Dr. John C. Densmore Profile

Dr. John C. Densmore

at Children's Hospital of Wisconsin

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Proceedings Article | 4 January 1995 Paper

Laser-induced fluorescence in the detection of esophageal carcinoma

Kenneth Wang, Kumar Gutta, Mark Laukka, John Densmore

Proceedings Volume 2324, (1995) https://doi.org/10.1117/12.198731

KEYWORDS: Luminescence, Laser induced fluorescence, Esophagus, Tissues, Fluorescence spectroscopy, Tissue optics, Spectroscopy, Tumors, Biopsy, Fiber optics

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Laser induced fluorescence (LIF) is a technique which can perform an 'optical biopsy' of gastrointestinal mucosa. LIF was performed in resected specimens using a pulsed N₂-laser coupled fiberoptically to a probe. Fluorescence was measured using a 0.2 meter spectroscope with an intensified photodiode array. Measurements were made on fresh (<30 minutes after resection) esophageal specimens containing normal mucosa, Barrett's esophagus, and adenocarcinoma. Each tissue section was examined using an optical probe consisting of a central fiber for delivering the excitation energy and a 6 fiber bundle surrounding the central fiber for detection of the fluorescence. An excitation wavelength of 337 nm was used which generated 3-ns pulses while fluorescence intensities were acquired from 300-800 nm. Spectra were obtained from each section in a standardized fashion and background spectra subtracted. Fluorescence readings were taken from 54 normal esophageal sections and 32 sections of adenocarcinoma. A fluorescence index obtained from the tumor sections was 0.68+/- 0.01 compared with 0.51+/- 0.01 for the normal sections (p<0.001). Using a discriminant value of 0.65, this technique had a sensitivity of 81% and a specificity of 100% for detection of malignant tissue. The positive predictive value was 100% and the negative predictive value was 90% for an overall accuracy of 93%. LIF is a promising technique which has the capability of distinguishing normal versus malignant tissue in the esophagus with good accuracy.

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