In vivo cancer diagnosis of the esophagus using differential normalized fluorescence (DNF) indices

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Abstract
Background and Objective: We report the use of new diagnostic parameters based on the differential normalized fluorescence (DNF) signals for malignant tumor diagnosis. Study Design/Materials and Methods: Over 200 measurements of endogenous fluorescence from normal and malignant esophageal tissues were performed during routine endoscopy in 48 patients. A pulsed nitrogen‐pumped dye laser was used to provide in situ excitation at 410 nm. Direct collection of the fluorescence signal emitted by the tissue was achieved using an intensified photodiode array detector equipped with a fiberoptic probe. Results: The fluorescence signals were normalized with respect to the total fluorescence signal area. The cancer diagnosis indices were defined by the difference between the normalized fluorescence signal of a tumor and the mean value of a reference set of normal tissues. The results of the DNF approach were compared with endoscopic examinations and histopathology interpretations of the biopsy samples. Excellent correlation in the classification of normal and malignant tumors for the samples was found. Conclusion: The data indicated that the DNF approach has a significant potential to provide a direct, real‐time, and in‐situtechnique for cancer diagnosis of the esophagus without requiring biopsy of the tumors and time‐consuming histopathology tests.