Measuring Airway Remodeling in Patients With Different COPD Staging Using Endobronchial Optical Coherence Tomography

Ding, Ming; Chen, Yu; Guan, Weijun; Zhong, Chang-Hao; Jiang, Mei; Luo, Weizhan; Chen, Xiaobo; Tang, Chunli; Tang, Yan; Jian, Qi-Ming; Wang, Wei; Li, Shiyue; Zhong, Nanshan

doi:10.1016/j.chest.2016.07.033

Cited by 52 publications

(50 citation statements)

References 19 publications

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“…In the untreated RML, edema was also present in a substantial but reduced proportion, less pronounced, and without signs of epithelial damage. None of these effects were seen in earlier published OCT data in asthmatic [16,23] and non-asthmatic airways [12,15], indicating that the identified effects were most likely related to BT treatment. The identified acute OCT effects in airways directly treated with BT are in line with previously published CT imaging studies in severe asthma patients in which CT was performed immediately after BT and peribronchial consolidations with ground glass opacities were described in almost all treated lobes [9,10].…”

Section: Discussionmentioning

confidence: 65%

“…However, the limitation in resolution makes it difficult to assess the exact nature and extent of acute effects in the airway wall. Optical coherence tomography (OCT) is a novel imaging technique in which near-infrared light is used to obtain cross-sectional, high-resolution images of the airway wall over a length of 5.4 cm [11][12][13]. Previous studies have shown a high correlation between histology and OCT for assessing and quantifying the airway wall [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Bronchial Thermoplasty-Induced Acute Airway Effects Assessed with Optical Coherence Tomography in Severe Asthma

et al. 2018

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Background: Bronchial thermoplasty (BT) is an endoscopic treatment for severe asthma targeting airway smooth muscle (ASM) with radiofrequent energy. Although implemented worldwide, the effect of BT treatment on the airways is unclear. Optical coherence tomography (OCT) is a novel imaging technique, based on near-infrared light, that generates high-resolution cross-sectional airway wall images. Objective: To assess the safety and feasibility of OCT in severe asthma patients and determine acute airway effects of BT by OCT and compare these to the untreated right middle lobe (RML). Methods: Severe asthma patients were treated with BT (TASMA trial). During the third BT procedure, OCT imaging was performed immediately following BT in the airways of the upper lobes, the right lower lobe treated 6 weeks prior, and the untreated RML. Results: 57 airways were imaged in 15 patients. No adverse events occurred. Three distinct OCT patterns were discriminated: low-intensity scattering pattern of (1) bronchial and (2) peribronchial edema and (3) high-intensity scattering pattern of epithelial sloughing. (Peri)bronchial edema was seen in all BT-treated airways, and less pronounced in only 1/3 of the RML airways. These effects extended beyond the ASM layer and more distal than the directly BT-treated areas and were reduced, but not resolved, after 6 weeks. Epithelial sloughing occurred in 11/14 of the BT-treated airways and was absent in untreated RML airways. Conclusions: Acute BT effects can be safely assessed with OCT and 3 distinct patterns were identified. The acute effects extended beyond the targeted ASM layer and distal of directly BT-treated airway areas, suggesting that BT might also target smaller distal airways.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Bronchial Thermoplasty-Induced Acute Airway Effects Assessed with Optical Coherence Tomography in Severe Asthma

et al. 2018

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“…Elastic properties of airway passages are relatively difficult to assess in comparison with lung tissue, which dominates volume and pressure signals recorded at the mouth. Bronchoscopic delivery of OCT probes to the airway surface has been used to quantify lumen area and examine wall morphology 3, 5 . However, for assessment of airway elastance, it is necessary to control and measure the applied stress, easily achieved in vitro through application of a known force.…”

Section: Discussionmentioning

confidence: 99%

“…In the respiratory field, an increasing number of new applications for OCT are emerging 2 . Various endoscopic, needle and bench top OCT systems have been used to measure lumen dimensions in small 3 , large 4, 5 and upper airways 6 , to assess wall morphology and thickness 4, 7 , and to visualise individual alveoli 8 . However, one feature of OCT in the respiratory system that could provide significant clinical application has yet to be fully exploited – assessment of respiratory tissue mechanics.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography-based contact indentation for diaphragm mechanics in a mouse model of transforming growth factor alpha induced lung disease

Wang

Astell

Wijesinghe

et al. 2017

Sci Rep

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This study tested the utility of optical coherence tomography (OCT)-based indentation to assess mechanical properties of respiratory tissues in disease. Using OCT-based indentation, the elastic modulus of mouse diaphragm was measured from changes in diaphragm thickness in response to an applied force provided by an indenter. We used a transgenic mouse model of chronic lung disease induced by the overexpression of transforming growth factor-alpha (TGF-α), established by the presence of pleural and peribronchial fibrosis and impaired lung mechanics determined by the forced oscillation technique and plethysmography. Diaphragm elastic modulus assessed by OCT-based indentation was reduced by TGF-α at both left and right lateral locations (p < 0.05). Diaphragm elastic modulus at left and right lateral locations were correlated within mice (r = 0.67, p < 0.01) suggesting that measurements were representative of tissue beyond the indenter field. Co-localised images of diaphragm after TGF-α overexpression revealed a layered fibrotic appearance. Maximum diaphragm force in conventional organ bath studies was also reduced by TGF-α overexpression (p < 0.01). Results show that OCT-based indentation provided clear delineation of diseased diaphragm, and together with organ bath assessment, provides new evidence suggesting that TGF-α overexpression produces impairment in diaphragm function and, therefore, an increase in the work of breathing in chronic lung disease.Optical coherence tomography (OCT) is an interferometric imaging technique that forms volumetric images of tissue structure based on contrast generated by the back-scattering of light waves 1 . In the respiratory field, an increasing number of new applications for OCT are emerging 2 . Various endoscopic, needle and bench top OCT systems have been used to measure lumen dimensions in small 3 , large 4, 5 and upper airways 6 , to assess wall morphology and thickness 4,7 , and to visualise individual alveoli 8 . However, one feature of OCT in the respiratory

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“…Airway remodeling: Airway remodeling is a crucial feature for the early detection and prognostic assessment of diseases such as chronic obstructive pulmonary disease (COPD) and asthma. OCT changes in airway architecture in patients with more advanced COPD can be detected before functional abnormalities [163]. Comparison of OCT measurements of airway dimensions, like lumen and wall area in patients with obstructive airway disease showed a strong correlation to results from computed tomography, which is currently used for assessment of airway remodeling in addition to pathological analysis of surgical specimens [164].…”

Section: Pulmonary Tractmentioning

confidence: 98%

Endoscopic optical coherence tomography: technologies and clinical applications [Invited]

Gora¹,

Suter²,

Tearney³

et al. 2017

Biomed. Opt. Express

253

203

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Abstract:In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forwardviewing probes, along with different scanning mechanisms (proximal-scanning versus distalscanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed. References and links 1. T. Cao and H. L. Tey, "High-definition optical coherence tomography -an aid to clinical practice and research in dermatology," J. Dtsch. Dermatol. Ges. 13(9), 886-890 (2015). 2. J. Olsen, L. Themstrup, and G. B. Jemec, "Optical coherence tomography in dermatology," G. Ital. Dermatol.Venereol. 150(5), 603-615 (2015). 3. M. Ulrich, L. Themstrup, N. de Carvalho, M. Manfredi, C. Grana, S. Ciardo, R. Kästle, J. Holmes, R.Whitehead, G. B. Jemec, G. Pellacani, and J. Welzel, "Dynamic Optical Coherence Tomography in Dermatology," Dermatology (Basel) 232(3), 298-311 (2016). 4. G. J. Tearney, S. A. Boppart, B. E. Bouma, M. E. Brezinski, N. J. Weissman, J. F. Southern, and J. G. Fujimoto, "Scanning single-mode fiber optic catheter-endoscope for optical coherence tomography," Opt. Lett. 21(7), 543-545 (1996). 5. A. M. Rollins, R. Ung-Arunyawee, A. Chak, R. C. K. Wong, K. Kobayashi, M. V. Sivak, Jr., and J. A. Izatt, "Real-time in vivo imaging of human gastrointestinal ultrastructure by use of endoscopic optical coherence tomography with a novel efficient interferometer design," Opt. Lett. 24(19), 1358-1360 (1999). 6. M. V. Sivak, Jr., K. Kobayashi, J. A. Izatt, A. M. Rollins, R. Ung-Runyawee, A. Chak, R. C. Wong, G. A.Isenberg, and J. Willis, "High-resolution endoscopic imaging of the GI tract using optical coherence tomography," Gastrointest. Endosc. 51(4), 474-479 (2000). 7. J. Xi, A. Zhang, Z. Liu, W. Liang, L. Y. Lin, S. Yu, and X. Li, "Diffractive catheter for ultrahigh-resolution spectral-domain volumetric OCT imaging," Opt. Lett. 39(7), 2016-2019 (2014). 8. P. H. Tran, D. S. Mukai, M. Brenner, and Z. Chen, "In vivo endoscopic optical coherence tomography by use of a rotational microelectromechanical system probe," Opt. Lett. 29(11), 1236-1238 (2004). Goodnow, and C. Petersen, "Micromotor endoscope catheter for in vivo, ultrahigh-resolution optical coherence tomography," Opt. Lett. 29(19), 2261-2263 (2004). 10. T.-H. Tsai, B. Potsaid, Y. K. Tao, V. Jayaraman, J. Jiang, P. J. S. Heim, M. F. Kraus, C. Zhou, J. Hornegger, H.Mashimo, A. E. Cable, and J. G. Fujimoto, "Ultrahigh speed endoscopic optical coherence tomography using micromotor imaging catheter and VCSEL technology," Biomed. Opt. Express 4(7), 1119-11...

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Measuring Airway Remodeling in Patients With Different COPD Staging Using Endobronchial Optical Coherence Tomography

Cited by 52 publications

References 19 publications

Bronchial Thermoplasty-Induced Acute Airway Effects Assessed with Optical Coherence Tomography in Severe Asthma

Bronchial Thermoplasty-Induced Acute Airway Effects Assessed with Optical Coherence Tomography in Severe Asthma

Optical coherence tomography-based contact indentation for diaphragm mechanics in a mouse model of transforming growth factor alpha induced lung disease

Endoscopic optical coherence tomography: technologies and clinical applications [Invited]

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