Background: Fluorescence diagnostics uses the ability of tissues to fluoresce after exposition to a specific wavelength of
light. The change in fluorescence between normal and progression to cancer allows to see early cancer and precancerous
lesions often missed by white light.
Aim: To improve by computer image processing the sensitivity of fluorescence images obtained during examination of
skin, oral cavity, vulva and cervix lesions, during endoscopy, cystoscopy and bronchoscopy using Xillix ONCOLIFE.
Methods: Function of image f(x,y):R2 → R3 was transformed from original color space RGB to space in which vector of
46 values refers to every point labeled by defined xy-coordinates- f(x,y):R2 → R46. By means of Fisher discriminator
vector of attributes of concrete point analalyzed in the image was reduced according to two defined classes defined as
pathologic areas (foreground) and healthy areas (background). As a result the highest four fisher's coefficients allowing
the greatest separation between points of pathologic (foreground) and healthy (background) areas were chosen. In this
way new function f(x,y):R2 → R4 was created in which point x,y corresponds with vector Y, H, a*, c2.
In the second step using Gaussian Mixtures and Expectation-Maximisation appropriate classificator was constructed.
This classificator enables determination of probability that the selected pixel of analyzed image is a pathologically
changed point (foreground) or healthy one (background). Obtained map of probability distribution was presented by
means of pseudocolors.
Results: Image processing techniques improve the sensitivity, quality and sharpness of original fluorescence images.
Conclusion: Computer image processing enables better visualization of suspected areas examined by means of
fluorescence diagnostics.
Solitary rectal ulcer syndrome (SRUS) is a chronic disease of the rectum. Although SRUS is a benign condition there are
studies which suggest that chronic ischaemia which occurs in the SRUS may lead to "transitional mucosa" that is similar
to that adjacent to colorectal carcinomas and adenomas and may lead to colorectal dysplasia and carcinoma development.
The exclusion of primary or metastatic malignancy is the most important aim in the differential diagnosis of SRUS. In our
study we assess the possibilities of autofluorescence colonoscopy (AFC) in diagnosis and management of SRUS.
We performed white light colonoscopy first. The tissue samples were taken for pathological examination. When SRUS
was histopathologically confirmed AFC was performed by means of Xillix OncoLIFE. During AFC numerical colour
value (NCV) of autofluorescence of SRUS lesions was noted.
During 1946 colonoscopies eight persons were diagnosed as having solitary rectal ulcer syndrome. We did not observe
autofluorescence increase in case of polipoid and flat ulcer lesions (NCV 0,39-0,67; mean 0,525) and little increase of
autofluorescence in case of erythema lesion (NCV- 0,94).
SRUS is a rare disorder of the rectum but it causes differential diagnosis problems. The most common reason for
incorrect diagnosis are inadequate tissue specimens. AFC allows to reveal subtle areas within the lesions of more intense
autofluorescence and localizes the potential cancer-transformating dysplasia. In this way the most representative area
with highest risk of pre- or cancerous changes, for biopsy specimen is indicated.
Introduction. Life induced fluorescence (LIFE) diagnostics can be used as an imaging system of
precancerous and neoplastic lesions of the oral mucosa. Neoplastic lesions are visible in pseudo colours,
healthy tissue in green colour and abnormal tissue in red colour. All the observed colours present
different intensity. Colour intensity is relevant to the grade of dysplasia, carcinoma progress and is called
Numerological Value of Color Index (NCV). The aim of our study was to find correlation between
autofluorescence diagnostics combined with NCV assessment and histopathological findings of taken
specimen biopsies. Patients and methods. 10 patients participated in our study. Lesions affected a variety of
intraoral sites. The most common location was: buccal, gingival and mandibular mucosa. Patients were
examined using Life Induced Fluorescence diagnosis (400 - 750 nm wavelength) with Numerological
Value of Color index (NCV) using Onco LIFE system. Afterwards the specimen biopsies from the lesions
were taken and histopathological examination was performed. Results. Different NCV and dependence of
NCV on the histopathological findings were observed. Conclusion. Diagnostic procedures with the
application of white-light imaging with LIFE imaging is not only a significantly faster method and a
better diagnostic tool of preneoplastic and neoplastic lesions, but there exist also correlations between
measured NCV and histopathological diagnosis. The farther investigations are necessary in order to prove
these preliminary findings.
Introduction. The whole mechanism of the cellular level of tumor destruction by photodynamic therapy (PDT) is still
unknown. Despite necrotic and apoptotic ways of cell death, there is a variety of events leading to and magnifying the
inactivation of tumor cells. Material and methods. J-774A.1 were incubated with δ-aminolevulinic acid (ALA) at different concentrations (125, 250, 500, 1000 μM) and then irradiated with VIS (400 - 750 nm) at the dose of 5,10 and 30 J/cm2 delivered from the incoherent light source. The effects of the application of ALA-PDT were evaluated on the basis of cell viability,
nitric oxide (NO), tumor necrosis factor α- (TNF-α) and interleukin-1β (IL-1β) produced by the J-774A.1 cells. Results. The cell viability (assessed using MTT test) was comparable with control group at 5,10 and 30 J/cm2. At these doses of
energy using different concentrations of ALA we have observed that at the higher energy doses, the greater increase of TNF-α release, lowering of the level of IL-1β production and decrease of NO release were observed. There was also observed the dependence of the secretional activity of the cells on the ALA concentrations. Conclusion. The cell viability and production of cytokines depended on ALA concentrations and energy doses of the light. The higher some cytokines' release after PDT could be an additional factor for the complete eradication of tumor.
The results of application of photodynamic diagnostics (PDD) and photodynamic therapy (PDT) for diagnosis and treatment of premalignant lesions and malignant tumours of different tissues were presented. In the period 1998-2000 a total of 314 patients were diagnosed with use of different methods of PDD and a total of 78 patients were treated with use of PDD. On the basis of obtained result we consider PDD and PDT to be sensitive, efficient and non-invasive methods of diagnostics and therapy of malignant lesions.
110 patients were subjected to colonscopy under white light and autofluorescence. An adapted Xillix LIFE system and xenon light source with interference filter were used in the autofluorescence diagnostics. Both techniques revealed 67 small lesions, including 45 neoplastic ones and 22 others in the examined patients. The autofluorescence examination revealed 43 neoplastic changes, while conventional white-light colonscopy allowed for localization of 39 neoplastic lesions. Autofluorescent imaging of large intestine mucosa is more sensitive in the detection of small neoplastic changes than traditional colonscopy.
The efficiency of autofluorescence diagnosis within urinary bladder was analyzed in the study. We examined two groups of patients: the first one consisting of 22 patients suspected to have bladder cancer and the second one consisting of 45 patients who have undergone transurethral electro resection due to urinary bladder neoplasms. Our goal was to detect cancerous tissue invisible in white-light examination. In the first group sensitivity was 100 percent and specificity was 69.23 percent. In the second group sensitivity was 96 percent and specificity was 80 percent. We also report in the study treatment efficiency of PDT in 12 patients with superficial bladder cancer. In our procedure two hours after the instillation of bladder with ALA solution, the lesion was irradiated by laser light. In 9 out of 12 treated patients regression of bladder tumor was obtained, while in 3 cases a progression of neoplasmatic process was observed.
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