In vivo multifunctional optical coherence tomography at the periphery of the lungs

Feroldi, Fabio; Willemse, Joy; Davidoiu, Valentina; Gräfe, Maximilian G. O.; Iperen, Dirck J. van; Goorsenberg, Annika W.M.; Annema, Jouke T.; Daniëls, Hans; Bonta, Peter I.; Boer, Johannes F. de

doi:10.1364/boe.10.003070

Cited by 27 publications

(17 citation statements)

References 49 publications

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“…Studies underway may provide insights into novel clinical or inflammatory predictors of a therapeutic response to bronchial thermoplasty (ClinicalTrials.gov Identifier: NCT01185275) 23. Imaging of the airways by optical coherence tomography,46,47 computed tomography (CT)48 and endobronchial ultrasound are also being investigated as potential noninvasive methods to identify predictors of a beneficial response to bronchial thermoplasty.…”

Section: Predictors Of a Beneficial Responsementioning

confidence: 99%

<p>Recent Developments In Bronchial Thermoplasty For Severe Asthma</p>

Thomson¹

2019

JAA

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PurposeBronchial thermoplasty is approved in many countries worldwide as a non-pharmacological treatment for severe asthma. This review summarizes recent publications on the selection of patients with severe asthma for bronchial thermoplasty, predictors of a beneficial response and developments in the procedure and discusses specific issues about bronchial thermoplasty including effectiveness in clinical practice, mechanism of action, cost-effectiveness, and place in management.ResultsBronchial thermoplasty is a treatment option for patients with severe asthma after assessment and management of causes of difficult-to-control asthma, such as nonadherence, poor inhaler technique, comorbidities, under treatment, and other behavioral factors. Patients treated with bronchial thermoplasty in clinical practice have worse baseline characteristics and comparable clinical outcomes to clinical trial data. Bronchial thermoplasty causes a reduction in airway smooth muscle mass although it is uncertain whether this effect explains its efficacy since other mechanisms of action may be relevant, such as alterations in airway epithelial, gland, and/or nerve function; improvements in small airway function; or a placebo effect. The cost-effectiveness of bronchial thermoplasty is greater in countries where the costs of hospitalization and emergency department are high. The place of bronchial thermoplasty in the management of severe asthma is not certain, although some experts propose that bronchial thermoplasty should be considered for patients with severe asthma associated with non-type 2 inflammation or who fail to respond favorably to biologic therapies targeting type 2 inflammation.ConclusionBronchial thermoplasty is a modestly effective treatment for severe asthma after assessment and management of causes of difficult-to-control asthma. Asthma morbidity increases during and shortly after treatment. Follow-up studies provide reassurance on the long-term safety of the procedure. Uncertainties remain about predictors of response, mechanism(s) of action, and place in management of severe asthma.

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Section: Predictors Of a Beneficial Responsementioning

confidence: 99%

<p>Recent Developments In Bronchial Thermoplasty For Severe Asthma</p>

Thomson¹

2019

JAA

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“…Including the local contrast modes (OAxU 41 , 50 , 51 and local birefringence 40 ), in addition to cumulative DPPR as published in previous work, 20 , 26 , 27 , 52 allowed better evaluation of the extent of fibrotic lesions in depth and made judgment regarding the presence of SRFib more reliable. OAxU and local birefringence are also more convenient to use.…”

Section: Discussionmentioning

confidence: 99%

“…39 Images of three PS-OCT contrast modalities were used to identify birefringent fibrotic areas in tissue: cumulative double-pass phase retardation (DPPR), 30,35 local birefringence, 40 and optic axis uniformity (OAxU). [41][42][43] The cumulative DPPR measures the phase retardation between the principle polarization states along the complete optical path through the tissue. When deeper locations are measured within birefringent tissues, the optical path becomes longer, and more cumulative DPPR will be measured until reaching a value of π , from which it decreases again due to phase wrapping.…”

Section: Processing and Evaluationmentioning

confidence: 99%

Subretinal Fibrosis Detection Using Polarization Sensitive Optical Coherence Tomography

Gräfe

Kreeke

Willemse

et al. 2020

Trans. Vis. Sci. Tech.

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Citation: Gräfe MGO, van de Kreeke JA, Willemse J, Braaf B, de Jong Y, Tan HS, Verbraak FD, de Boer JF. Subretinal fibrosis detection using polarization sensitive optical coherence tomography. Trans Vis Sci Tech. 2020;9(4):13, https://doi.org/10. 1167/tvst.9.4.13 Purpose: Subretinal fibrosis (SRFib) is an important cause of permanent loss-of-vision diseases with submacular neovascularization, but a reliable diagnostic method is currently missing. This study uses polarization-sensitive optical coherence tomography (PS-OCT) to detect SRFib within retinal lesions by measurement of its birefringent collagen fibers.Methods: Twenty-five patients were enrolled with retinal pathology in one or both eyes containing (1) suspected SRFib, (2) lesions suspected not to be fibrotic, or (3) lesions with doubtful presence of SRFib. All eyes were evaluated for SRFIb using conventional diagnostics by three retinal specialists. PS-OCT images were visually evaluated for SRFib based on cumulative phase retardation, local birefringence, and optic axis uniformity.Results: Twenty-nine eyes from 22 patients were scanned successfully. In 13 eyes, SRFib was diagnosed by all retinal specialists; of these, 12 were confirmed by PS-OCT and one was inconclusive. In nine eyes, the retinal specialists expected no SRFib, which was confirmed by PS-OCT in all cases. In seven eyes, the retinal specialists' evaluations were inconsistent with regard to the presence of SRFib. PS-OCT confirmed the presence of SRFib in four of these eyes and the absence of SRFib in two eyes and was inconclusive in one eye. Conclusions:In 21 out of 22 eyes, PS-OCT confirmed the evaluation of retinal specialists regarding the presence of SRFib. PS-OCT provided additional information to distinguish SRFib from other tissues within subretinal neovascular lesions in 6 out of 7 eyes.Translational Relevance: PS-OCT can identify and quantify SRFib in doubtful cases for which a reliable diagnosis is currently lacking.

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“…Ya se están haciendo mejoras, como la cuantificación automatizada [42] y la segmentación automatizada de moco [37, 103]. De igual manera, la investigación se halla enfocada en mejorar las técnicas, por ejemplo, mediante el uso de TCO sensible a la polarización, que no solamente muestra las capas estructurales de la vía respiratoria, sino también la distribución del tejido [104]. Esto hace posible distinguir varias estructuras en las vías respiratorias, como los componentes de la vía respiratoria (p.…”

Section: Perspectivas a Futurounclassified

Avances en tomografía de coherencia óptica y endomicroscopía confocal láser en enfermedades pulmonares

Goorsenberg¹,

Kalverda²,

Annema³

et al. 2021

Kompass Neumol

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El diagnóstico y monitoreo de enfermedades pulmonares depende en gran medida de los estudios de imagen, las pruebas de función fisiológica y la toma de muestras de tejido. La tomografía de coherencia óptica (TCO) y la endomicroscopía confocal láser (ECL) son técnicas de imagen novedosas con resolución casi microscópica, que pueden combinarse de manera fácil y segura con la broncoscopía convencional. Mediante estas técnicas pueden visualizarse compartimentos anatómicos pulmonares relacionados con enfermedades, en tiempo real. En enfermedades pulmonares obstructivas, pueden identificarse y cuantificarse las capas en las paredes de las vías respiratorias y el remodelado estructural asociado. En neoplasias pulmonares, es posible discriminar entre áreas normales y malignas en las vías respiratorias centrales, el parénquima pulmonar, los nodos linfáticos y la pleura. Un número creciente de enfermedades pulmonares intersticiales (EPIs) han podido visualizarse mediante TCO o ECL. Es posible estudiar por imagen varios cambios estructurales asociados con EPIs: fibrosis, infiltración celular, bronqui(ol)ectasias, quistes y el patrón microscópico en panal de abejas. Aunque aún no se han implantado en la práctica clínica, la TCO y la ECL tienen el potencial de mejorar la detección y el monitoreo de enfermedades pulmonares y pueden contribuir a desentrañar la fisiopatología de varias enfermedades y el mecanismo de acción de nuevos tratamientos. De hecho, el examen de las paredes de las vías respiratorias mediante TCO podría ser útil al evaluar tratamientos contra el remodelado de las vías respiratorias. Al visualizar células malignas individuales, la ECL tiene potencial como herramienta para detectar el cáncer en tiempo real. En el futuro, ambas técnicas podrían combinarse con la detección de marcadores fluorescentes con láser. Esta revisión discute el valor de la TCO y la ECL en la medicina pulmonar, presentando de forma sumaria la evidencia actual, y se comentan las perspectivas a futuro.

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In vivo multifunctional optical coherence tomography at the periphery of the lungs

Cited by 27 publications

References 49 publications

<p>Recent Developments In Bronchial Thermoplasty For Severe Asthma</p>

<p>Recent Developments In Bronchial Thermoplasty For Severe Asthma</p>

Subretinal Fibrosis Detection Using Polarization Sensitive Optical Coherence Tomography

Avances en tomografía de coherencia óptica y endomicroscopía confocal láser en enfermedades pulmonares

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