Evaluation of Tracheal Imaging by Optical Coherence Tomography

Han, Sukgu; El-Abbadi, Naglaa; Hanna, Nevine; Mahmood, Usama; Mina-Araghi, Reza; Jung, Woong Gyu; Chen, Zhongping; Colt, Henri G.; Brenner, Matthew

doi:10.1159/000087680

Cited by 48 publications

(33 citation statements)

References 22 publications

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“…(5,13) Imaging with OCT can be performed in a few minutes, as part of conventional bronchoscopy. In addition, during the same procedure, it is possible to perform bronchoalveolar lavage, endobronchial biopsy, and dynamic inspection.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the penetration depth is still limited (approximately 3 mm), and the imaging catheter is very fragile and has a reduced diameter, requiring extremely careful handling. (4,5,14) There are several ongoing clinical studies aimed at determining the usefulness of OCT in characterizing normal tissue and differentiating diseases. Ophthalmology is the medical specialty in which OCT is most commonly used, OCT being a valuable tool in the diagnosis and clinical follow-up of macular edema, choroidal neovascularization, and glaucoma-related changes.…”

Section: Discussionmentioning

confidence: 99%

“…(1) The use of OCT allows measurement of biological tissues at a resolution that is 20 times as high as that of ultrasound (10 µ vs. 200 µ). (5) The images are displayed on a monitor in real time, appearing as black and white microscope slides, at a rate of ten frames per second. (6) In situations in which it is pertinent to take high-resolution images of a given surface, OCT has a range of potential uses.…”

Section: Introductionmentioning

confidence: 99%

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Tomografia de coerência óptica broncoscópica

et al. 2012

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Objective: To evaluate the feasibility of and the potential for using optical coherence tomography in conjunction with conventional bronchoscopy in the evaluation of the airways. Methods: This was a pilot study based on an ex vivo experimental model involving three animals: one adult New Zealand rabbit and two Landrace pigs. An optical coherence tomography imaging catheter was inserted through the working channel of a flexible bronchoscope in order to reach the distal trachea of the animals. Images of the walls of the trachea were systematically taken along its entire length, from the distal to the proximal portion. Results: The imaging catheter was easily adapted to the working channel of the bronchoscope. High-resolution images of cross sections of the trachea were taken in real time, precisely delineating microstructures, such as the epithelium, submucosa, and cartilage, as well as the adventitia of the anterior and lateral tracheal walls. The corresponding layers of the epithelium, mucosa, and cartilage were clearly differentiated. The mucosa, submucosa, and trachealis muscle were clearly identified in the posterior wall. Conclusions: It is feasible to use an optical coherence tomography imaging catheter in combination with a flexible bronchoscope. Optical coherence tomography produces highresolution images that reveal the microanatomy of the trachea, including structures that are typically seen only on images produced by conventional histology.Keywords: Tomography, optical coherence; Trachea; Bronchoscopy; Microscopy; Diagnostic techniques, respiratory system. ResumoObjetivo: Avaliar a viabilidade e o potencial do uso da tomografia de coerência óptica em conjunto com um broncoscópio convencional na avaliação das vias aéreas. Métodos: Estudo piloto baseado em um modelo experimental ex vivo com três animais: um coelho adulto da raça Nova Zelândia e dois suínos da raça Landrace. Um cateter de imagem de tomografia de coerência óptica foi inserido no canal de trabalho de um broncoscópio flexível para alcançarmos a traqueia distal dos animais. As imagens foram obtidas sistematicamente em toda a traqueia ao longo das paredes, partindo da porção distal para a proximal. Resultados: O cateter de imagem se adaptou com facilidade ao canal de trabalho do broncoscópio. Imagens em alta resolução de cortes transversais da traqueia foram obtidas em tempo real, sendo delineadas microestruturas, tais como epitélio, submucosa, cartilagem e camada adventícia nas paredes anteriores e laterais da traqueia. As camadas correspondentes do epitélio, mucosa e cartilagens foram claramente diferenciadas. Na parede posterior, foi possível identificar mucosa, submucosa e musculatura traqueal. Conclusões: O uso de tomógrafo de coerência óptica em conjunto com um broncoscópio flexível é viável. A tomografia de coerência óptica produz imagens de alta resolução que permitem visualizar a microanatomia da traqueia, inclusive estruturas que normalmente são visualizadas somente na histologia convencional.Descritores: Tomografia de coerênc...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tomografia de coerência óptica broncoscópica

et al. 2012

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“…Its current use in the respiratory system is limited: research to date has focused on detection of dysplastic and neoplastic epithelial changes. Airway validation studies using explanted animal and human airways have been performed and demonstrate near-histological resolution [88][89][90]. A recent study by COXSON et al [91] used OCT to measure airway lumen and wall area in 44 current and former smokers.…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques

Williamson¹,

James²,

Phillips³

et al. 2009

Eur Respir J

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The ability to measure airway dimensions is important for clinicians, interventional bronchoscopists and researchers in order to accurately quantify structural abnormalities and track their changes over time or in response to treatment.Most quantitative airway measurements are based on X-ray computed tomography and, more recently, on multidetector computed tomography. Quantitative bronchoscopic techniques have also been developed, although these are less widely employed. Emerging techniques, including magnetic resonance imaging, endoscopic optical coherence tomography, endobronchial ultrasound and confocal endomicroscopy, provide new research tools with potential clinical applications.An understanding of issues related to the acquisition, processing and analysis of images, and how such issues impact on imaging the tracheobronchial tree, is essential in order to assess measurement accuracy and to make effective use of the newer methods. This article contributes to this understanding by providing a comprehensive review of current and emerging techniques for quantifying airway dimensions.KEYWORDS: Airway dimensions, confocal endomicroscopy, multidetector computed tomography, optical coherence tomography, videobronchoscopy A dvances over the past 20 yrs in medical imaging and bronchoscopy have heralded an era of unprecedented access to quantitative information on tracheobronchial structure and, increasingly, function. The expanding scope of technical advances challenges the ability of clinicians and researchers to keep abreast of recent developments and emerging techniques. Computed tomography (CT) and, to a lesser extent, bronchoscopy are the two imaging tools that have contributed most to our understanding of the airway in vivo and are used on a daily basis by clinicians in the management of airway diseases. Newer techniques, such as magnetic resonance imaging, optical coherence tomography, fibreoptic confocal endomicroscopy and endobronchial ultrasound, offer fresh insights into the way we view and quantify the airway.Over the coming years, the clinical applications of these newer techniques will be defined. As with endobronchial ultrasound, which has been adopted by interventional bronchoscopists in a little over a decade from its first reported use [1], it is likely that smoking-related lung diseases, such as bronchogenic cancer and chronic obstructive pulmonary disease (COPD), will drive the rapid development of new endoscopic imaging modalities and maintain the current pace of technical improvements of existing techniques, in particular CT. Initial applications of these techniques may focus on screening and surveillance of endobronchial malignancies and the use of real-time airway measurements during interventional procedures to deploy endobronchial stents. In these settings, accurate real-time quantitative imaging is advantageous.

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“…High-resolution flexible fiber optic optical coherence tomography (OCT) provides the potential to observe real-time changes in the airway mucosa and epithelium using minimally invasive imaging techniques. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Most importantly, some of the early pathologic changes following smoke inhalation that may be indicative of the extent of injury such as edema and hyperemia 2,[26][27][28][29] may not be apparent clinically, endoscopically, or following histologic preparations of excised specimens, but can be readily detected on OCT. 30 Previous OCT airway injury studies 30 in rabbit smoke inhalation models suggested to us that the upper trachea airway may react very differently to acute smoke inhalation compared to distal trachea and proximal bronchi. The purpose of this study was to demonstrate the potential role of OCT in quantitatively detecting early smoke inhalation injury and assessing differences in response of more proximal versus distal large airways to smoke inhalation injury.…”

Section: Introductionmentioning

confidence: 99%

In vivo optical coherence tomography detection of differences in regional large airway smoke inhalation induced injury in a rabbit model

Brenner

Kreuter

et al. 2008

J. Biomed. Opt.

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Smoke inhalation injury causes acute airway injury that may result in airway compromise with significant morbidity and mortality. We investigate the ability of high resolution endobronchial optical coherence tomography (OCT) to obtain real-time images for quantitatively assessing regional differences between upper tracheal versus lower tracheal and bronchial airway injury responses to smoke inhalation in vivo using a prototype spectral domain (SLD)-OCT system we constructed, and flexible fiber optic probes. 33 New Zealand White rabbits are intubated and mechanically ventilated. The treatment groups are exposed to inhaled smoke. The OCT probe is introduced through the endotracheal tube and maintained in place for 5 to 6 h. Images of airway mucosa and submucosa are obtained at baseline and at specified intervals postexpo-sure. Starting within less than 15 min after smoke inhalation, there is significant airway thickening in the smoke-exposed animals. This is maintained over 5 h of imaging studies. The lower tracheal airway changes, correlating closely with carboxyhemoglobin levels, are much greater than upper tracheal changes. Significant differences are seen in lower trachea and bronchi after acute smoke inhalation compared to upper trachea as measured in vivo by minimally invasive OCT. OCT is capable of quantitatively detecting regional changes in airway swelling following inhalation injury.

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Evaluation of Tracheal Imaging by Optical Coherence Tomography

Cited by 48 publications

References 22 publications

Tomografia de coerência óptica broncoscópica

Tomografia de coerência óptica broncoscópica

Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques

In vivo optical coherence tomography detection of differences in regional large airway smoke inhalation induced injury in a rabbit model

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