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High definition bronchoscopy: a randomized exploratory study of diagnostic value compared to standard white light bronchoscopy and autofluorescence bronchoscopy.

van der Heijden EH, Hoefsloot W, van Hees HW, Schuurbiers OC - Respir. Res. (2015)

Bottom Line: In 29 patients all videos were available for analysis.Sites suspicious for preinvasive lesions were most frequently reported using AFB (0.74 ± 0.12 sites per patient) as compared to 0.17 ± 0.06 for both WLB and HD bronchoscopy (P = 0.003).Further investigations using this technique relating imaging to histology are warranted.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Videobronchoscopy is an essential diagnostic procedure for evaluation of the central airways and pivotal for the diagnosis and staging of lung cancer. Technological improvements have resulted in high definition (HD) images with advanced real time image enhancement techniques (i-scan).

Objectives: In this study we aimed to explore the sensitivity of HD+ i-scan bronchoscopy for detection of epithelial changes like vascular abnormalities and suspicious preinvasive lesions, and tumors.

Methods: In patients scheduled for a therapeutic or diagnostic procedure under general anesthesia videos of the bronchial tree were made using 5 videobronchoscopy modes in random order: normal white light videobronchoscopy (WLB), HD-bronchoscopy (HD), HD bronchoscopy with surface enhancement technique (i-scan1), HD with surface- and tone enhancement technique (i-scan2) and dual mode autofluorescence videobronchoscopy (AFB). The videos were scored in random order by two independent and blinded expert bronchoscopists.

Results: In 29 patients all videos were available for analysis. Vascular abnormalities were scored most frequently in HD + i-scan2 bronchoscopy (1.33 ± 0.29 abnormal or suspicious sites per patient) as compared to 0.12 ± 0.05 site for AFB (P = 0.003). Sites suspicious for preinvasive lesions were most frequently reported using AFB (0.74 ± 0.12 sites per patient) as compared to 0.17 ± 0.06 for both WLB and HD bronchoscopy (P = 0.003). Tumors were detected equally by all modalities. The preferred modality was HD bronchoscopy with i-scan (tone- plus surface and surface enhancement in respectively 38% and 35% of cases P = 0.006).

Conclusions: This study shows that high definition bronchoscopy with image enhancement technique may result in better detection of subtle vascular abnormalities in the airways. Since these abnormalities may be related to preneoplastic lesions and tumors this is of clinical relevance. Further investigations using this technique relating imaging to histology are warranted.

No MeSH data available.


Related in: MedlinePlus

Number of sites with abnormal and suspicious vascular changes. WLB: standard white light bronchoscopy; HD: High Definition bronchoscopy; i-scan1: HD bronchoscopy with surface enhancement; i-scan2: HD bronchoscopy with tone enhancement; AFB: autofluorescence video bronchoscopy twin mode (dual image SAFE3000).
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Fig3: Number of sites with abnormal and suspicious vascular changes. WLB: standard white light bronchoscopy; HD: High Definition bronchoscopy; i-scan1: HD bronchoscopy with surface enhancement; i-scan2: HD bronchoscopy with tone enhancement; AFB: autofluorescence video bronchoscopy twin mode (dual image SAFE3000).

Mentions: Using the different modalities for bronchoscopy the number of vascular abnormal and suspicious lesions detected varied from 0.12 ± 0.05 for AFB to 1.33 ± 0.29 for i-scan2 (P = 0.003, Table 1, Figure 3). Using normal WLB 0.28 ± 0.08 vascular abnormal sites were detected and HD and i-scan1 detected 0.72 ± 0.17 and 0.78 ± 0.22 lesions respectively.Table 1


High definition bronchoscopy: a randomized exploratory study of diagnostic value compared to standard white light bronchoscopy and autofluorescence bronchoscopy.

van der Heijden EH, Hoefsloot W, van Hees HW, Schuurbiers OC - Respir. Res. (2015)

Number of sites with abnormal and suspicious vascular changes. WLB: standard white light bronchoscopy; HD: High Definition bronchoscopy; i-scan1: HD bronchoscopy with surface enhancement; i-scan2: HD bronchoscopy with tone enhancement; AFB: autofluorescence video bronchoscopy twin mode (dual image SAFE3000).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4352538&req=5

Fig3: Number of sites with abnormal and suspicious vascular changes. WLB: standard white light bronchoscopy; HD: High Definition bronchoscopy; i-scan1: HD bronchoscopy with surface enhancement; i-scan2: HD bronchoscopy with tone enhancement; AFB: autofluorescence video bronchoscopy twin mode (dual image SAFE3000).
Mentions: Using the different modalities for bronchoscopy the number of vascular abnormal and suspicious lesions detected varied from 0.12 ± 0.05 for AFB to 1.33 ± 0.29 for i-scan2 (P = 0.003, Table 1, Figure 3). Using normal WLB 0.28 ± 0.08 vascular abnormal sites were detected and HD and i-scan1 detected 0.72 ± 0.17 and 0.78 ± 0.22 lesions respectively.Table 1

Bottom Line: In 29 patients all videos were available for analysis.Sites suspicious for preinvasive lesions were most frequently reported using AFB (0.74 ± 0.12 sites per patient) as compared to 0.17 ± 0.06 for both WLB and HD bronchoscopy (P = 0.003).Further investigations using this technique relating imaging to histology are warranted.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Videobronchoscopy is an essential diagnostic procedure for evaluation of the central airways and pivotal for the diagnosis and staging of lung cancer. Technological improvements have resulted in high definition (HD) images with advanced real time image enhancement techniques (i-scan).

Objectives: In this study we aimed to explore the sensitivity of HD+ i-scan bronchoscopy for detection of epithelial changes like vascular abnormalities and suspicious preinvasive lesions, and tumors.

Methods: In patients scheduled for a therapeutic or diagnostic procedure under general anesthesia videos of the bronchial tree were made using 5 videobronchoscopy modes in random order: normal white light videobronchoscopy (WLB), HD-bronchoscopy (HD), HD bronchoscopy with surface enhancement technique (i-scan1), HD with surface- and tone enhancement technique (i-scan2) and dual mode autofluorescence videobronchoscopy (AFB). The videos were scored in random order by two independent and blinded expert bronchoscopists.

Results: In 29 patients all videos were available for analysis. Vascular abnormalities were scored most frequently in HD + i-scan2 bronchoscopy (1.33 ± 0.29 abnormal or suspicious sites per patient) as compared to 0.12 ± 0.05 site for AFB (P = 0.003). Sites suspicious for preinvasive lesions were most frequently reported using AFB (0.74 ± 0.12 sites per patient) as compared to 0.17 ± 0.06 for both WLB and HD bronchoscopy (P = 0.003). Tumors were detected equally by all modalities. The preferred modality was HD bronchoscopy with i-scan (tone- plus surface and surface enhancement in respectively 38% and 35% of cases P = 0.006).

Conclusions: This study shows that high definition bronchoscopy with image enhancement technique may result in better detection of subtle vascular abnormalities in the airways. Since these abnormalities may be related to preneoplastic lesions and tumors this is of clinical relevance. Further investigations using this technique relating imaging to histology are warranted.

No MeSH data available.


Related in: MedlinePlus