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Titolo:
Autofluorescence bronchoscopy: The d-light system
Autore:
Haussinger, K; Pichler, J; Stanzel, F; Markus, A; Stepp, H; Morresi-Hauff, A; Baumgartner, R;
Indirizzi:
Asklepios Fachkliniken Munchen Gauting, Clin Pneumol & Thorac Surg, Munich, Germany Asklepios Fachkliniken Munchen Gauting Munich Germany , Munich, Germany Univ Munich, Dept Urol, Laser Res Inst, Munich, Germany Univ Munich Munich Germany , Dept Urol, Laser Res Inst, Munich, Germany
Titolo Testata:
INTERVENTIONAL BRONCHOSCOPY
, volume: 30, anno: 2000,
pagine: 243 - 252
SICI:
1422-2140(2000)30:<243:ABTDS>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
5-AMINOLEVULINIC ACID; LUNG-CANCER; PHOTODYNAMIC THERAPY; FLUORESCENCE PHOTODETECTION; INTRAVESICAL INSTILLATION; PROTOPORPHYRIN-IX; LESIONS; LOCALIZATION; MICROSCOPY; DIAGNOSIS;
Tipo documento:
Article
Natura:
Collana
Settore Disciplinare:
Clinical Medicine
Citazioni:
56
Recensione:
Indirizzi per estratti:
Indirizzo: Haussinger, K Asklepios Fachkliniken Munchen Gauting, Zentrum Pneumol & Thoraxchirurg, Robert Koch Allee 2, D-82131 Gauting, Germany Asklepios Fachkliniken Munchen Gauting Robert Koch Allee 2 Gauting Germany D-82131
Citazione:
K. Haussinger et al., "Autofluorescence bronchoscopy: The d-light system", PROG R RES, 30, 2000, pp. 243-252

Abstract

Early malignant changes are difficult to detect by conventional white light bronchoscopy (WLB). These lesions are only a few cell layers thick and some millimeters in surface diameter. Therefore, the endoscopic changes are very subtle and can be missed even by experienced bronchoscopists. On the other hand, dysplasia and carcinoma in situ occur in up to 10% of high risk patients. New methods can help to improve the detection rate of these findings. The most promising technique for this purpose is based on the detectionof autofluorescence phenomena. Up to now, several different systems have been developed, some of them being in the state of clinical evaluation. All fluorescence bronchoscopy systems depend on the individual, subjective experience of the investigator. The technical and scientific effort aims firstly to simplify the technical procedure, secondly to objectify the endoscopicfindings, and thirdly to increase sensitivity and specificity further on. Some possibilities to obtain these targets are: (1) Replacement of lasers by conventional white light sources with the advantage of using WLB and autofluorescence bronchoscopy (AFB) in one diagnostic procedure. (2) Development of appropriate image processing routines and implementation of wavelength-resolving spectral analysis. (3) Integration of various filters for emission of specific wavelength is necessary to stimulate exogenous fluorescence sensitizers (e.g. aminolevulinic acid). (4) Combination of various detection methods in one technical system. Some of the above-mentioned targets havebeen implemented in a newly developed diagnostic system described in detail in this paper. Preliminary results of this system show a more than twofold increase of the sensitivity for early stages by the use of additional AFBin comparison to WLB. Future research should be focused on the use of autofluorescence phenomena on a cellular level too. The diagnosis of early malignancy should include newly developed cytological methods to preselect patients with clinically occult malignancies within a screening program. Finally, these highly selected patients should be investigated by highly efficient interventional fluorescence bronchoscopy methods to localize and to characterize the malignancy. This will offer the chance for endoscopic therapeutic procedures and might help to significantly reduce mortality for patientswith lung cancer.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/03/20 alle ore 10:39:51