Abstract
Background Autofluorescence (AF) examination in thoracoscopy has not been used frequently. Here,
our aim was to determine whether AF examination contributes additional information
to white-light (WL) examination when attempting to detect malignant pleural lesions.
We also liked to know whether the effectiveness of WL and AF-mode combination would
be different for various pathologies or lesions of the pleura.
Methods It is a retrospective study. Thirty-three patients with unexplained exudative pleural
effusions underwent AF-assisted video-assisted thoracic surgery (VATS). Patients'
data from the files were evaluated. In each case, the pleural cavity was thoroughly
examined under WL alone and then in AF mode.
Results The sensitivity and specificity of AF-assisted VATS for detecting malignant pleural
lesions were 78.7 and 85%, respectively, and there were 21.3% false negatives. In
the group with metastatic pleural disease, AF VATS correctly identified all lesions
as AF positive, whereas sensitivity was lower for the group with malignant mesothelioma.
Seven lesions, which were not diagnosed under WL, were detected in AF mode.
Conclusion The overall sensitivity of AF-assisted VATS for detecting pleural malignancies was
not satisfactory because of diagnostic errors in malignant mesothelioma. But it would
be useful in detecting small malignant pleural lesions, which are not diagnosed under
WL.
Keywords
video-assisted thoracoscopic surgery - autofluorescence - pleura - effusion - malignant
