A Novel Laser Fiberscope for Simultaneous Imaging and Phototherapy of Peripheral Lung Cancer

Tomonari Kinoshita, Andrew Effat, Alexander Gregor, Terunaga Inage, Tsukasa Ishiwata, Yamato Motooka, Hideki Ujiie, Brian C. Wilson, Gang Zheng, Robert Weersink, Hisao Asamura, Kazuhiro Yasufuku

Research output: Contribution to journalArticle

Abstract

Background: Phototherapy is an alternative treatment for patients with localized non-small cell lung cancer who are unable to undergo surgical resection. However, phototherapy is currently limited to treatment of centrally located lung cancer, with the much larger proportion of peripheral lesions remaining inaccessible. There are also concerns over the accuracy of targeted laser treatment because of the need to exchange visualization and irradiation fibers during therapy, preventing the operator from confirming the final location of the irradiation fiber. Methods: A newly developed parallel-type ultrasmall composite optical fiberscope (Laser-eYe Ultrathin fiberscope [LYU]), which enables simultaneous white-light imaging and phototherapy, was evaluated in preclinical lung cancer models. Three models were used: human lung cancer xenografts (A549) in mice, orthotopic VX2 lung tumors in rabbits, and ex vivo pig lungs into which A549 tumor tissue was transplanted. A multifunctional porphyrin-phospholipid nanoparticle (porphysome) was used as a photosensitizer to evaluate fluorescence-guided photothermal therapy. Results: The LYU's 0.97 mm diameter and hydrophilic coating allowed easy passage through the working channel of all types of bronchoscopes and controlled guidance of the LYU tip in any desired direction. The LYU could visualize the peripheral bronchus and porphysome-laden peripheral tumors. The LYU could also perform photothermal therapy with simultaneous imaging. Conclusions: The LYU enables simultaneous imaging and phototherapy that allows accurate irradiation of peripheral lung cancers. This new laser device may enable ultraminimally invasive transbronchial treatment of peripheral lung cancer.

Original languageEnglish
JournalChest
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Phototherapy
Lung Neoplasms
Lasers
Therapeutics
Bronchoscopes
Neoplasms
Lung
Photosensitizing Agents
Porphyrins
Bronchi
Heterografts
Non-Small Cell Lung Carcinoma
Nanoparticles
Phospholipids
Swine
Fluorescence
Rabbits
Light
Equipment and Supplies

Keywords

  • composite fiberscope
  • nanoparticle
  • peripheral lung cancer
  • phototherapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kinoshita, T., Effat, A., Gregor, A., Inage, T., Ishiwata, T., Motooka, Y., ... Yasufuku, K. (2019). A Novel Laser Fiberscope for Simultaneous Imaging and Phototherapy of Peripheral Lung Cancer. Chest. https://doi.org/10.1016/j.chest.2019.04.010

A Novel Laser Fiberscope for Simultaneous Imaging and Phototherapy of Peripheral Lung Cancer. / Kinoshita, Tomonari; Effat, Andrew; Gregor, Alexander; Inage, Terunaga; Ishiwata, Tsukasa; Motooka, Yamato; Ujiie, Hideki; Wilson, Brian C.; Zheng, Gang; Weersink, Robert; Asamura, Hisao; Yasufuku, Kazuhiro.

In: Chest, 01.01.2019.

Research output: Contribution to journalArticle

Kinoshita, T, Effat, A, Gregor, A, Inage, T, Ishiwata, T, Motooka, Y, Ujiie, H, Wilson, BC, Zheng, G, Weersink, R, Asamura, H & Yasufuku, K 2019, 'A Novel Laser Fiberscope for Simultaneous Imaging and Phototherapy of Peripheral Lung Cancer', Chest. https://doi.org/10.1016/j.chest.2019.04.010
Kinoshita, Tomonari ; Effat, Andrew ; Gregor, Alexander ; Inage, Terunaga ; Ishiwata, Tsukasa ; Motooka, Yamato ; Ujiie, Hideki ; Wilson, Brian C. ; Zheng, Gang ; Weersink, Robert ; Asamura, Hisao ; Yasufuku, Kazuhiro. / A Novel Laser Fiberscope for Simultaneous Imaging and Phototherapy of Peripheral Lung Cancer. In: Chest. 2019.
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AU - Motooka, Yamato

AU - Ujiie, Hideki

AU - Wilson, Brian C.

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AB - Background: Phototherapy is an alternative treatment for patients with localized non-small cell lung cancer who are unable to undergo surgical resection. However, phototherapy is currently limited to treatment of centrally located lung cancer, with the much larger proportion of peripheral lesions remaining inaccessible. There are also concerns over the accuracy of targeted laser treatment because of the need to exchange visualization and irradiation fibers during therapy, preventing the operator from confirming the final location of the irradiation fiber. Methods: A newly developed parallel-type ultrasmall composite optical fiberscope (Laser-eYe Ultrathin fiberscope [LYU]), which enables simultaneous white-light imaging and phototherapy, was evaluated in preclinical lung cancer models. Three models were used: human lung cancer xenografts (A549) in mice, orthotopic VX2 lung tumors in rabbits, and ex vivo pig lungs into which A549 tumor tissue was transplanted. A multifunctional porphyrin-phospholipid nanoparticle (porphysome) was used as a photosensitizer to evaluate fluorescence-guided photothermal therapy. Results: The LYU's 0.97 mm diameter and hydrophilic coating allowed easy passage through the working channel of all types of bronchoscopes and controlled guidance of the LYU tip in any desired direction. The LYU could visualize the peripheral bronchus and porphysome-laden peripheral tumors. The LYU could also perform photothermal therapy with simultaneous imaging. Conclusions: The LYU enables simultaneous imaging and phototherapy that allows accurate irradiation of peripheral lung cancers. This new laser device may enable ultraminimally invasive transbronchial treatment of peripheral lung cancer.

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