Solitary pulmonary nodule imaging approaches and the role of optical fibre-based technologies.
Solitary pulmonary nodule imaging approaches and the role of optical fibre-based technologies.
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DOI：
10.1183/13993003.02537-2020
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Dhaliwal K
中科院分区：
文献类型：
--
作者：
Fernandes S;Williams G;Williams E;Ehrlich K;Stone J;Finlayson N;Bradley M;Thomson RR;Akram AR;Dhaliwal K
孤立性肺结节 (SPN) 是一项临床挑战，因为没有单一的临床体征或放射学特征可以明确识别良性和恶性 SPN。肺癌的早期发现对生存结果具有巨大影响。因此，人们对恶性 SPN 的及时诊断和治疗非常感兴趣。目前的诊断途径涉及支气管内/经胸组织活检或放射学监测，这可能与诊断率不理想、医疗费用和患者焦虑有关。需要尖端技术来颠覆和改善现有的护理途径。基于光纤的技术可以通过支气管镜的工作通道或经胸腔穿刺针进行传输，可以为 SPN 患者提供先进的诊断能力。光学内窥镜是一种基于自发荧光的成像技术，可显示体内 SPN 的异常肺泡结构。替代光学指纹识别方法，例如时间分辨荧光光谱和荧光寿命成像显微镜，在区分肺癌与周围健康组织方面已显示出前景。同时，基于光纤的拉曼光谱已经能够对 SPN 进行体内实时表征。基于纤维的技术有潜力实现 SPN 的原位表征和实时显微成像，这可以帮助 SPN 患者立即做出治疗决策。本综述讨论了当前评估 SPN 的成像方式的进展，包括计算机断层扫描 (CT) 和正电子发射断层扫描 -CT。它探讨了基于光纤的技术的出现，并讨论了它们在 SPN 和疑似肺癌患者中的潜在作用。孤立性肺结节是一个巨大的诊断挑战。基于光纤的技术与支气管镜和经胸平台相结合，是检测早期肺癌的有前途的新型诊断工具。 https://bit.ly/3cOIDx4
Solitary pulmonary nodules (SPNs) are a clinical challenge, given there is no single clinical sign or radiological feature that definitively identifies a benign from a malignant SPN. The early detection of lung cancer has a huge impact on survival outcome. Consequently, there is great interest in the prompt diagnosis, and treatment of malignant SPNs. Current diagnostic pathways involve endobronchial/transthoracic tissue biopsies or radiological surveillance, which can be associated with suboptimal diagnostic yield, healthcare costs and patient anxiety. Cutting-edge technologies are needed to disrupt and improve, existing care pathways. Optical fibre-based techniques, which can be delivered via the working channel of a bronchoscope or via transthoracic needle, may deliver advanced diagnostic capabilities in patients with SPNs. Optical endomicroscopy, an autofluorescence-based imaging technique, demonstrates abnormal alveolar structure in SPNs in vivo. Alternative optical fingerprinting approaches, such as time-resolved fluorescence spectroscopy and fluorescence-lifetime imaging microscopy, have shown promise in discriminating lung cancer from surrounding healthy tissue. Whilst fibre-based Raman spectroscopy has enabled real-time characterisation of SPNs in vivo. Fibre-based technologies have the potential to enable in situ characterisation and real-time microscopic imaging of SPNs, which could aid immediate treatment decisions in patients with SPNs. This review discusses advances in current imaging modalities for evaluating SPNs, including computed tomography (CT) and positron emission tomography-CT. It explores the emergence of optical fibre-based technologies, and discusses their potential role in patients with SPNs and suspected lung cancer. Solitary pulmonary nodules are a huge diagnostic challenge. Optical fibre-based technologies, in conjunction with bronchoscopic and transthoracic platforms, are promising novel diagnostic tools in the detection of early lung cancer. https://bit.ly/3cOIDx4
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