Quantification of airway thickness changes in smoke-inhalation injury using in-vivo 3-D endoscopic frequency-domain optical coherence tomography

Lee, Sang-Won; Heidary, Andrew E.; Yoon, David; Mukai, David; Ramalingam, Tirunelveli S.; Mahon, Sari B.; Yin, Jiechen; Jing, Joseph C.; Liu, Gangjun; Chen, Zhongping; Brenner, Matthew

doi:10.1364/boe.2.000243

Cited by 26 publications

(19 citation statements)

References 28 publications

(45 reference statements)

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“…The airway wall segmentation and measurement methods have been described in detail (31); similar software-based airway tissue measurement has been validated in previous OCT studies (12)(13)(14)(15)(16)(17). A single optimal data set from each LR-OCT case was selected based on signal-to-noise ratio, clarity of tissue contours, and soft tissue substructural resolution.…”

Section: Image Segmentation and Micrometrymentioning

confidence: 99%

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Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury

Sharma

Ahuja²,

Wiedmann

et al. 2015

Am J Respir Crit Care Med

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Rationale: Subglottic edema and acquired subglottic stenosis are potentially airway-compromising sequelae in neonates following endotracheal intubation. At present, no imaging modality is capable of in vivo diagnosis of subepithelial airway wall pathology as signs of intubation-related injury.Objectives: To use Fourier domain long-range optical coherence tomography (LR-OCT) to acquire micrometer-resolution images of the airway wall of intubated neonates in a neonatal intensive care unit setting and to analyze images for histopathology and airway wall thickness.Methods: LR-OCT of the neonatal laryngotracheal airway was performed a total of 94 times on 72 subjects (age, 1-175 d; total intubation, 1-104 d). LR-OCT images of the airway wall were analyzed in MATLAB. Medical records were reviewed retrospectively for extubation outcome. Measurements and Main Results:Backward stepwise regression analysis demonstrated a statistically significant association between log(duration of intubation) and both laryngeal (P , 0.001; multiple r 2 = 0.44) and subglottic (P , 0.001; multiple r 2 = 0.55) airway wall thickness. Subjects with positive histopathology on LR-OCT images had a higher likelihood of extubation failure (odds ratio, 5.9; P = 0.007). Longer intubation time was found to be significantly associated with extubation failure.Conclusions: LR-OCT allows for high-resolution evaluation and measurement of the airway wall in intubated neonates. Our data demonstrate a positive correlation between laryngeal and subglottic wall thickness and duration of intubation, suggestive of progressive soft tissue injury. LR-OCT may ultimately aid in the early diagnosis of postintubation subglottic injury and help reduce the incidences of failed extubation caused by subglottic edema or acquired subglottic stenosis in neonates.Clinical trial registered with www.clinicaltrials.gov (NCT 00544427).

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Section: Image Segmentation and Micrometrymentioning

confidence: 99%

“…OCT evaluation and measurement of airway wall microanatomy has been validated with comparative computed ORIGINAL ARTICLE tomography (12) and histology (13)(14)(15)(16)(17). Previous reports describe OCT imaging of postintubation subglottic injury in ex vivo animal models (17,18) and intubated neonates (19).…”

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confidence: 99%

Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury

Sharma

Ahuja²,

Wiedmann

et al. 2015

Am J Respir Crit Care Med

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“…Increased thickening of basement membrane according to the epithelial thickening was apparent with following OCT monitoring. In several studies, the extent of injury has been quantitatively measured with this spectral-domain OCT system [13][14][15]. In this study, we first measured thickness of the basement membrane in injured tracheas.…”

Section: Discussionmentioning

confidence: 99%

Optical imaging of subacute airway remodeling and adipose stem cell engraftment after airway injury

Ahn

Kim

Hwang

et al. 2013

Biomed. Opt. Express

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Acquired airway injury is frequently caused by endotracheal intubations, long-term tracheostomies, trauma, airway burns, and some systemic diseases. An effective and less invasive technique for both the early assessment and the early interventional treatment of acquired airway stenosis is therefore needed. Optical coherence tomography (OCT) has been proposed to have unique potential for early monitoring from the proliferative epithelium to the cartilage in acute airway injury. Additionally, stem cell therapy using adipose stem cells is being investigated as an option for early interventional treatment in airway and lung injury. Over the past decade, it has become possible to monitor the level of injury using OCT and to track the engraftment of stem cells using stem cell imaging in regenerative tissue. The purpose of this study was to assess the engraftment of exogenous adipose stem cells in injured tracheal epithelium with fluorescent microscopy and to detect and monitor the degree of airway injury in the same tracheal epithelium with OCT. OCT detected thickening of both the epithelium and basement membrane after tracheal scraping. The engraftment of adipose stem cells was successfully detected by fluorescent staining in the regenerative epithelium of injured tracheas. OCT has the potential to be a high-resolution imaging modality capable of detecting airway injury in combination with stem cell imaging in the same tracheal mucosa. Berns, S. C. George, Z. Chen, and M. Brenner, "Detection and monitoring of early airway injury effects of halfmustard (2-chloroethylethylsulfide) exposure using high-resolution optical coherence tomography," J. Biomed.

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“…As a nonionizing, non-invasive medical imaging modality, optical coherence tomography (OCT) has been used to perform high resolution, cross-sectional imaging of biological tissues. Previous studies [6][7][8][9][10][11] have demonstrated the flexibility of OCT to image the airways of different animals in vivo. Among them, the Fourier domain long-range swept source OCT (LR-SSOCT) exhibits higher sensitivity, faster imaging speed and an extended imaging range compared to conventional OCT systems.…”

Section: Introductionmentioning

confidence: 99%

Automatic airway wall segmentation and thickness measurement for long-range optical coherence tomography images

Huang

Heidari

et al. 2015

Opt. Express

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Abstract:We present an automatic segmentation method for the delineation and quantitative thickness measurement of multiple layers in endoscopic airway optical coherence tomography (OCT) images. The boundaries of the mucosa and the sub-mucosa layers are accurately extracted using a graph-theory-based dynamic programming algorithm. The algorithm was tested with sheep airway OCT images. Quantitative thicknesses of the mucosal layers are obtained automatically for smoke inhalation injury experiments.

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Quantification of airway thickness changes in smoke-inhalation injury using in-vivo 3-D endoscopic frequency-domain optical coherence tomography

Cited by 26 publications

References 28 publications

Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury

Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury

Optical imaging of subacute airway remodeling and adipose stem cell engraftment after airway injury

Automatic airway wall segmentation and thickness measurement for long-range optical coherence tomography images

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