Department of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Respiratory Medicine, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
BMJ Open Respir Res. 2023 Aug;10(1). doi: 10.1136/bmjresp-2023-001628.
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.
To assess pulmonary fibrosis in interstitial lung diseases (ILD) patients with in vivo EB-PS-OCT using histology as reference standard.
Visualisation and quantification of pulmonary fibrosis by EB-PS-OCT.
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.
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.
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.
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.
支气管内偏振敏感光相干断层扫描（EB-PS-OCT）是一种支气管镜成像技术，其分辨率比高分辨率 CT（HRCT）高出 50 倍。它检测胶原双折射，从而能够识别和量化纤维化。
使用组织学作为参考标准，通过体内 EB-PS-OCT 评估间质性肺疾病（ILD）患者的肺纤维化。
通过 EB-PS-OCT 可视化和量化肺纤维化。
比较 EB-PS-OCT 和 HRCT 检测的纤维化与组织学，识别 EB-PS-OCT 图像中的 ILD 组织学特征，以及比较离体 PS-OCT 结果与组织学。
观察性前瞻性探索性研究。计划进行经支气管冷冻活检或手术肺活检的 ILD 患者在组织采集前接受体内 EB-PS-OCT 成像。将哮喘患者纳入非纤维化对照组。在每个成像的肺段中，通过评估 EB-PS-OCT 图像中的双折射面积来自动定量纤维化。比较 HRCT 区域和活检中纤维化的程度与 EB-PS-OCT 检测的纤维化。在 EB-PS-OCT 图像上识别微观 ILD 特征，并与同一节段的活检相匹配。
共纳入 19 名患者（16 名 ILD；3 名哮喘）。在 49 个体内成像的气道段中，成功定量了实质的双折射面积，范围从 2.54%（无至最小纤维化）到 21.01%（广泛纤维化）。EB-PS-OCT 检测到的双折射面积增加与组织学证实的纤维化增加相对应，具有比 HRCT 更好的预测价值。在体内和离体 PS-OCT 图像上都可以识别微观 ILD 特征。
EB-PS-OCT 能够定量肺纤维化，因此具有作为附加支气管镜成像技术诊断和检测 ILD 纤维化（早期）的潜力。
