In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study

Introduction 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.Study aim To assess...

Full description

Saved in:
Bibliographic Details
Main Authors: Michael W T Tanck, Onno M Mets, Erik Thunnissen, Jouke T Annema, Peter I Bonta, Inge A H van den Berk, Margherita Vaselli, Kirsten Kalverda-Mooij, Johannes F de Boer
Format: Article
Language:English
Published: BMJ Publishing Group 2023-07-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/10/1/e001628.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850034023305314304
author Michael W T Tanck
Onno M Mets
Erik Thunnissen
Jouke T Annema
Peter I Bonta
Inge A H van den Berk
Margherita Vaselli
Kirsten Kalverda-Mooij
Johannes F de Boer
author_facet Michael W T Tanck
Onno M Mets
Erik Thunnissen
Jouke T Annema
Peter I Bonta
Inge A H van den Berk
Margherita Vaselli
Kirsten Kalverda-Mooij
Johannes F de Boer
author_sort Michael W T Tanck
collection DOAJ
description Introduction 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.Study aim To assess pulmonary fibrosis in interstitial lung diseases (ILD) patients with in vivo EB-PS-OCT using histology as reference standard.Primary objective Visualisation and quantification of pulmonary fibrosis by EB-PS-OCT.Secondary objectives 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.Methods 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.Results 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.Conclusions 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.
format Article
id doaj-art-5cd12ee71d6c4ff7923b1b0b0b041585
institution DOAJ
issn 2052-4439
language English
publishDate 2023-07-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open Respiratory Research
spelling doaj-art-5cd12ee71d6c4ff7923b1b0b0b0415852025-08-20T02:57:59ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392023-07-0110110.1136/bmjresp-2023-001628In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational studyMichael W T Tanck0Onno M Mets1Erik Thunnissen2Jouke T Annema3Peter I Bonta4Inge A H van den Berk5Margherita Vaselli6Kirsten Kalverda-Mooij7Johannes F de Boer8Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsDepartment of Radiology and Nuclear Medicine, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Pathology, Amsterdam University Medical Centra, Amsterdam, The NetherlandsRespiratory Medicine, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsDepartment of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsRespiratory Medicine, Amsterdam University Medical Centres, Amsterdam, The NetherlandsDepartment of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsIntroduction 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.Study aim To assess pulmonary fibrosis in interstitial lung diseases (ILD) patients with in vivo EB-PS-OCT using histology as reference standard.Primary objective Visualisation and quantification of pulmonary fibrosis by EB-PS-OCT.Secondary objectives 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.Methods 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.Results 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.Conclusions 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.https://bmjopenrespres.bmj.com/content/10/1/e001628.full
spellingShingle Michael W T Tanck
Onno M Mets
Erik Thunnissen
Jouke T Annema
Peter I Bonta
Inge A H van den Berk
Margherita Vaselli
Kirsten Kalverda-Mooij
Johannes F de Boer
In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study
BMJ Open Respiratory Research
title In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study
title_full In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study
title_fullStr In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study
title_full_unstemmed In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study
title_short In vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease: a prospective, exploratory, observational study
title_sort in vivo polarisation sensitive optical coherence tomography for fibrosis assessment in interstitial lung disease a prospective exploratory observational study
url https://bmjopenrespres.bmj.com/content/10/1/e001628.full
work_keys_str_mv AT michaelwttanck invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT onnommets invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT erikthunnissen invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT jouketannema invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT peteribonta invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT ingeahvandenberk invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT margheritavaselli invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT kirstenkalverdamooij invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy
AT johannesfdeboer invivopolarisationsensitiveopticalcoherencetomographyforfibrosisassessmentininterstitiallungdiseaseaprospectiveexploratoryobservationalstudy