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Diagnostic of Lung Cancer: Confocal Bronchoscopy

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Interventions in Pulmonary Medicine

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Abstract

With the recent development of confocal endomicroscopy, bronchoscopy has now entered the era of in vivo microscopic imaging. Confocal fluorescence endomicroscopy is based on the principle of confocal microscopy, where the microscope objective has been replaced by fiber-optic probes. Two endomicroscope systems could theoretically be used for human explorations, differing by the position of the scanning system into the device. Due to the respiratory tract size, the only system currently available, called “probe-based confocal laser endomicroscopy” (or pCLE), uses the principle of proximal scanning. This system produces images through a 1 mm flexible miniprobe that can enter the 2 mm working channel of the bronchoscope. pCLE has a lateral resolution of 3 μm and produces real-time imaging at 9 frames per second. pCLE has the capability to image, at a microscopic scale, the fluorescence of the bronchial epithelial and subepithelial layers, as well as the more distal parts of the lungs, from the terminal bronchioles down to the alveolar ducts and sacs. Confocal endomicroscopy can be coupled with nuclear fluorescent dyes and has the potential to image targeted fluorescent molecular probes. Potential applications of FCFM include “optical biopsy” of early bronchial cancers, bronchial wall remodeling evaluation, diffuse peripheral lung disease exploration, as well as in vivo diagnosis of peripheral lung nodules.

This chapter details the capabilities and possible limitations of confocal microendoscopy for proximal and distal lung exploration with special focus on lung cancer imaging in vivo.

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Author information

Authors and Affiliations

  1. Clinique Pneumologique, Hôpital Charles Nicolle, Rouen University Hospital, 1 rue de Germont, Rouen, 76000, France

    Luc Thiberville M.D.

  2. Department of Pulmonary Medicine, Rouen University Hospital, Rouen, France

    Luc Thiberville M.D. & Mathieu Salaun M.D.

Authors
  1. Luc Thiberville M.D.
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  2. Mathieu Salaun M.D.
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Correspondence to Luc Thiberville M.D. .

Editor information

Editors and Affiliations

  1. MD Anderson Cancer Center, Houston, TX, Department of Pulmonary Medicine, Bellvitge University Hospital, Barcelona, 08907, Spain

    Jose Pablo Díaz-Jimenez

  2. Clinica Y Maternidad Colon, Pulmonary Department, Mar Del Plata, Buenos Aires, 7600, Argentina

    Alicia N. Rodriguez

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Thiberville, L., Salaun, M. (2013). Diagnostic of Lung Cancer: Confocal Bronchoscopy. In: Díaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_14

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  • DOI: https://doi.org/10.1007/978-1-4614-6009-1_14

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  • Online ISBN: 978-1-4614-6009-1

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