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Chest. 2019 Apr 26. pii: S0012-3692(19)30875-X. doi: 10.1016/j.chest.2019.04.010. [Epub ahead of print]

A Novel Laser Fiberscope for Simultaneous Imaging and Phototherapy of Peripheral Lung Cancer.

Author information

1
Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Division of General Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
2
Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
3
Princess Margaret Cancer Centre, University Health Network/University of Toronto, Toronto, ON, Canada.
4
Princess Margaret Cancer Centre, University Health Network/University of Toronto, Toronto, ON, Canada; TECHNA Institute for the Advancement of Technology for Health, University Health Network, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
5
Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
6
Division of General Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
7
Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network/University of Toronto, Toronto, ON, Canada; TECHNA Institute for the Advancement of Technology for Health, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada. Electronic address: kazuhiro.yasufuku@uhn.ca.

Abstract

BACKGROUND:

Phototherapy is an alternative treatment for patients with localized non-small cell lung cancer who are unable to undergo surgical resection. However, phototherapy is currently limited to treatment of centrally located lung cancer, with the much larger proportion of peripheral lesions remaining inaccessible. There are also concerns over the accuracy of targeted laser treatment because of the need to exchange visualization and irradiation fibers during therapy, preventing the operator from confirming the final location of the irradiation fiber.

METHODS:

A newly developed parallel-type ultrasmall composite optical fiberscope (Laser-eYe Ultrathin fiberscope [LYU]), which enables simultaneous white-light imaging and phototherapy, was evaluated in preclinical lung cancer models. Three models were used: human lung cancer xenografts (A549) in mice, orthotopic VX2 lung tumors in rabbits, and ex vivo pig lungs into which A549 tumor tissue was transplanted. A multifunctional porphyrin-phospholipid nanoparticle (porphysome) was used as a photosensitizer to evaluate fluorescence-guided photothermal therapy.

RESULTS:

The LYU's 0.97 mm diameter and hydrophilic coating allowed easy passage through the working channel of all types of bronchoscopes and controlled guidance of the LYU tip in any desired direction. The LYU could visualize the peripheral bronchus and porphysome-laden peripheral tumors. The LYU could also perform photothermal therapy with simultaneous imaging.

CONCLUSIONS:

The LYU enables simultaneous imaging and phototherapy that allows accurate irradiation of peripheral lung cancers. This new laser device may enable ultraminimally invasive transbronchial treatment of peripheral lung cancer.

KEYWORDS:

composite fiberscope; nanoparticle; peripheral lung cancer; phototherapy

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