Optical coherence tomography in imaging of peripheral pulmonary arteries

Abstract

Background: To establish an optical coherence tomography (OCT)-based method for imaging peripheral pulmonary arteries. Methods:We recruited eight patients (five men; average age, 48±12 years; peripheral pulmonary artery thrombosis, three patients; idiopathic pulmonary hypertension, three patients; interstitial lung disease, and September 2010. OCT was performed using both the conventional OCT imaging method (COI) and the improved pulmonary artery imaging method (IPI). In the IPI, contrast agent was used as an indicator of balloon inflation meanwhile increases in flushing speed of the replacement fluid. The percentage of optimal images, inflation pressure, flushing speeds and complications were compared between the two methods.Results: We performed OCT of 33 vessel segments by both methods. IPI produced more optimal images than COI (88% vs. 24%). Mean inflation pressure and flushing speed were higher during IPI than COI (0.62±0.15 vs. 0.43±0.08 atm; 1 atm =101.3 kPa; 0.82±0.10 vs. 0.42±0.06 mL/s; both P<0.01). Decreased blood oxygen saturation (SaO2) was associated with 9% and 30% segments (P<0.01) in the COI (mean decrease, 8.4%±3.6%) and IPI groups (mean decrease, 12.1%±5.3%; P<0.05) respectively. SaO2 recovered to pre-imaging levels after oxygen inhalation.Conclusions: IPI is safe and effective for OCT of peripheral pulmonary arteries.

Evaluation of the diagnostic and prognostic potential of optical coherence tomography (OCT) of the pulmonary arteries during standardised right heart catheterisation in patients with pulmonary hypertension: a cross-sectional single-centre experience

“…In patients with PH, Jiang et al even showed a positive predictive value of 91% for a WT of ≥0.176 mm, underlining the potential of OCT as an additional diagnostic parameter in PH patients ( 20 ). However, to our best knowledge, no standardised settings for the operational procedure ( 21 ) and image analysis procedure of pulmonary arterial OCT have been determined. Comparison of absolute values for measured WT of the PA deviates ( 18 , 20 , 22 ).…”

“…Also, the penetration depth of OCT in the PA is 2–3 mm which limits a detailed presentation of the strongly thickened pulmonary arterial walls ( 11 , 37 ). However, in this study, a minimum of one OCT record per patient had sufficient quality, although insufficient image quality is a limiting factor.…”

“…Since 2010, several authors have reported on the safe use of OCT in the PA of adults and its potential to visualize morphologic changes in the PA vessel wall of patients with PH in vivo . The potential of PA OCT in PH to guide clinical decision making has been recognised ( 12 , 14 - 21 ). In 2018, Homma et al showed for the first time that OCT is a promising tool for the evaluation of the PA wall even in children with PH ( 22 ).…”