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British Columbia Cancer Research Center developed a new technique for detection of lung cancer with a device called the lung-imaging fluorescence endoscope (LIFE). Our aim was to confirm whether LIFE system would be useful in diagnosis of dysplasia of bronchial mucosa and lung cancer. Thirty patients with suspected lung cancer were included in this study. All patients underwent bronchoscopic examination by LIFE following examination by the conventional white-light bronchoscope. Pathological examination was performed for the abnormal areas detected by white-light or fluorescence bronchoscopic examination. Malignant tumors were diagnosed in 12 patients by both conventional bronchoscopy and LIFE; one dysplasia was also diagnosed by conventional bronchoscopy. The LIFE system diagnosed malignancy in four regions and one dysplasia that conventional bronchoscopy could not. Malignant lesions diagnosed by conventional bronchoscopy at three locations were proved later by the LIFE system to be benign. The sensitivity and specificity of the conventional bronchoscope for detection of dysplasia and cancer were 65% and 71%, respectively. The LIFE system's sensitivity was 90% and its specificity was 77.4%. No complications related to the LIFE system were detected throughout the course of this study. We conclude that the LIFE system can detect minute malignant lesions which are commonly non-detectable by conventional bronchoscopy without any complications. This method may be applicable in the screening of high risk groups for lung cancer.