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 09/21/2018] [Accepted: 10/26/2018] [Indexed: 12/18/2022]
Abstract
Computed tomography (CT)-based screening on lung cancer mortality is poised to make lung nodule management a growing public health problem. Biopsy and pathologic analysis of suspicious nodules is necessary to ensure accurate diagnosis and appropriate intervention. Biopsy techniques vary as do the specialists that perform them and the ways lung nodule patients are referred and triaged. The largest dichotomy is between minimally invasive biopsy (MIB) and surgical biopsy (SB). Cases of unsuccessful MIB preceding a SB can result in considerable delay in definitive care with potentially an adverse impact on prognosis besides potentially avoidable healthcare expenditures. An automated method that predicts the optimal biopsy method for a given lung nodule could save time and healthcare costs by facilitating referral and triage patterns. To our knowledge, no such method has been published. Here, we used CT image features and radiologist-annotated semantic features to predict successful MIB in a way that has not been described before. Using data from the Lung Image Database Consortium image collection (LIDC-IDRI), we trained a logistic regression model to determine whether a MIB or SB procedure was used to diagnose lung cancer in a patient presenting with lung nodules. We found that in successful MIB cases, the nodules were significantly larger and more spiculated. Our model illustrates that using robust machine learning tools on easily accessible semantic and image data can predict whether a patient's nodule is best biopsied by MIB or SB. Pending further validation and optimization, clinicians could use our publicly accessible model to aid clinical decision-making.
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Affiliation(s)
- Yohan Sumathipala
- Biomedical Informatics Program, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, United States.
| | - Majid Shafiq
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, United States.
| | - Erika Bongen
- Program in Immunology, Stanford University School of Medicine, Stanford, CA, United States.
| | - Connor Brinton
- Department of Computer Science, Stanford University School of Engineering, Stanford, CA, United States.
| | - David Paik
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States.
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Mehta AC, Hood KL, Schwarz Y, Solomon SB. The Evolutional History of Electromagnetic Navigation Bronchoscopy. Chest 2018; 154:935-947. [DOI: 10.1016/j.chest.2018.04.029] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/09/2018] [Accepted: 04/18/2018] [Indexed: 01/05/2023] Open
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Chen YF, Mao XW, Zhang YJ, Zhang CY, Yu YF, Qin E, Chen X, Shen JX. Endobronchial Ultrasound Elastography Differentiates Intrathoracic Lymph Nodes: A Meta-Analysis. Ann Thorac Surg 2018; 106:1251-1257. [DOI: 10.1016/j.athoracsur.2018.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 12/27/2022]
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Doubeni CA, Gabler NB, Wheeler CM, McCarthy AM, Castle PE, Halm EA, Schnall MD, Skinner CS, Tosteson ANA, Weaver DL, Vachani A, Mehta SJ, Rendle KA, Fedewa SA, Corley DA, Armstrong K. Timely follow-up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium. CA Cancer J Clin 2018; 68:199-216. [PMID: 29603147 PMCID: PMC5980732 DOI: 10.3322/caac.21452] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/09/2018] [Accepted: 02/21/2018] [Indexed: 12/19/2022] Open
Abstract
Timely follow-up for positive cancer screening results remains suboptimal, and the evidence base to inform decisions on optimizing the timeliness of diagnostic testing is unclear. This systematic review evaluated published studies regarding time to follow-up after a positive screening for breast, cervical, colorectal, and lung cancers. The quality of available evidence was very low or low across cancers, with potential attenuated or reversed associations from confounding by indication in most studies. Overall, evidence suggested that the risk for poorer cancer outcomes rises with longer wait times that vary within and across cancer types, which supports performing diagnostic testing as soon as feasible after the positive result, but evidence for specific time targets is limited. Within these limitations, we provide our opinion on cancer-specific recommendations for times to follow-up and how existing guidelines relate to the current evidence. Thresholds set should consider patient worry, potential for loss to follow-up with prolonged wait times, and available resources. Research is needed to better guide the timeliness of diagnostic follow-up, including considerations for patient preferences and existing barriers, while addressing methodological weaknesses. Research is also needed to identify effective interventions for reducing wait times for diagnostic testing, particularly in underserved or low-resource settings. CA Cancer J Clin 2018;68:199-216. © 2018 American Cancer Society.
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Affiliation(s)
- Chyke A. Doubeni
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Nicole B. Gabler
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Cosette M. Wheeler
- Departments of Pathology, and Obstetrics and Gynecology, University of New Mexico Health Science Center, Albuquerque, NM
| | - Anne Marie McCarthy
- General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Philip E. Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Ethan A. Halm
- Departments of Internal Medicine and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mitchell D. Schnall
- Department of Radiology, Breast Imaging Section, University of Pennsylvania, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Celette S. Skinner
- Department of Clinical Sciences and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX
| | - Anna N. A. Tosteson
- The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Donald L. Weaver
- Department of Pathology, UVM Cancer Center, University of Vermont, Burlington, VT
| | - Anil Vachani
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shivan J. Mehta
- Department of Medicine, Perelman School of Medicine and Penn Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA
| | - Katharine A. Rendle
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Stacey A Fedewa
- Surveillance and Health Services Research, American Cancer Society. Atlanta, GA
| | - Douglas A. Corley
- Kaiser Permanente Division of Research, Oakland, CA, and San Francisco Medical, Kaiser Permanente Northern California, San Francisco, CA
| | - Katrina Armstrong
- General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Hofman P. PD-L1 immunohistochemistry for non-small cell lung carcinoma: which strategy should be adopted? Expert Rev Mol Diagn 2017; 17:1097-1108. [PMID: 29069958 DOI: 10.1080/14737159.2017.1398083] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION PD-L1 detection with immunohistochemistry (IHC) is the only predictive biomarker available to date for PD-L1/PD1 immunotherapy in thoracic oncology. While many studies have been published on this biomarker, they raise a number of questions concerning mainly, (i) the type of antibody for use and its condition of utilization, (ii) the threshold to be used, (iii) the message and information to communicate to the thoracic oncologist and, (iv) the adoption of this methodology as part of the daily practices of a pathology laboratory. Areas covered: This review provides an update on the use of the different PD-L1 antibodies for IHC in the context of metastatic non-small cell lung cancer (NSCLC) and discusses their use as companion or complementary diagnostic tests. The limits of PD-L1 IHC as a predictive test, the precautions to be adopted as well as some perspectives will then be considered. Expert commentary: IHC for PD-L1 can be considered as a theranostic test, which implies providing an extremely reliable result that avoids any false positive and negative results. PD-L1 IHC requires considerable expertise and specific training of pathologists. PD-L1 IHC can be a companion or complementary diagnostic test depending on the clone employed, the molecular therapy prescribed and the indication of use.
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Affiliation(s)
- Paul Hofman
- a Laboratoire de Pathologie Clinique et Expérimentale, Hôpital Pasteur , Centre Hospitalo-Universitaire de Nice, Université de Nice Sophia Antipolis , Nice cedex 01 , France.,b Biobanque Hospitalière (BB-0033-00025) , Hôpital Pasteur , Nice , France.,c FHU OncoAge , Hôpital Pasteur, Université Nice Côte d'Azur , Nice , France
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