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Early Lung Cancer: Methods for Detection

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Interventions in Pulmonary Medicine

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Abstract

Although the incidence and death due to lung cancer continue to decline in recent years, lung cancer is still the leading cause of death in North America. Screening, and early detection will be one of the most important clinical practices for improving lung cancer survival. Airway assessment by white light observation has been enhanced by developing new image sensors such as a high-resolution charge coupled device (CCD) and high-resolution complementary metal oxide semiconductor (CMOS). These new image sensors deliver the digital high magnification image as well. The techniques beyond white light observation have also been accepted in current clinical environment for early endobronchial malignancy detection and surveillance. Autofluorescence bronchoscopy (AFB) and narrow band imaging (NBI) are some of the advanced bronchoscopic imaging techniques capable of detecting preinvasive lesions currently available in clinical practice. These technologies allow to differentiate between pre-malignant and malignant lesions utilizing differential patterns of normal and pathological tissue autofluorescence or vasculature. Endocytoscopy, confocal laser endomicroscopy (CLE), and optical coherence tomography (OCT) are still investigational, but these novel technologies will open a new avenue for more precise evaluation of bronchial epithelium as well as bronchial structure and it may contribute for very early detection of lung cancer.

The technology which received the most attention in interventional pulmonology over the past two decades was the development of endobronchial ultrasound. Endobronchial ultrasound allows advanced assessment of the airway as well as the mediastinum and peripheral lung nodules. The radial probe endobronchial ultrasound (EBUS) allows a more precise evaluation of newly detected preinvasive lesions within the airway. Optical coherence tomography is another new technology for more detailed observation of endobronchial structures. This chapter will review the advanced bronchoscopic imaging technologies for detection of early lung cancer.

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Acknowledgments

TN received honoraria and lecture fees from Olympus Corporation, and KY received unrestricted educational and research grant from Olympus Corporation.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan

    Takahiro Nakajima

  2. Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada

    Kazuhiro Yasufuku

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  1. Takahiro Nakajima
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  2. Kazuhiro Yasufuku
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Correspondence to Kazuhiro Yasufuku .

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  1. Interventional Pulmonary Department Hospital, Universitari de Bellvitge Hospitalet de Llobregat, Barcelona, Spain

    José Pablo Díaz-Jiménez

  2. School of Medicine, National University of Mar del Plata, Buenos Aires, Argentina

    Alicia N. Rodríguez

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Nakajima, T., Yasufuku, K. (2023). Early Lung Cancer: Methods for Detection. In: Díaz-Jiménez, J.P., Rodríguez, A.N. (eds) Interventions in Pulmonary Medicine. Springer, Cham. https://doi.org/10.1007/978-3-031-22610-6_21

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