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SENSITIVITY AND NEGATIVE PREDICTIVE VALUE OF AUTOFLUORESCENCE IMAGING (AFI) IN PATIENTS AT HIGH RISK FOR LUNG CANCER

CHU Charleroi, Charleroi, Belgium

PURPOSE: Autofluorescence Imaging (Olympus Ltd, Japan) is a new videoscope system allowing to display both the images of conventional and autofluorescence modes on the same monitor. We retrospectively assessed the sensitivity and negative predictive value of this combined video system in patients with high risk for lung cancer.

METHODS: A total number of 705 AFI examinations were performed in 541 different patients between March 2004 and December 2006. In both modes, findings considered as suspicious were noted and biopsied. In patients with suspicious images, a control biopsy was performed in a normal area, provided the patient signed an informed consent. Indications were as follows: preoperative assessment (n=48 patients), heavy smoking (>30 pack.years, n=222 patients), non small cell lung cancer follow-up after radical treatment (n=136 patients), head and neck cancer (n=70 patients), radio-occult lung cancer staging (n=27 patients), or other (n=38 patients).

RESULTS: 380 AFI examinations (performed in 289 patients) showed abnormalities. During these 380 examinations, 670 suspect areas were observed and biopsied, and 202 control biopsies were done in 202 patients. Overall, histological analysis of these samples revealed moderate dysplasia or worse in 73 (11%) of the 670 biopsies performed in abnormal areas and only in 6 (3%) of the 202 control biopsies, including 5 moderate dysplasia and one severe dysplasia.

CONCLUSION: The sensitivity and negative predictive value of AFI examination for the detection of moderate dysplasia or worse were respectively 92.4%, and 98.5%. Specificity and positive predictive value, 24.7% and 10.9%.

CLINICAL IMPLICATIONS: After normal AFI examination, the likelihood that lesions corresponding to moderate dysplasia or worse are missed seems very low.

DISCLOSURE: Philippe Pierard, None.