Laser-Induced Differential Fluorescence for Cancer Diagnosis without Biopsy

Abstract

An optical diagnostic procedure based on laser-induced fluorescence was developed for direct in vivo cancer diagnosis without requiring biopsy. The methodology was applied in a clinical study involving over 100 patients in order to differentiate normal tissue from malignant tumors of the esophagus. Endogenous fluorescence of normal and malignant tissues was measured directly with the use of a fiber-optic probe inserted through an endoscope. The measurements were performed in vivo during routine endoscopy. Detection of the fluorescence signal from the tissue was performed with the use of laser excitation. This report describes the differential normalized fluorescence (DNF) procedure using the amplified spectral differences between the normalized fluorescence of malignant tissue and normal mucosa. The results of this DNF approach were compared with histopathology results of the biopsy samples and indicated excellent agreement in the classification of normal tissue and malignant tumors for the samples investigated. Data related to various grades of Barrett's esophagus are discussed. The DNF procedure could lead to the development of a rapid and cost-effective technique for cancer diagnosis.