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How should we be investigating suspected lung cancer?
S36 Check novel in vivo real time imaging of the bronchial mucosa using an endo-cytoscopy
  1. K Shibuya1,3,
  2. N Okada1,
  3. H Kohno1,
  4. N Iwai1,
  5. M Noro2,
  6. B Akikusa2,
  7. H Hoshino3,
  8. I Yoshino3
  1. 1Department of Chest Surgery, Matsudo City Hospital, 4005 Kamihongo, Matsudo, 271–8511, Japan
  2. 2Department of Pathology, Matsudo City Hospital, 4005 Kamihongo, Matsudo, 271–8511, Japan
  3. 3Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260–8670, Japan

Abstract

Objectives We investigated the capabilities of an Endo-Cytoscopy system (ECS) that enables microscopic imaging of the tracheobronchial tree during bronchoscopy, including normal bronchial epithelium, dysplastic mucosa and hilar lung cancer.

Methods The newly developed integrated-type ECS for the bronchoscope has a built-in two imaging system with a conventional mode and a high-power endocytoscopic mode. ECS has a high magnification of 570×. Thirty-seven patients including 9 hilar lung cancer, 6 abnormal sputum cytology, 19 squamous dysplasia, and 3 after photodynamic therapy were entered into the study and underwent white light, narrow band imaging and autofluorescence imaging bronchoscopy. Both the abnormal area of interest and surrounding normal bronchial mucosa were stained with 0.5% methylene blue and examined with ECS. Histological examinations with haematoxylin and eosin stain were performed using the biopsied specimens. The ECS imaging was analysed and correlated with the corresponding histological examination.

Results ECS imaging could distinguish between different types of bronchial epithelium including normal bronchial mucosa, squamous dysplasia, and hilar lung cancer. Squamous dysplasia and hilar lung cancer were predictive with sensitivity of 85.7% (12/14) and 90.9% (10/11) and specificity of 100% (12/12), respectively. These ECS images corresponded well conventional histology.

Conclusion ECS was useful for the discrimination between normal bronchial epithelial cells and dysplastic cells or malignant cells during bronchoscopy in real time. This novel technology has an excellent potential to provide in vivo diagnosis during bronchoscopic examinations.

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