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 journalArticlepeer-review

40 Scopus citations


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
Issue number14
StatePublished - Jul 15 2009

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Color fluorescence ratio for detection of bronchial dysplasia and carcinoma in situ'. Together they form a unique fingerprint.

Cite this