Optical detection of preneoplastic lesions of the central airways

Optical imaging of tissue obtained by transbronchial biopsies of peripheral lung lesions

BACKGROUND

Bronchoscopic procedures have been increasingly used for the diagnosis of peripheral lung cancers, but the yield remains moderately low. The aim of this study is to assess the feasibility and ability of a custom-built bimodal optical spectroscopy system to enhance the on-site discrimination between malignant and benign specimens obtained from the transbronchial lung biopsies (TBLB) of peripheral lung lesions.

METHODS

We conducted a prospective and single-center pilot study to examine the TBLB specimens obtained from peripheral lung lesions. Diffuse reflectance spectroscopy (DRS) and diffuse fluorescence spectroscopy (DFS) parameters were used to analyze the optical characteristics of these specimens.

RESULTS

One hundred and sixteen biopsy specimens from 15 patients were analyzed using optical imaging. All specimens had a confirmed pathologic diagnosis. Notably, 22 of the 116 specimens were malignant, and 10 of the 94 non-malignant specimens were necrotic biopsies. Individual parameters showed significant difference between the three groups (malignant, non-malignant and necrosis). Multivariate analysis of the blood, scattering and fluorescence parameters demonstrated a sensitivity of 77.3% and specificity of 73.1% in differentiating between malignant and benign specimens and a sensitivity of 90.9% and specificity of 100% in differentiating malignant from necrotic specimens.

CONCLUSIONS

We conclude that optical spectroscopy is a feasible modality for on-site discrimination between malignant and benign as well as malignant and necrotic TBLB specimens of peripheral lung lesions.