Evaluation of Rabbit Tracheal Inflammation Using Optical Coherence Tomography

Mahmood, Usama; Hanna, Nevine; Han, Sugku; Jung, Woong Gyu; Chen, Zhonping; Jordan, Bryan S.; Yershov, A. L.; Walton, Ronald S.; Brenner, Matthew

doi:10.1378/chest.130.3.863

Cited by 15 publications

(13 citation statements)

References 13 publications

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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).…”

mentioning

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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“…The movements should be smooth and coordinated in order not to compromise the quality of the image. The similarity between OCT images and those produced evaluation of smoke-induced airway injury, (2) evaluation of anastomosis and small airways in lung transplantation, performance of endobronchial biopsies, (21) and measurement of tracheobronchial stenosis, (20) as well as evaluation of normal microanatomy and small airway and smooth muscle thickening in asthma patients, (22) COPD patients, (23) cystic fibrosis patients, and smokers, (24,25) together with pre-and post-bronchial thermoplasty evaluation. (26) In addition, OCT can aid in determining the size of the bronchi in the endoscopic treatment of emphysema with one-way valves.…”

Section: Discussionmentioning

confidence: 92%

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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“…Their study demonstrated the diagnostic sensitivity of FD-OCT in identifying and characterizing tissue planes within the subglottic mucosa. Additional studies comparing OCT and histology demonstrate the validity of OCT-based measurements of airway mucosal thickness in animal models [25, 26] and human tissue [27]. …”

Section: Discussionmentioning

confidence: 99%

Long-range Fourier domain optical coherence tomography of the pediatric subglottis

Volgger

Sharma

Jing

et al. 2015

International Journal of Pediatric Otorhinolaryngology

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Background Acquired subglottic stenosis (SGS) most commonly results from prolonged endotracheal intubation and is a diagnostic challenge in the intubated child. At present, no imaging modality allows for in vivo characterization of subglottic microanatomy to identify early signs of acquired SGS while the child remains intubated. Fourier domain optical coherence tomography (FD-OCT) is a minimally invasive, light-based imaging modality which provides high resolution, three dimensional (3D) cross-sectional images of biological tissue. We used long-range FD-OCT to image the subglottis in intubated pediatric patients undergoing minor head and neck surgical procedures in the operating room. Methods A long-range FD-OCT system and rotary optical probes (1.2 mm and 0.7 mm outer diameters) were constructed. Forty-six pediatric patients (ages 2–16 years) undergoing minor upper airway surgery (e.g. tonsillectomy, adenoidectomy) were selected for intraoperative, trans-endotracheal tube FD-OCT of the subglottis. Images were analyzed for anatomical landmarks and subepithelial histology. Volumetric image sets were rendered into virtual 3D airway models in Mimics software. Results FD-OCT was performed on 46 patients (ages 2–16 years) with no complications. Gross airway contour was visible on all 46 data sets. Twenty (43%) high-quality data sets clearly demonstrated airway anatomy (e.g., tracheal rings, cricoid, vocal folds) and layered microanatomy of the mucosa (e.g., epithelium, basement membrane, lamina propria). The remaining 26 data sets were discarded due to artifact, high signal-to-noise ratio or missing data. 3D airway models allowed for user-controlled manipulation and multiplanar airway slicing (e.g. sagittal, coronal) for visualization of OCT data at multiple anatomic levels simultaneously. Conclusions Long-range FD-OCT produces high-resolution, 3D volumetric images of the pediatric subglottis. This technology offers a safe and practical means for in vivo evaluation of lower airway microanatomy in intubated pediatric patients. Ultimately, FD-OCT may be applied to serial monitoring of the neonatal subglottis in long-term intubated infants at risk for acquired SGS.

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Evaluation of Rabbit Tracheal Inflammation Using Optical Coherence Tomography

Cited by 15 publications

References 13 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

Tomografia de coerência óptica broncoscópica

Long-range Fourier domain optical coherence tomography of the pediatric subglottis

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