TY - JOUR
T1 - In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease
T2 - a prospective, exploratory, observational study
AU - Vaselli, Margherita
AU - Kalverda-Mooij, Kirsten
AU - Thunnissen, Erik
AU - Tanck, Michael W. T.
AU - Mets, Onno M.
AU - van den Berk, Inge A. H.
AU - Annema, Jouke T.
AU - Bonta, Peter I.
AU - de Boer, Johannes F.
N1 - Funding Information: This study was funded by the Netherlands Organisation for health Research and Development (ZonMW) (843001813). This work is part of the MedPhot research programme 00770372 with project number 00770384, which is (partly) financed by the Dutch Research Council (NWO). This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 871124 and 654148. Funding Information: JFdB reports grants from the Dutch National Science foundation (NWO, Medphot consortium grant), LaserLab Europe, the Dutch science foundation in collaboration with industry (Heidelberg Engineering) and research institutes (TNO) and from Health Holland and is an inventor on patents related to OCT technology. All other authors have no conflict of interest. Publisher Copyright: © 2023 BMJ Publishing Group. All rights reserved.
PY - 2023/8/8
Y1 - 2023/8/8
N2 - INTRODUCTION: Endobronchial polarisation sensitive optical coherence tomography (EB-PS-OCT) is a bronchoscopic imaging technique exceeding resolution of high-resolution CT (HRCT) by 50-fold. It detects collagen birefringence, enabling identification and quantification of fibrosis. STUDY AIM: To assess pulmonary fibrosis in interstitial lung diseases (ILD) patients with in vivo EB-PS-OCT using histology as reference standard. PRIMARY OBJECTIVE: Visualisation and quantification of pulmonary fibrosis by EB-PS-OCT. SECONDARY OBJECTIVES: Comparison of EB-PS-OCT and HRCT detected fibrosis with histology, identification of ILD histological features in EB-PS-OCT images and comparison of ex vivo PS-OCT results with histology. METHODS: Observational prospective exploratory study. Patients with ILD scheduled for transbronchial cryobiopsy or surgical lung biopsy underwent in vivo EB-PS-OCT imaging prior to tissue acquisition. Asthma patients were included as non-fibrotic controls. Per imaged lung segment, fibrosis was automatically quantified assessing the birefringent area in EB-PS-OCT images. Fibrotic extent in corresponding HRCT areas and biopsies were compared with EB-PS-OCT detected fibrosis. Microscopic ILD features were identified on EB-PS-OCT images and matched with biopsies from the same segment. RESULTS: 19 patients were included (16 ILD; 3 asthma). In 49 in vivo imaged airway segments the parenchymal birefringent area was successfully quantified and ranged from 2.54% (no to minimal fibrosis) to 21.01% (extensive fibrosis). Increased EB-PS-OCT detected birefringent area corresponded to increased histologically confirmed fibrosis, with better predictive value than HRCT. Microscopic ILD features were identified on both in vivo and ex vivo PS-OCT images. CONCLUSIONS: EB-PS-OCT enables pulmonary fibrosis quantification, thereby has potential to serve as an add-on bronchoscopic imaging technique to diagnose and detect (early) fibrosis in ILD.
AB - INTRODUCTION: Endobronchial polarisation sensitive optical coherence tomography (EB-PS-OCT) is a bronchoscopic imaging technique exceeding resolution of high-resolution CT (HRCT) by 50-fold. It detects collagen birefringence, enabling identification and quantification of fibrosis. STUDY AIM: To assess pulmonary fibrosis in interstitial lung diseases (ILD) patients with in vivo EB-PS-OCT using histology as reference standard. PRIMARY OBJECTIVE: Visualisation and quantification of pulmonary fibrosis by EB-PS-OCT. SECONDARY OBJECTIVES: Comparison of EB-PS-OCT and HRCT detected fibrosis with histology, identification of ILD histological features in EB-PS-OCT images and comparison of ex vivo PS-OCT results with histology. METHODS: Observational prospective exploratory study. Patients with ILD scheduled for transbronchial cryobiopsy or surgical lung biopsy underwent in vivo EB-PS-OCT imaging prior to tissue acquisition. Asthma patients were included as non-fibrotic controls. Per imaged lung segment, fibrosis was automatically quantified assessing the birefringent area in EB-PS-OCT images. Fibrotic extent in corresponding HRCT areas and biopsies were compared with EB-PS-OCT detected fibrosis. Microscopic ILD features were identified on EB-PS-OCT images and matched with biopsies from the same segment. RESULTS: 19 patients were included (16 ILD; 3 asthma). In 49 in vivo imaged airway segments the parenchymal birefringent area was successfully quantified and ranged from 2.54% (no to minimal fibrosis) to 21.01% (extensive fibrosis). Increased EB-PS-OCT detected birefringent area corresponded to increased histologically confirmed fibrosis, with better predictive value than HRCT. Microscopic ILD features were identified on both in vivo and ex vivo PS-OCT images. CONCLUSIONS: EB-PS-OCT enables pulmonary fibrosis quantification, thereby has potential to serve as an add-on bronchoscopic imaging technique to diagnose and detect (early) fibrosis in ILD.
KW - Bronchoscopy
KW - Imaging/CT MRI etc
KW - Interstitial Fibrosis
UR - http://www.scopus.com/inward/record.url?scp=85167370506&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bmjresp-2023-001628
DO - https://doi.org/10.1136/bmjresp-2023-001628
M3 - Article
C2 - 37553184
SN - 2052-4439
VL - 10
JO - BMJ Open Respiratory Research
JF - BMJ Open Respiratory Research
IS - 1
M1 - e001628
ER -