Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ

Pyng Lee, Remco M. Van Den Berg, Stephen Lam, Adi F. Gazdar, Katrien Grunberg, Annette McWilliams, Jean LeRiche, Pieter E. Postmus, Tom G. Sutedja

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Autofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead to excessive biopsy and increased procedural time. Onco-LIFE, a device that combines fluorescence and reflectance imaging, allows numeric representation by expressing red-to-green ratio (R/G ratio) within the region of interest. The aim of the study was to determine if color fluorescence ratio (R/G ratio) added to autofluorescence bronchoscopy could provide an objective means to guide biopsy. Methods: Subjects at risk for lung cancer were recruited at two centers: VU University Medical Centre (Amsterdam) and BC Cancer Agency (Canada). R/G ratio for each site appearing normal or abnormal was measured before biopsy. R/G ratios were correlated with pathology, and a receiver operating characteristic curve of R/G ratio for high-grade and moderate dysplasia was done. Following analysis of the training data set obtained from two centers, a prospective validation study was done. Results: Three thousand three hundred sixty-two adequate biopsies from 738 subjects with their corresponding R/G ratios were analyzed. R/G ratio 0.54 conferred 85% sensitivity and 80% specificity for the detection of high-grade and moderate dysplasia, area under the curve was 0.90, and 95% confidence interval was 0.88 to 0.92. In another 70 different sites that were assessed, κ measurements of agreement of R/G ratios with visual scores and pathology were 0.66 (P < 0.0001) and 0.61 (P < 0.0001), respectively. R/G ratio combined with visual score improved specificity to 88% (95% confidence interval, 0.73-0.96) for high-grade and moderate dysplasia. Conclusion: Color fluorescence ratio can objectively guide the bronchoscopist in selecting sites for biopsy with good pathologic correlation.

Original languageEnglish (US)
Pages (from-to)4700-4705
Number of pages6
JournalClinical Cancer Research
Volume15
Issue number14
DOIs
StatePublished - Jul 15 2009

Fingerprint

Bronchogenic Carcinoma
Carcinoma in Situ
Color
Fluorescence
Biopsy
Bronchoscopy
Confidence Intervals
Pathology
Validation Studies
Optical Imaging
ROC Curve
Area Under Curve
Canada
Lung Neoplasms
Prospective Studies
Sensitivity and Specificity
Equipment and Supplies
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Lee, P., Van Den Berg, R. M., Lam, S., Gazdar, A. F., Grunberg, K., McWilliams, A., ... Sutedja, T. G. (2009). Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ. Clinical Cancer Research, 15(14), 4700-4705. https://doi.org/10.1158/1078-0432.CCR-08-1644

Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ. / Lee, Pyng; Van Den Berg, Remco M.; Lam, Stephen; Gazdar, Adi F.; Grunberg, Katrien; McWilliams, Annette; LeRiche, Jean; Postmus, Pieter E.; Sutedja, Tom G.

In: Clinical Cancer Research, Vol. 15, No. 14, 15.07.2009, p. 4700-4705.

Research output: Contribution to journalArticle

Lee, P, Van Den Berg, RM, Lam, S, Gazdar, AF, Grunberg, K, McWilliams, A, LeRiche, J, Postmus, PE & Sutedja, TG 2009, 'Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ', Clinical Cancer Research, vol. 15, no. 14, pp. 4700-4705. https://doi.org/10.1158/1078-0432.CCR-08-1644
Lee P, Van Den Berg RM, Lam S, Gazdar AF, Grunberg K, McWilliams A et al. Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ. Clinical Cancer Research. 2009 Jul 15;15(14):4700-4705. https://doi.org/10.1158/1078-0432.CCR-08-1644
Lee, Pyng ; Van Den Berg, Remco M. ; Lam, Stephen ; Gazdar, Adi F. ; Grunberg, Katrien ; McWilliams, Annette ; LeRiche, Jean ; Postmus, Pieter E. ; Sutedja, Tom G. / Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ. In: Clinical Cancer Research. 2009 ; Vol. 15, No. 14. pp. 4700-4705.
@article{e9bd936841624164b908b41e73d791fe,
title = "Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ",
abstract = "Background: Autofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead to excessive biopsy and increased procedural time. Onco-LIFE, a device that combines fluorescence and reflectance imaging, allows numeric representation by expressing red-to-green ratio (R/G ratio) within the region of interest. The aim of the study was to determine if color fluorescence ratio (R/G ratio) added to autofluorescence bronchoscopy could provide an objective means to guide biopsy. Methods: Subjects at risk for lung cancer were recruited at two centers: VU University Medical Centre (Amsterdam) and BC Cancer Agency (Canada). R/G ratio for each site appearing normal or abnormal was measured before biopsy. R/G ratios were correlated with pathology, and a receiver operating characteristic curve of R/G ratio for high-grade and moderate dysplasia was done. Following analysis of the training data set obtained from two centers, a prospective validation study was done. Results: Three thousand three hundred sixty-two adequate biopsies from 738 subjects with their corresponding R/G ratios were analyzed. R/G ratio 0.54 conferred 85{\%} sensitivity and 80{\%} specificity for the detection of high-grade and moderate dysplasia, area under the curve was 0.90, and 95{\%} confidence interval was 0.88 to 0.92. In another 70 different sites that were assessed, κ measurements of agreement of R/G ratios with visual scores and pathology were 0.66 (P < 0.0001) and 0.61 (P < 0.0001), respectively. R/G ratio combined with visual score improved specificity to 88{\%} (95{\%} confidence interval, 0.73-0.96) for high-grade and moderate dysplasia. Conclusion: Color fluorescence ratio can objectively guide the bronchoscopist in selecting sites for biopsy with good pathologic correlation.",
author = "Pyng Lee and {Van Den Berg}, {Remco M.} and Stephen Lam and Gazdar, {Adi F.} and Katrien Grunberg and Annette McWilliams and Jean LeRiche and Postmus, {Pieter E.} and Sutedja, {Tom G.}",
year = "2009",
month = "7",
day = "15",
doi = "10.1158/1078-0432.CCR-08-1644",
language = "English (US)",
volume = "15",
pages = "4700--4705",
journal = "Clinical Cancer Research",
issn = "1078-0432",
publisher = "American Association for Cancer Research Inc.",
number = "14",

}

TY - JOUR

T1 - Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ

AU - Lee, Pyng

AU - Van Den Berg, Remco M.

AU - Lam, Stephen

AU - Gazdar, Adi F.

AU - Grunberg, Katrien

AU - McWilliams, Annette

AU - LeRiche, Jean

AU - Postmus, Pieter E.

AU - Sutedja, Tom G.

PY - 2009/7/15

Y1 - 2009/7/15

N2 - Background: Autofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead to excessive biopsy and increased procedural time. Onco-LIFE, a device that combines fluorescence and reflectance imaging, allows numeric representation by expressing red-to-green ratio (R/G ratio) within the region of interest. The aim of the study was to determine if color fluorescence ratio (R/G ratio) added to autofluorescence bronchoscopy could provide an objective means to guide biopsy. Methods: Subjects at risk for lung cancer were recruited at two centers: VU University Medical Centre (Amsterdam) and BC Cancer Agency (Canada). R/G ratio for each site appearing normal or abnormal was measured before biopsy. R/G ratios were correlated with pathology, and a receiver operating characteristic curve of R/G ratio for high-grade and moderate dysplasia was done. Following analysis of the training data set obtained from two centers, a prospective validation study was done. Results: Three thousand three hundred sixty-two adequate biopsies from 738 subjects with their corresponding R/G ratios were analyzed. R/G ratio 0.54 conferred 85% sensitivity and 80% specificity for the detection of high-grade and moderate dysplasia, area under the curve was 0.90, and 95% confidence interval was 0.88 to 0.92. In another 70 different sites that were assessed, κ measurements of agreement of R/G ratios with visual scores and pathology were 0.66 (P < 0.0001) and 0.61 (P < 0.0001), respectively. R/G ratio combined with visual score improved specificity to 88% (95% confidence interval, 0.73-0.96) for high-grade and moderate dysplasia. Conclusion: Color fluorescence ratio can objectively guide the bronchoscopist in selecting sites for biopsy with good pathologic correlation.

AB - Background: Autofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead to excessive biopsy and increased procedural time. Onco-LIFE, a device that combines fluorescence and reflectance imaging, allows numeric representation by expressing red-to-green ratio (R/G ratio) within the region of interest. The aim of the study was to determine if color fluorescence ratio (R/G ratio) added to autofluorescence bronchoscopy could provide an objective means to guide biopsy. Methods: Subjects at risk for lung cancer were recruited at two centers: VU University Medical Centre (Amsterdam) and BC Cancer Agency (Canada). R/G ratio for each site appearing normal or abnormal was measured before biopsy. R/G ratios were correlated with pathology, and a receiver operating characteristic curve of R/G ratio for high-grade and moderate dysplasia was done. Following analysis of the training data set obtained from two centers, a prospective validation study was done. Results: Three thousand three hundred sixty-two adequate biopsies from 738 subjects with their corresponding R/G ratios were analyzed. R/G ratio 0.54 conferred 85% sensitivity and 80% specificity for the detection of high-grade and moderate dysplasia, area under the curve was 0.90, and 95% confidence interval was 0.88 to 0.92. In another 70 different sites that were assessed, κ measurements of agreement of R/G ratios with visual scores and pathology were 0.66 (P < 0.0001) and 0.61 (P < 0.0001), respectively. R/G ratio combined with visual score improved specificity to 88% (95% confidence interval, 0.73-0.96) for high-grade and moderate dysplasia. Conclusion: Color fluorescence ratio can objectively guide the bronchoscopist in selecting sites for biopsy with good pathologic correlation.

UR - http://www.scopus.com/inward/record.url?scp=68049087938&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68049087938&partnerID=8YFLogxK

U2 - 10.1158/1078-0432.CCR-08-1644

DO - 10.1158/1078-0432.CCR-08-1644

M3 - Article

C2 - 19584169

AN - SCOPUS:68049087938

VL - 15

SP - 4700

EP - 4705

JO - Clinical Cancer Research

JF - Clinical Cancer Research

SN - 1078-0432

IS - 14

ER -