Solitary pulmonary nodule imaging approaches and the role of optical fibre-based technologies.
“Solitary pulmonary nodules (SPNs) are difficult to diagnose as benign or malignant using current clinical or imaging tools. Early lung cancer detection greatly improves survival, yet existing pathways—biopsies or imaging surveillance—have limitations. Optical fibre-based technologies offer real-time, in situ diagnostic capabilities via bronchoscopy or needle access. Techniques like optical endomicroscopy, time-resolved fluorescence, and Raman spectroscopy show promise in distinguishing malignant from healthy tissue. These innovations could improve diagnostic accuracy, reduce patient anxiety, and guide immediate treatment. This review highlights advances in SPN imaging, including CT and PET-CT, and explores the emerging role of fibre-based optical diagnostics in lung cancer care.”
Fibre-based fluorescence-lifetime imaging microscopy: a real-time biopsy guidance tool for suspected lung cancer.
“Lung cancer is the leading cause of cancer deaths globally. Current diagnostic methods have limitations in accuracy and safety. We evaluated a fibre-based fluorescence-lifetime imaging system (FLIM) using 488 nm excitation to distinguish lung cancer from healthy tissue in resected samples from 21 patients. FLIM revealed significantly shorter lifetimes in cancerous tissue (1.79±0.40 ns) compared to non-cancerous tissue (2.15±0.26 ns, P<0.0001), with 81.0% sensitivity and 71.4% specificity. This label-free, minimally invasive technique offers real-time imaging and quantitative analysis, showing strong potential as a biopsy guidance tool to improve lung cancer diagnostic accuracy.”
Specific in situ immuno-imaging of pulmonary-resident memory lymphocytes in human lungs.
“We developed a novel in situ immunolabelling method using fibre-based optical endomicroscopy (OEM) to detect tissue-resident memory T (TRM) and B (BRM) cells in human lungs during ex vivo lung ventilation (EVLV). Fluorescently labelled TRM/BRM cells were visualised in vitro and after reintroduction into EVLV lungs. Direct intra-alveolar delivery of fluorescent antibodies enabled rapid, wash-free in situ labelling and imaging of TRM/BRM cells. This technique allows real-time detection of immune cells in lung tissue and expands the potential of EVLV and preclinical models for respiratory immunology research.”
“We present two new methods for fabricating endoscopic imaging fibers using low-cost, telecom-grade graded index preforms. Our square array design, with varied core sizes to avoid adjacent identical cores, outperforms a common commercial fiber across a broad wavelength range. It resolves 3.1 μm features at 520–600 nm and 3.48 μm at 650–750 nm. Fabricated using a simplified stacking method and lower index contrast (NA 0.3 vs. 0.4), this approach enables cost-effective production of disposable imaging fibers, suitable for clinical applications.”
A layer-level multi-scale architecture for lung cancer classification with fluorescence lifetime imaging endomicroscopy.
“We present a unique fluorescence lifetime imaging microscopy (FLIM) dataset with over 100,000 images from 18 pairs of cancerous and non-cancerous human lung tissues, collected using a custom fibre-based system. To advance research, we share best practices for image post-processing and introduce ResNetZ, a novel hierarchically aggregated multi-scale CNN architecture. ResNetZ combines layer-wise global and branch-wise local features to improve binary classification. Integrated into ResNet, we evaluate various ResNetZ configurations and compare it with feature-level multi-scale models, demonstrating its superior performance and highlighting the benefits of multi-scale feature aggregation at different levels.”
Impact of Clinical Practice Gaps on the Implementation of Personalized Medicine in Advanced Non–Small-Cell Lung Cancer.
“Personalized medicine offers new opportunities for cancer patients, but many with advanced non–small-cell lung cancer miss out on effective treatments due to gaps in biomarker testing and clinical care. Using data from over 500,000 US patients, we found that 49.7% of patients were lost in the precision oncology pathway before receiving biomarker results, and 29.2% of those tested did not get appropriate targeted therapy. Overall, about 64% of eligible patients do not benefit from precision treatments. Addressing these clinical practice gaps is crucial to improving personalized medicine delivery in lung cancer and beyond.”