UBC Theses and Dissertations
Laser Raman spectroscopy as an adjunct in vivo endoscopic device for improving early lung cancer detection McGregor, Hanna Claire
Lung cancer has an 18% five year survival rate, which is among the lowest in all cancer types. Typically, this low survival rate is due to the detection of the disease at a late stage not amendable to curative therapy. To combat this poor prognosis, many efforts have been made to detect early lung cancers before they become metastatic. Diagnosis of lung cancer involves localization and biopsy but the diagnostic accuracy of small lung lesions is currently sub-optimal. In the central airways autofluorescent bronchoscopy can localize suspicious areas for biopsy with high sensitivity but the specificity is relatively low. In the peripheral airways abnormal tissue is localized through the radial endobronchial ultrasound procedure. The diagnostic yield is relatively low in the sixty percent range, therefore, there remains a need for real time detailed information about benign versus malignant lung tissue for endoscopic diagnosis. Raman spectroscopy, a technique that utilizes the inelastic scattering of light by a molecule, has the ability to show detailed biochemical information that current procedures do not provide. Here we study the feasibility of incorporating Raman spectroscopy into standard clinical procedures. In the central airways we conduct a large scale single centre trial using Raman Spectroscopy as an adjunct to autofluorescence bronchoscopy procedures. It was found that adjunct RS can greatly improve the classification of malignant from benign/normal lesions with a high diagnostic sensitivity (90%) and good specificity (65%). In the peripheral airways, we present the design and development of a novel miniature Raman probe capable of navigating the bronchial architecture into the small airways. To our knowledge, we show the first in vivo clinical test of a fibre bundle peripheral probe and the first Raman spectra of peripheral lung cancer and normal tissue. With follow up clinical testing and validation we believe the opportunity to use Raman spectroscopy as an adjunct device in the entire lung is feasible.
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