Abstrakt

Technical development of visual and bioptic techniques in bronchoscopy have continuously improved the diagnosis of lung tumors and their premalignant stages. Several procedures compete and complement to one another in terms of diagnostic yield. Autofluorescence bronchoscopy is based on specific alteration of light refraction, caused by changes in bronchial wall structure. It increases diagnostic sensitivity however, on the cost of its specifity. Narrow band imaging (NBI) is a novel method to visualize atypical vascularization often associated with angiodysplasia of squamous epithelium by means of narrowing the white light spectrum. Confocal fluorescence microendoscopy is based on laser technology. It can depict epithelial structures down to the cellular level with the potential to display premalignant lesions. Endobronchial ultrasound (EBUS) combines high resolution of wall structures and vascularization by targeted duplex sonography. With endobronchial, ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), diagnostic yield of mediastinal lymph nodes sampling can markedly be improved. One limitation is the penetration depth of available biopsy needles. Electromagnetic navigation utilizes an electromagnetic field to navigate biopsy instruments to areas of interest within the lungs. The procedure is aligned to the diagnosis of peripheral lesions also in combination with EBUS. Virtual bronchoscopy can be useful in localization of peripheral lesions and proves useful for bronchoscopic on site training. Optical coherence tomography (OCT) is a light-based imaging tool and thus, is not limited by air. This owns advantages for its use within the airways. Bronchoscopic microsampling is diagnostic tool to analyze and quantify cellular, microbial and pharmacological components within the alveolar space. Further studies have to define the value of some of these novel methods in the diagnostic spectrum of fiberbronchoscopy.

Autoreninformation

Autoren

• R.W. Hauck
• U. Gropper

Abteilungen

• Medizinische Abteilung II, Lungenzentrum SüdOst, Kreisklinik Bad Reichenhall

Adresse

Prof. Dr. med. R.W. Hauck
Dr. med. U. Gropper
Medizinische Abteilung II
Lungenzentrum SüdOst
Kreisklinik Bad Reichenhall
Riedelstraße 5
D–83435 Bad Reichenhall
Email: [email protected]

Citation