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Fluorescence Bronchoscopy

image: onco-life scope machine
The Onco-LIFET scope being used at NYU and Bellevue allows for earlier detection of precancerous lesions in the airway. larger image

image: examples of detection of early cancer
Examples of detection of early cancer with the Onco-LIFET. more info
By Harvey I. Pass, M.D.

White light (WL) bronchoscopy is a procedure which allows the airway to be examined for cancer. It is one of multiple tools used for staging and diagnosis of lung cancer.

While conventional bronchoscopy can be used to stage early lung cancer, even doctors experienced in bronchoscopy find detecting pre-cancerous lesions to be difficult. In an effort to improve detection, the Onco-LIFE™ Endoscopic Light Source and Video Camera may be used with bronchoscopes during endoscopic examination to illuminate and acquire real-time images of the lung or other hollow organs.

The Onco-LIFE™ consists of an endoscopic light source and video camera. It can operate in two modes:

  1. a conventional white light (WL) mode, also referred to as color imaging mode
  2. a fluorescence (FL) mode, in which it functions in the same way as conventional endoscopic light sources and cameras
In the FL mode, Onco-LIFE™ images native tissue fluorescence to aid in identifying potentially pre-cancerous and cancerous tissue. Blue light illuminates the tissue and excites fluorophors naturally present in the tissue. Areas suspicious for disease are displayed in red in the video image.

Light-induced fluorescence endoscopy (FL), when used as an adjunct to WL, has been demonstrated to improve the sensitivity for detection of pre-invasive and invasive lesions in the lung. A recent multi-center study using Onco-LIFE™ demonstrated that WL+FL bronchoscopy using this device was 1.33 times more sensitive than WL alone in detecting disease, and 4.25 times more sensitive than WL specifically in detecting pre-invasive lesions.

Physicians at both NYU Medical Center and Bellevue Hospital routinely use this method to evaluate the airway for otherwise undetected cancers, improving the early detection and treatment of lung cancer.