Integration of single-fiber reflectance spectroscopy into ultrasound-guided endoscopic lung cancer staging of mediastinal lymph nodes.

We describe the incorporation of a single-fiber reflectance spectroscopy probe into the endoscopic ultrasound fine-needle aspiration (EUS-FNA) procedure utilized for lung cancer staging. A mathematical model is developed to extract information about the physiological and morphological properties of lymph tissue from single-fiber reflectance spectra, e.g., microvascular saturation, blood volume fraction, bilirubin concentration, average vessel diameter, and Mie slope. Model analysis of data from a clinical pilot study shows that the single-fiber reflectance measurement is capable of detecting differences in the physiology between normal and metastatic lymph nodes. Moreover, the clinical data show that probe manipulation within the lymph node can perturb the in vivo environment, a concern that must be carefully considered when developing a sampling strategy. The data show the feasibility of this novel technique; however, the potential clinical utility has yet to be determined.

[1]  A. Ahuja,et al.  Sonographic evaluation of cervical lymph nodes. , 2005, AJR. American journal of roentgenology.

[2]  Arjen Amelink,et al.  Confidence intervals on fit parameters derived from optical reflectance spectroscopy measurements. , 2008, Journal of biomedical optics.

[3]  K. Yuasa,et al.  Change of angiostructure and hemodynamics in lymph node metastases in rabbits. , 2002, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[4]  R K Jain,et al.  Determinants of tumor blood flow: a review. , 1988, Cancer research.

[5]  V. Chen,et al.  Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans. , 2005, The Annals of thoracic surgery.

[6]  G. Silvestri,et al.  Invasive staging: The guidelines , 2003 .

[7]  Steven L. Jacques,et al.  Developing an optical fiber reflectance spectrometer to monitor bilirubinemia in neonates , 1997, Photonics West - Biomedical Optics.

[8]  R. Brodersen.  Bilirubin. Solubility and interaction with albumin and phospholipid. , 1979, The Journal of biological chemistry.

[9]  A. Ahuja,et al.  Ultrasound of neck lymph nodes: How to do it and how do they look? , 2006 .

[10]  A. Amelink,et al.  Empirical model of the photon path length for a single fiber reflectance spectroscopy device. , 2009, Optics express.

[11]  G. Ott,et al.  Vascular patterns in reactive and malignant lymphadenopathy , 2004, European Radiology.

[12]  Arjen Amelink,et al.  Optical biopsy of breast tissue using differential path-length spectroscopy , 2005, Physics in medicine and biology.

[13]  Arjen Amelink,et al.  Effect of hemoglobin extinction spectra on optical spectroscopic measurements of blood oxygen saturation. , 2009, Optics letters.

[14]  J. Roodenburg,et al.  Non-invasive measurement of the morphology and physiology of oral mucosa by use of optical spectroscopy. , 2007, Oral oncology.

[15]  Scott A. Prahl,et al.  In-vivo sized-fiber spectroscopy , 2000, BiOS.

[16]  J. Mourant,et al.  Particle size analysis of turbid media with a single optical fiber in contact with the medium to deliver and detect white light. , 2001, Applied optics.

[17]  V. Chen,et al.  Endoscopic ultrasound-guided fine-needle aspiration in patients with non-small cell lung cancer and prior negative mediastinoscopy. , 2005, The Annals of thoracic surgery.

[18]  D. Delpy,et al.  Quantification in tissue near–infrared spectroscopy , 1997 .

[19]  E. Reynolds,et al.  Introduction to a Discussion on Near-infrared spectroscopy and imaging of living systems. , 1997 .

[20]  M. Conron,et al.  The accuracy of EUS-FNA in assessing mediastinal lymphadenopathy and staging patients with NSCLC , 2005, European Respiratory Journal.

[21]  H. Hoogsteden,et al.  Measurement of hypoxia-related parameters in bronchial mucosa by use of optical spectroscopy. , 2005, American journal of respiratory and critical care medicine.

[22]  P. Herman,et al.  Regional blood flow to the lymph node during the immune response. , 1976, Lymphology.

[23]  Katherine W. Calabro,et al.  Analysis of changes in reflectance measurements on biological tissues subjected to different probe pressures. , 2008, Journal of biomedical optics.

[24]  L. O. Svaasand,et al.  In vivo spectroscopy of jaundiced newborn skin reveals more than a bilirubin index , 2005, Acta paediatrica.

[25]  J. Lindsey,et al.  PhotochemCAD ‡ : A Computer‐Aided Design and Research Tool in Photochemistry , 1998 .