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العنوان
Role of High Definition Bronchoscopy
And I- Scan Technology Compared To
Standard White Light Bronchoscopy In
Patients With Suspected Lung Cancer /
المؤلف
Mohamed, Hoda Atiatullah Mohamed.
هيئة الاعداد
باحث / Hoda Atiatullah Mohamed Mohamed
مشرف / Yasser Mostafa Mohamed
مشرف / Ashraf Mokhtar Madkour
مناقش / Ashraf Abbas Elmaraghy
تاريخ النشر
2018.
عدد الصفحات
178 P. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
الطب الرئوي والالتهاب الرئوى
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم الامراض الصدرية
الفهرس
Only 14 pages are availabe for public view

from 178

from 178

Abstract

Lung cancer is the leading cause of cancer-related mortality worldwide. Overall 5-year survival is poor at 15% with little improvement over the last twenty years (1.59 million deaths). Besides effective prevention strategies against the commonest risk factor; tobacco smoking, lung cancer mortality can be reduced if cases are detected and treated early. It is important to detect bronchial carcinoma in situ (CIS) since over 40% of these can develop into invasive cancer. Screening tests using sputum cytology and chest radiograph have been used with limited success (Siegel et al., 2012).
The use of flexible bronchoscopy in the investigation of patients suspected to have lung cancer is well established. Its diagnostic yield may be prescribed as good, but in the same time is still less than needed (Rivera et al., 2003).
I-scan technology is a novel endoscopic imaging technique based on a digital contrast process involving three modes of image enhancement; surface enhancement, contrast enhancement and tone enhancement. It is a software-driven technology that allows modifications of sharpness, hue, and contrast to enhance view of the texture of the mucosal surface. In addition to that it can be effected simply and instantaneously by pushing a button, therefore, it is an easy method for screening or detailed inspection without being cost or time consuming (Shinya et al., 2010).
The aim of this study was to study the role of i- scan technology compared to high definition white light bronchoscopy in patients with suspected lung cancer and to detect the sensitivity and specificity of this new technology. The study was performed at Chest department, Ain Shams University Hospital, from November 2015 till December 2017.The study included ninty one patients suspected to be lung cancer patients, 73 males and 18 females with mean age 55 years, ranged from 14 to 80 years. Lung cancer was confirmed in 40 patients; 18 cases with squamous cell carcinoma (SCC), 13 cases had adenocarcinoma, 3 cases had small cell (SCLC) and 1 case had large cell lung cancer, 3 cases had carcinoid, 1case had spindle cell carcinoma and 1 case had adenoid cystic carcinoma
Prior to the procedure, all patients were evaluated clinically and radiologically. Standard flexible bronchoscopic white-light examination followed by I-scan 1, 2 and 3 modes assessment with taking endobronchial biopsies as indicted. Monitoring during the procedure for hemodynamic and blood gas changes and follow up for occurrence of complications were done for all study patients. Pathological analysis was performed by an expert pathologist.
from the present study the following results were obtained:
1- Lung masses were classified according to their radiological location as central (in medial half of the hilar-costal distance) 46.4%, peripheral (in lateral half) 53.5%.
2- By examination by the I-scan modes (1,2,3), It was demonstrated that all lesions were seen much more demarcated and delineated in 80 patient (87.9 %) of all cases with no additional vascular lesions seen. All lesions seen by the i-scan were also seen by the WLB but it gets much more demarcated and delineated by the I-scan modes (1, 2, 3). While those shown normal by the WLB were also normal by the i-scan examination 11(12 %).
3- 44% of patients showed positive results for malignancy, while 56% were negative. There was statistically significant relation between gender and certain types of pathologies (squamous cell carcinoma). Squamous cell carcinoma more common in males while sarcoidosis, adenoid cystic carcinoma, spindle cell carcinoma and sarcoid reaction were more in females.
4- There was high statistically significant difference between smoking and squamous cell carcinoma, while no statistically significant relation between smoking and other pathologies. There was no statistically significant difference between age and other pathologies.
5- Overall sensitivity of I-scan was 100 % and specificity 100 % in comparison to white light bronchoscopy.
6- For the complications, none of the major complications occurred in any of the patients. Minimal haemoptysis was the commonest complication to occur in (3.3%) of cases. No mortality was reported.