Optical Coherence Tomography as an Adjunct to Flexible Bronchoscopy in the Diagnosis of Lung Cancer

Michel, Ross G.; Kinasewitz, Gary T.; Fung, Kar Ming; Keddissi, Jean I.

doi:10.1378/chest.10-0753

Cited by 90 publications

(60 citation statements)

References 24 publications

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“…Bronchoscopic OCT imaging has been evaluated in ex vivo and in vivo lung pathology [30][31][32][33][34][35][36][37][38][39] and is capable of visualizing the fi ne features of normal airway layering and alveolar attachments. OCT imaging can identify pathologic changes, including preinvasive and preneoplastic airway lesions.…”

Section: Oct Criteria Development For Spn and Lung Parenchymamentioning

confidence: 99%

“…Motion artifacts may occur in the in vivo setting that are not refl ected in ex vivo imaging. Successful in vivo OCT imaging of normal and diseased lung has previously been conducted and demonstrated images of comparable quality to ex vivo OCT images, [32][33][34][35][36] with minimal motion artifact. Thus, it is not anticipated that motion artifact will hinder image quality and/or interpretation.…”

Section: Validationmentioning

confidence: 99%

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Toward the Guidance of Transbronchial Biopsy

Hariri

Mino‐Kenudson

Applegate

et al. 2013

Chest

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Background: Solitary pulmonary nodules (SPNs) frequently require transbronchial needle aspiration (TBNA) or biopsy to determine malignant potential, but have variable diagnostic yields. Confi rming needle placement within SPNs during TBNA could signifi cantly increase diagnostic yield. Optical coherence tomography (OCT) provides nondestructive, high-resolution, microstructural imaging with potential to distinguish SPN from parenchyma. We have developed needle-based OCT probes compatible with TBNA. Before OCT can play any signifi cant role in guiding clinical TBNA, OCT interpretation criteria for differentiating SPN from lung parenchyma must be developed and validated. Methods: OCT of SPN and parenchyma was performed on 111 ex vivo resection specimens. OCT criteria for parenchyma and SPN were developed and validated in a blinded assessment. Six blinded readers (two pulmonologists, two pathologists, and two OCT experts) were trained on imaging criteria in a 15-min training session prior to interpreting the validation data set. Results: OCT of lung parenchyma displayed evenly spaced signal-void alveolar spaces, signal-intense backrefl ections at tissue-air interfaces, or both. SPNs lacked both of these imaging features. Independent validation of OCT criteria by the six blinded readers demonstrated sensitivity and specifi city of 95.4% and 98.2%, respectively. Conclusions: We have developed and validated OCT criteria for lung parenchyma and SPN with sensitivity and specifi city . 95% in this ex vivo study. We anticipate that OCT could be a useful complementary imaging modality to confi rm needle placement during TBNA to potentially increase diagnostic yield. CHEST 2013; 144(4):1261-1268Abbreviations: OCT 5 optical coherence tomography; SPN 5 solitary pulmonary nodule; TBNA 5 transbronchial needle aspiration; TB-OCT 5 transbronchial optical coherence tomography

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Section: Oct Criteria Development For Spn and Lung Parenchymamentioning

confidence: 99%

Section: Validationmentioning

confidence: 99%

Toward the Guidance of Transbronchial Biopsy

Hariri

Mino‐Kenudson

Applegate

et al. 2013

Chest

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“…(27) In lung cancer, OCT has been used for differentiating normal mucosa from pre-neoplastic lesions. Three groups of authors (28)(29)(30) studied the tracheobronchial trees of patients suspected of having cancer and compared OCT images with images of biopsy of suspicious sites; the authors concluded that OCT, in addition to being well tolerated, was able to differentiate between normal tissue and tissue with neoplastic infiltration, suggesting that OCT can be an adjuvant technique in the early diagnosis of neoplastic lesions.…”

Section: Discussionmentioning

confidence: 99%

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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“…Optical coherence tomography has been used to assess the pulmonary airways and parenchyma in animal models [56][57][58][59][60][61] and in vivo human airway. [62][63][64][65][66][67][68] Optical coherence tomography imaging of the normal bronchial wall (Figure 4, A through E) reveals the fine, layered features of the airway, including the epithelium, basement membrane, lamina propria, salivary-type glands and ducts, vessels, and cartilage with surrounding perichondrium. In more distal airways, airway layering and attached lattice-like, signalvoid alveoli can be appreciated.…”

Section: Oct In Pulmonary Imagingmentioning

confidence: 99%

“…In vivo OCT imaging of airway-based carcinomas reveals architectural disorganization of the bronchial layering, segments of mucosa where normal surface maturation is lost, and increased surfaceimage intensity when compared with the underlying tissue. 64,66,67 The ability of OCT to discern preinvasive cancers of the bronchial mucosa has been assessed. 67,68 Lam et al 68 used OCT to evaluate bronchial mucosal lesions identified by autofluorescence bronchoscopy in a group of high-risk smokers.…”

Section: Oct In Pulmonary Imagingmentioning

confidence: 99%

In Vivo Optical Coherence Tomography: The Role of the Pathologist

Hariri

Mino‐Kenudson

Mark

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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Optical coherence tomography (OCT) is a nondestructive, high-resolution imaging modality, providing cross-sectional, architectural images at near histologic resolutions, with penetration depths up to a few millimeters. Optical frequency domain imaging is a second-generation OCT technology that has equally high resolution with significantly increased image acquisition speeds and allows for large area, high-resolution tissue assessments. These features make OCT and optical frequency domain imaging ideal imaging techniques for surface and endoscopic imaging, specifically when tissue is unsafe to obtain and/or suffers from biopsy sampling error. This review focuses on the clinical impact of OCT in coronary, esophageal, and pulmonary imaging and the role of the pathologist in interpreting high-resolution OCT images as a complement to standard tissue pathology.

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Optical Coherence Tomography as an Adjunct to Flexible Bronchoscopy in the Diagnosis of Lung Cancer

Cited by 90 publications

References 24 publications

Toward the Guidance of Transbronchial Biopsy

Toward the Guidance of Transbronchial Biopsy

Tomografia de coerência óptica broncoscópica

In Vivo Optical Coherence Tomography: The Role of the Pathologist

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