Bronchoscopic Diagnosis of Solitary Pulmonary Nodules with the Use of NIR Spectroscopy

Votruba Jiri¹, Brůha Tomas^1*, Balaz Teodor²

¹1st Pulmonary Clinic, Charles University Prague, Praha, Czech Republic.
²University of Defense, Brno, Czech Republic.

DOI: 10.4236/aces.2015.54051                

Abstract

Background: Recently, SPN has become a much more frequently encountered issue in bronchology. Efficient and reliable guidance method for SPN morphological proof is highly needed. Objectives: The aim of study was to compare the diagnostic values of NIR (near infrared) spectroscopy with EBUS for SPN diagnostic. Fluoroscopic guidance with TBB and needle biopsy were done in all patients. Methods: In our study, we used two types of monitoring systems. Fluoroscopic guidance was combined with either a radial EBUS or a NIR spectroscopy probe for tissue confirmation. 139 male and 71 female patients, having a medial age of 68 years with CT/PET findings of metabolically active SPN were examined between 2/2010 and 2/2013. We designed an instrument for measurement of the penetration of the NIR through lung tissue. Indicating and source fibers were navigated towards the SPN. An EBUS radial probe was used, during fluoroscopic navigation. Results: The statistical analysis of the results obtained showed a comparative specificity and sensitivity of the NIR spectroscopy, with radial EBUS. Conclusions: NIR spectroscopy produced similar efficacies as the radial EBUS. However, the number of positive biopsies was more dependent upon the ability to direct the confirmatory device to the SPN during fluoroscopic guidance than on the type of the device.

Keywords

Solitary Pulmonary Nodule, Near Infrared Spectroscopy, Endobronchial Ultrasound, Fluoroscopy, Biopsy

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Burt, J.R., Iribarren, C., Fair, J.M., et al. (2008) Incidental Findings on Cardiac Multidetector Row Computed Tomography among Healthy Older Adults: Prevalence and Clinical Correlates. Archives of Internal Medicine, 168, 756-761. http://dx.doi.org/10.1001/archinte.168.7.756
[2]	Ost, D., Fein, A.M. and Feinsilver, S.H. (2003) Clinical Practice: The Solitary Pulmonary Nodule. The New England Journal of Medicine, 348, 2535-2542. http://dx.doi.org/10.1056/NEJMcp012290
[3]	Wahidi, M.M., Govert, J.A., Goudar, R.K., Gould, M.K. and McCrory, D.C. (2007) Evidence for the Treatment of Patients with Pulmonary Nodules: When Is It Lung Cancer ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition). CHEST, 132, 94S-107S.
[4]	Cronin, P., Dwamena, B.A., Kelly, A.M. and Carlos, R.C. (2008) Solitary Pulmonary Nodules: Meta-Analytic Comparison of Cross-Sectional Imaging Modalities for Diagnosis of Malignancy. Radiology, 246, 772-782.
[5]	Eberhardt, R., Ernst, A. and Herth, F.J.F. (2009) Ultrasound-Guided Transbronchial Biopsies of Solitary Pulmonary Nodules Less than 20 mm. ERJ, 34, 1284-1287. http://dx.doi.org/10.1183/09031936.00166708
[6]	Ntziachristos, V., Ripoll, J. and Weissleder, R. (2002) Would Near-Infrared Fluorescence Signals Propagate through Large Human Organs for Clinical Studies? Optics Letters, 27, 333. http://dx.doi.org/10.1364/OL.27.000333
[7]	Pogue, B.W., Patterson, M.S., et al. (2006) Review of Tissue Simulating Phantoms for Optical Spectroscopy, Imaging and Dosimetry. Journal of Biomedical Optics, 11, 041102. http://dx.doi.org/10.1117/1.2335429
[8]	Prakash, U.B.S. (2005) Bronchoscopy. In: Mason, R.J., Murray, J.F., Broaddus, V.C. and Nadel, J.A., Eds., Murray & Nadel’s Textbook of Respiratory Medicine, 4th Edition, Saunders Elsevier, Philadelphia, Ch 22.
[9]	Wolf, M., Ferrari, M. and Quaresima, V. (2007) Progress of Near-Infrared Spectroscopy and Topography for Brain and Muscle Clinical Applications. Journal of Biomedical Optics, 12, 062104.