Fine-needle aspiration biopsy is crucial for modern diagnostics of endoscopic procedures and thus an efficient and reliable method for increasing biopsy yields is urgently needed. In our study, we address the limited availability and high price of the rapid onsite evaluation (ROSE) technique by introducing the technique of near-infrared on-site evaluation (NOSE) consisting of spectral measurement of near-infrared radiation (NIR) transmitted through the evaluated material. For this purpose, we designed a special optical probe consisting of two fibres, of which one is a source fibre and the second is a detector fibre. The distal ends of both fibres are brought together into one bundle which is, with the help of a special extension, applied to a cuvette with an analysed sample at a defined distance from the cuvette bottom and fixed in place. A portion of the NIR radiation received by the detector fibre after it propagates through the sample then depends on the optical and therefore morphological characteristics of the sample. Based on the measured spectral curve, we can calculate the attenuation coefficient curve and subsequently the parameter of the sample richness and the parameter characterising the autofluorescence peak as well. We found that the value of our introduced parameters is in significant relation to sample richness as well as to sample malignity. NOSE evaluation of EBUS/EUSb (endobronchial/oesophageal ultrasound bronchoscopy) specimens can be considered an easy new technique aiming to improve sampling diagnostic accuracy and to diminish costs related to the presence of a cytopathologist and related instrumentation in the endoscopy suite.

Background: The accurate measurement of the distances within the airways during bronchoscopy is necessary for diagnostic purposes; however, a reliable and simple device does not exist. Methods: The LJ system, consisting of a probe, a box with a display, an encoder, and a microcontroller, has been developed, and its prototype has been tested in vitro and validated in clinical practice in suitable procedures of interventional bronchoscopy. Results: In vitro, the device measurements showed a good correlation with the control performed with a digital caliper. Subsequently, ten patients were included in a pilot study evaluating this novel prototype of a measurement device. The device was used on four patients with tracheal stenosis indicated for Y-stent placement, four patients indicated for open surgery, and two cases of tracheoesophageal fistula. The measurements have been validated using computed tomography imaging or by direct inspection and measurement during open surgical procedures. Conclusions: The first experience and pilot study evaluating this novel instrument for distance measurements during interventional bronchology procedures showed that the LJ device can provide precise readings of the distance from the vocal cords, the lengths of tracheal stenoses, or the size of tumorous and other lesions. Its use might be widened to other endoscopic indications.

Background: The accurate measurement of the distances within the airways during bronchoscopy is negligible for diagnostic purposes, however, a reliable and simple device does not exist. Methods: The LJ system, consisting of the probe, box with a display, encoder, and microcontroller has been developed and its prototype has been tested in vitro and validated in clinical practice in suitable procedures of interventional bronchoscopy. Results: In vitro, the device measurements showed a good correlation with the control performed by a digital caliper. Subsequently, ten patients were included in the pilot study evaluating this novel prototype of a measurement device. The device was used in four patients with tracheal stenosis indicated for Y stent placement, four patients indicated for open surgery, and two cases of tracheoesophageal fistula. Most measurements have been validated by computed tomography imaging or by direct inspection and measurement during open surgical procedures. Conclusions: The first experience and pilot study evaluating this novel instrument for distance measurements during interventional bronchology procedures showed that the LJ can provide precise readings of the distance from the vocal cords, the lengths of tracheal stenoses, or the size of tumorous and other lesions. Its use might be widened to other endoscopic indications.

Introduction: An accurate diagnosis of interstitial lung disease (ILD) and its severity is crucial for both prognosis and treatment. Aims and objectives: We have attempted to correlate lung tissue density in HU for patients with ILD based on HRCT scans with average absorption of NIR in lung parenchyma measured during bronchoscopy examination. Methods: We have designed the optical probe for measurement of penetrated NIR through the lung tissue. It consists of two fibres contained in one bundle where the indicator fibre is 0.3 cm longer. We have evaluated data form 12 patients with different degree of ILD aged 48-81 years. During bronchoscopy the probe was inserted to the airways via working channel and resulting spectral curve of transmitted NIR in diagnostic window (620-700 nm) was detected. Measured signal was normalised to master signal and based on obtained value and known optical pathlenght, local absorption coefficient was calculated. Average parenchymal density value has been calculated from standard HRCT scans at target lobes. Results: Obtained values for 12 ILD patients showed regression curve with clear linear trend and satisfying correlation R2=0,931 (Figure 1). Conclusions: We proved that our novel method enables to measure lung parenchymal density in real time during bronchoscopic examination and results are in good correlation with CT densitometry.

Introduction: Fine-needle aspiration biopsy is crucial for modern diagnostics in a wide range of endoscopic biopsy procedures. The methodology uses several optimization procedures to increase biopsy yields such MOSE – macroscopic onsite evaluation or the rapid on site evaluation- ROSE. We address limited availability and high price of ROSE technique by technique of NOSE (near infrared onsite evaluation). The technology is based on instant ex-vivo measurement of EBUS/EUS material by near- infrared spectroscopy. Methods: We use simple 2 fiber system adaptable to every cuvette used for evaluation. allowing NIR translumination and spectroscopy of analyzed sample. 60 EBUS procedures has been conveyed at one bronchoscopy center from 11/22 to 12/23. After every EBUS/EUSb pass the content of cuvette has been examined by NIR spectroscopy. Real time evaluation of spectroscopic curves allowed us to obtain information about sample density and cellularity/tumorous content- Results: We selected main criteria defining sample quality. a) the ratio between maximal absorbance to maximum absorption of blood and water in the interval 638-900 nm and b) maximum peak of auto fluorescence signal at 698-719 nm. The resulting combined arbitrary value of more then 2.5 is predictive for high quality sample and achieving that value resulted in 98% diagnostic yield by histology /cytosediment evaluation. Discussion: NOSE evaluation of EBUS/EUSb specimen is a new easy technique aiming to improve the sampling diagnostic accuracy and to diminish costs related to the presence of a cytopathologist and its instrumentation in the endoscopy suite. Our results show good clinical applicability.