Light-induced fluorescence bronchoscopy has been used for several years to identify early lung lesions: A helium cadmium blue laser stimulates the lining of the bronchi to autofluoresce in a range of colors. Normal, healthy tissue is shown as being bright green, and suspicious tissue looks reddish-brown.
A summary of studies with this technique concluded that it can increase the detection rate of premalignant lesions by up to six times, compared with conventional, white-light bronchoscopy (Lung Cancer 2004;45[suppl. 2]:S29–37). “We wondered if we could use a similar technique to identify early breast lesions,” Dr. Jacobs said.
In 2003, he and Dr. Stefan Paepke began investigating the scientific and clinical potential of autofluorescence ductoscopy. “Transferring this technology from large-lumen bronchoscopy to small-lumen endoscopy seemed technically feasible. We were soon able to get our first prototypes developed and start a clinical evaluation,” he said.
Neither investigator claims a financial interest in either the procedure or the unit.
Although many of autofluorescence ductoscopy's benefits are still theoretical, some are immediate and proven, Dr. Jacobs said. The procedure can be done on an outpatient basis. It's relatively inexpensive (about 10 times cheaper than an open biopsy in Germany), minimally invasive, and eliminates the need for sedation or contrast agents—all important considerations for a procedure with the potential to enter into widespread use.
“Its long-term clinical impact is still unproven at the present time,” he said. “It's a target on the horizon. But we are convinced it's a target we can reach.”
Dr. Volker Jacobs displays images obtained with his prototype autofluorescence ductoscope. Courtesy Dr. Volker R. Jacobs