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Review
. 2013 Sep;5 Suppl 4(Suppl 4):S359-70.
doi: 10.3978/j.issn.2072-1439.2013.05.15.

Advanced bronchoscopic techniques in diagnosis and staging of lung cancer

Bojan Zaric  1 , Vladimir Stojsic, Tatjana Sarcev, Goran Stojanovic, Vladimir Carapic, Branislav Perin, Paul Zarogoulidis, Kaid Darwiche, Kosmas Tsakiridis, Ilias Karapantzos, Georgios Kesisis, Ioanna Kougioumtzi, Nikolaos Katsikogiannis, Nikolaos Machairiotis, Aikaterini Stylianaki, Christophoros N Foroulis, Konstantinos Zarogoulidis
Affiliations
Review

Advanced bronchoscopic techniques in diagnosis and staging of lung cancer

Bojan Zaric et al. J Thorac Dis. 2013 Sep.

Abstract

The role of advanced brochoscopic diagnostic techniques in detection and staging of lung cancer has steeply increased in recent years. Bronchoscopic imaging techniques became widely available and easy to use. Technical improvement led to merging in technologies making autofluorescence or narrow band imaging incorporated into one bronchoscope. New tools, such as autofluorescence imagining (AFI), narrow band imaging (NBI) or fuji intelligent chromo endoscopy (FICE), found their place in respiratory endoscopy suites. Development of endobronchial ultrasound (EBUS) improved minimally invasive mediastinal staging and diagnosis of peripheral lung lesions. Linear EBUS proven to be complementary to mediastinoscopy. This technique is now available in almost all high volume centers performing bronchoscopy. Radial EBUS with mini-probes and guiding sheaths provides accurate diagnosis of peripheral pulmonary lesions. Combining EBUS guided procedures with rapid on site cytology (ROSE) increases diagnostic yield even more. Electromagnetic navigation technology (EMN) is also widely used for diagnosis of peripheral lesions. Future development will certainly lead to new improvements in technology and creation of new sophisticated tools for research in respiratory endoscopy. Broncho-microscopy, alveoloscopy, optical coherence tomography are some of the new research techniques emerging for rapid technological development.

Keywords: Autofluorescence bronchoscopy (AFB); endobronchial ultrasound (EBUS); interventional bronchoscopy; narrow band imagning (NBI).

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Figures

Figure 1
Figure 1
AFI, granulation tissue, place of prior biopsy, normal autofluorescence.
Figure 2
Figure 2
AFI, dark-violet pathological fluorescence-squamous cell lung cancer.
Figure 3
Figure 3
AFI, faint violet fluorescence-dysplasia grade II.
Figure 4
Figure 4
NBI, tortuous blood vessels-squamous cell lung cancer.
Figure 5
Figure 5
NBI, abrupt ending blood vessels-squamous cell lung cancer.
Figure 6
Figure 6
NBI, dotted vascular pattern-adenocarcinoma of the lung.
Figure 7
Figure 7
NBI, background noise-endobronchial tuberculosis.
Figure 8
Figure 8
NBI, background noise-tracheitis.
Figure 9
Figure 9
NBI, background noise-chronic inflammation.
Figure 10
Figure 10
EBUS guided TBNA, real time image of the needle inside mediastinal lymph node station 4D.
Figure 11
Figure 11
EBUS guided TBNA, real time image of the needle inside mediastinal lymph node station 4L.
Figure 12
Figure 12
Radial EBUS, snow storm pattern of normal EBUS image in lung periphery.
Figure 13
Figure 13
Radial EBUS, image of the peripheral pulmonary lesion.
See this image and copyright information in PMC

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