Time-resolved autofluorescence spectroscopy of the bronchial mucosa for the detection of early cancer: Clinical results

Time-resolved measurements of endogenous tissue autofluorescence were carried out on the bronchial mucosa of 18 patients during endoscopy by the means of an optical fibre-based spectrometer. The objective was to assess the fluorescence lifetime as a new contrast parameter between normal and malignant tissue and to explain the origin of a previously observed contrast in fluorescence intensity. The intra- and interpatient variation of tissue autofluorescence intensity and decay on normal tissue was determined, with the outcome that a strong fluctuation in autofluorescence intensity but not in lifetime was observed on the normal tissue. Preliminary results were obtained by comparing fluorescence decays on normal mucosa and dysplasia/carcinoma in situ. No significant change in fluorescence decay nor in spectrum between 510 and 650 nm was found. Measurements in parallel with an endoscopic autofluorescence imaging device, on the other hand, indicated a contrast in intensity and spectrum on the same lesions. This suggests that the spectral contrast might be due to an enhanced blood concentration in deeper-lying layers of the lesion to which the optical fibre-based contact measurements are less sensitive. The difference in intensity might be due to a lower concentration in fluorophores or to the thickening of the epithelium in the neoplastic mucous membrane. However, no indication of fluorescence quenching in the upper layers of the mucous membrane was found as the reason for the reduced fluorescence intensity. The fluorescence decays showed a quite stable behaviour with three decay times of 6.9 ns, 2.0 ns and 0.2 ns in the spectral range between 430 and 680 nm. This can be an indication that there is one dominant fluorophore involved, the calculated decay times suggest that it might be elastin. However, a slight spectral dependence of the fluorescence decays lead to the presumption that there is a contribution from other fluorophores, probably flavins and NADH.