Value of autofluorescence imaging videobronchoscopy in detecting lung cancers and precancerous lesions: a review.

Bronchoscopy technology is a desirable method for detecting lung cancers arising in the central airways. Most early cancers and precancerous lesions are not visible on conventional white-light bronchoscopy (WLB). Autofluorescence bronchoscopy (AFB) is a newly developed technology that exploits the difference in autofluorescence intensity between normal and tumorous tissues to detect bronchial cancers and precancerous lesions. Several types of AFB systems have been used in clinical practice, and autofluorescence imaging videobronchoscopy (AFI) is one of these AFBs. In most of the studies on AFB other than AFI, AFB has provided a much higher sensitivity but a lower specificity than WLB. Regarding AFI, recent studies have reported controversial results on the sensitivity and specificity for detecting cancers and precancerous lesions, compared with WLB. In this paper we describe the working mechanisms and characteristics of AFBs, mainly AFI, and the diagnostic performance of AFI, compared with WLB, other AFBs, and narrow-band imaging, for detecting lung cancers and precancerous lesions.