Role of HD i-scan bronchoscopy in the diagnosis of nonendobronchial lung cancer

Abstract

Introduction Bronchoscopy with i-scan (image-scan) is a new image-enhanced endoscopic technology used for the detection of small intraepithelial and preinvasive lesions. Aim Comparing the diagnostic yield of high definition (HD)+i-scan bronchoscopy vs white light bronchoscopy (WLB) in the detection of vascular abnormalities and preinvasive lesions for early diagnosis of lung cancer. Patients and methods This cross-sectional study enrolled 40 patients with suspected lung cancer admitted to the Chest Department, Mansoura University, Egypt, 2016–2018. Patients with suspected lung cancer were included while patients unfit for bronchoscopy or with endobronchial mass were excluded. All patients after clinical, laboratory, and radiological assessment were screened by bronchoscopy using: WLB, HD-bronchoscopy, i-scan1, i-scan2, and i-scan3. When suspicious sites were detected, they were graded, counted, and categorized, afterwards cryobiopsies were taken to correlate between bronchoscopic and pathological findings followed by calculation of sensitivity and accuracy. Results Most of the patients were men, with a mean age of 59.25 years. Few abnormal sites detected by WLB (29) lesions were highly significantly lower than i-scan1, i-scan2, and i-scan3 (P<0.0001). Regarding i-scan1 there were 58 abnormal sites, was also significantly lower than i-scan2 and i-scan3 (P=0.04, 0.019). i-scan2 shows 66 abnormal sites, had a significant difference in comparison with i-scan3 which had 74 abnormal sites (P=0.019). WLB had low sensitivity and accuracy of 24 and, 30%, respectively; meanwhile, i-scan had high sensitivity and accuracy of 78 and 80%, respectively. Conclusion HD-bronchoscopy+i-scan which offers real-time image enhancement has a better diagnostic yield than WLB in the diagnosis of lung cancer with nonendobronchial extension.

Keywords

• bronchoscopy
• i-scan
• lung cancer
• nonendobronchial