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Early lung cancer detection, mucosal, and alveolar imaging

Sardi, Alejandro H.; Islam, Shaheen

Current Opinion in Pulmonary Medicine: May 2016 - Volume 22 - Issue 3 - p 271–280
doi: 10.1097/MCP.0000000000000270
INTERVENTIONAL PULMONOLOGY: Edited by Venerino Poletti and Praveen N. Mathur

Purpose of review: Lung cancer is the leading cause of cancer deaths worldwide. Early detection is essential for long-term survival. Screening of high-risk individuals with low-dose computed tomography screening has proven to increase survival. However, current radiological imaging techniques have poor specificity for lung cancer detection and poor sensitivity for detection of mucosal or alveolar preinvasive malignant lesions. Bronchoscopy allows imaging and sampling of early lung cancer, with the highest safety profile and high diagnostic accuracy.

Recent findings: Available technologies, such as autofluorescence bronchoscopy, narrow band imaging, and radial ultrasound bronchoscopy can significantly increase the yield and diagnostic accuracy of bronchoscopy for early cancer detection in the central airways. Newer technologies such as optical coherence tomography, confocal bronchoscopy, and Raman spectroscopy may significantly increase the diagnostic yield of both central and parenchymal early cancer lesions.

Summary: Although some of these technologies are still investigational and are not readily available in most centers, they may identify early mucosal and alveolar cancer lesions accurately in the least invasive manner to provide appropriate therapy and prolong patient survival from lung cancer.

Interventional Pulmonology, Division of Pulmonary Allergy, Critical Care & Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA

Correspondence to Shaheen Islam, MD, Professor of Medicine, The Ohio State University, 201 Davis Heart and Lung Research Institute, 473W 12th Avenue, Columbus, OH 43210, USA. Tel: +1 614 292 6563; fax: +1 614 293 4799; e-mail: shaheen.islam@osumc.edu

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