Diagnostic Value of I-Scan Bronchoscopy in Comparison to White Light Bronchoscopy in Suspected Lung Cancer Patients | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 170, Volume 100, Issue 1, July 2025, Page 3729-3737 PDF (645.28 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.448748 | ||||
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| Abstract | ||||
| Background: Lung cancer is a major cause of cancer-related mortality, with prognosis dependent on early, accurate diagnosis. White light bronchoscopy (WLB) is a standard diagnostic tool but has limited sensitivity for early or subtle lesions. I-scan bronchoscopy, an image-enhanced endoscopic technique, improves mucosal and vascular visualization, potentially increasing diagnostic yield. Objective: To compare the diagnostic value of I-scan bronchoscopy with WLB in suspected lung cancer and assess the benefit of combining both. Methods: A cross-sectional study was conducted on 60 patients (mean age 61.37 ± 11.83 years; 73.3% males) with clinical and radiological suspicion of lung cancer. Each patient underwent sequential WLB followed by I-scan bronchoscopy using a PENTAX EPK-i5000 system. Lesions were graded using predefined criteria, and targeted biopsies were histologically examined. Sensitivity, specificity, predictive values, and overall accuracy were compared. Results: Histopathology confirmed malignancy in 45 patients (75%) and benign pathology in 15 (25%). I-scan upgraded 40% of lesions initially graded low suspicion by WLB. For bronchoscopic grade 3–4 lesions, I-scan showed higher sensitivity (73.3% vs. 64.4%) with equal specificity (86.7%). In non-endobronchial lesions, sensitivity was markedly higher (76% vs. 36%), though specificity was slightly lower (78.6% vs. 92.9%). Negative predictive value improved from 44.8% with WLB to 90.7% with I-scan. Complications were minimal, with bleeding most common (38.3%). Conclusion: I-scan bronchoscopy enhances detection of early and subtle bronchial lesions compared with WLB, offering higher sensitivity and markedly improved negative predictive value, which may reduce missed diagnoses and unnecessary repeat procedures in high-risk patients. | ||||
| Keywords | ||||
| I-Scan Bronchoscopy; White Light Bronchoscopy; lung cancer | ||||
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