Category: Pulmonology

Objective: To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. Methods: A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to bronchoscopy-BAL and transbronchial biopsy (TBB). The BAL specimens were submitted to direct testing and culture for AFB and fungi, whereas the TBB specimens were submitted to histopathological examination. Results: Of the 286 patients studied, 225 (79%) were diagnosed on the basis of bronchoscopic findings, as follows: pulmonary tuberculosis, in 127 ...

Visualization and correct assessment of alveolar volume via intact lung imaging is important to study and assess respiratory mechanics. Optical Coherence Tomography (OCT), a real-time imaging technique based on near-infrared interferometry, can image several layers of distal alveoli in intact, ex vivo lung tissue. However optical effects associated with heterogeneity of lung tissue, including the refraction caused by air-tissue interfaces along alveoli and duct walls, and changes in speed of light as it travels through the tissue, result in inaccurate measurement of alveolar volume. Experimentally such errors have been difficult to analyze because of lack of ’ground truth,’ as the ...

The investigation of lung dynamics on alveolar scale is crucial for the understanding and treatment of lung diseases, such as acute lung injury and ventilator induced lung injury, and to promote the development of protective ventilation strategies. One approach to this is the establishment of numerical simulations of lung tissue mechanics where detailed knowledge about three-dimensional alveolar structure changes during the ventilation cycle is required. We suggest four-dimensional optical coherence tomography (OCT) imaging as a promising modality for visualizing the structural dynamics of single alveoli in subpleural lung tissue with high temporal resolution using a mouse model. A high-speed OCT ...

Determining the structure of lung tissue is difficult in ex-vivo samples. Optical coherence tomography (OCT) can image alveoli but ignores optical effects that distort the images. For example, light refracts and changes speed at the alveolar air-tissue surface. We employ ray-tracing to model OCT imaging with directional and speed changes included, using spherical shapes in 2D. Results show apparent thickening of inter-aveolar walls and distortion of shape and depth. Our approach suggests a correction algorithm by combining the model with image analysis. Distortion correction will allow inference of tissue mechanical properties and deeper imaging.

In the context of protective artificial ventilation strategies for patients with severe lung diseases, the contribution of ventilator settings to tissue changes on the alveolar level of the lung is still a question under debate. To understand the impact of respiratory settings as well as the dynamic process of respiration, high-resolution monitoring and visualization of the dynamics of lung alveoli are essential. An instrument allowing 3D imaging of lung tissue as well as imaging of functional constituents, such as elastin fibers, in in situ experimental conditions is presented in this study using a combination of Fourier domain optical coherence tomography ...

To develop new treatment possibilities for patients with severe lung diseases it is crucial to understand the lung function on an alveolar level. Optical coherence tomography (OCT) in combination with intravital microscopy (IVM) are used for imaging subpleural alveoli in animal models to gain information about dynamic and morphological changes of lung tissue during mechanical ventilation. The image content suitable for further analysis is influenced by image artifacts caused by scattering, refraction, reflection, and absorbance. Because the refractive index varies with each air-tissue interface in lung tissue, these effects decrease OCT image quality exceedingly. The quality of OCT images can ...

Architectural changes in and remodeling of the bronchial and pulmonary vasculature are important pathways in diseases such as asthma, chronic obstructive pulmonary disease (COPD), and lung cancer. However, there is a lack of methods that can find and examine small bronchial vasculature in vivo. Structural lung airway imaging using optical coherence tomography (OCT) has previously been shown to be of great utility in examining bronchial lesions during lung cancer screening under the guidance of autofluorescence bronchoscopy. Using a fiber optic endoscopic OCT probe, we acquire OCT images from in vivo human subjects. The side-looking, circumferentially-scanning probe is inserted down the ...

We have been investigating ultrahigh resolution optical coherence tomography (UHR-OCT) imaging of lung tissues using fiber super continuum sources. The high power, low-noise, Gaussian shaped supercontinuum generated with ultrashort pulses and optical fibers at several wavelengths were used as the broadband light sources for UHR-OCT. For the 800 nm wavelength region, the axial resolution was 3.0 um in air and 2.0 um in tissue. Since the lung consists of tiny alveoli which are separated by thin wall, the UHR-OCT is supposed to be effective for lung imaging. The clear images of alveoli of rat were observed with and ...

In this study, we report permeability coefficients of 30% glucose diffusion by the optical coherence tomography signal slope (OCTSS) method in four kind of human lung tissue in vitro: normal lung tissue, benign granulomatosis lung tissue, squamous cell carcinoma, and adenocarcinoma tumor. To quantify the permeability coefficient of the agent, the monitored region was the 80 um thickness at a tissue depth of approximately 230 um from the surface. The permeability coefficients of 30% glucose from 10 independent experiments were averaged and found to be (1.35 ± 0.13)×10 −5 cm/s from the normal lung tissue, (1.78 ...

Bronchoscopy is a minimally-invasive method for diagnosis of diseases of the airways and the lung parenchyma. Standard bronchoscopy uses the reflectance/scattering properties of white light from tissue to examine the macroscopic appearance of airways. It does not exploit the full spectrum of the optical properties of bronchial tissues. Advances in optical imaging such as optical coherence tomography (OCT), confocal endomicroscopy, autofluorescence imaging and laser Raman spectroscopy are at the forefront to allow in-vivo high resolution probing of the microscopic structure, biochemical compositions and even molecular alterations in disease states. OCT can visualize cellular and extracellular structures at and below ...

In this review, we discuss the detection, staging, and treatment of early-stage squamous cell lung cancer, with a focus on bronchoscopic techniques, including electrocauterization, argon plasma coagulation, cryotherapy, neodymium:yttriumaluminum- garnet laser therapy, photodynamic therapy, and intraluminal brachytherapy. The cure rate achieved with bronchoscopic techniques is 43-97%. Most bronchoscopic strategies are less morbid and less toxic than is non-bronchoscopic radiation therapy. Success depends on the application of stringent selection criteria for appropriate tumors, smaller tumors responding better. In some cases, electrocauterization, argon plasma coagulation, and cryotherapy can be conducted safely in an outpatient setting. There is sufficient technology available for ...

Optical coherence tomography (OCT) is a nondestructive imaging technique offering high temporal and spatial resolution, which makes it a natural choice for assessing tissue mechanical properties. We have developed methods to mechanically analyze the compliance of the rabbit trachea in vivo using tissue deformations induced by tidal breathing, offering a unique tool to assess the behavior of the airways during their normal function. Four-hundred images were acquired during tidal breathing with a custom-built endoscopic OCT system. The surface of the tissue was extracted from a set of these images via image processing algorithms, filtered with a bandpass filter set at ...

There have been many advances in the field of diagnostic and therapeutic pulmonary medicine in the past several years, with major progress in the field of imaging. Optical coherence tomography (OCT) is a high-resolution (micron level) imaging modality currently being advanced with the potential to image airway wall structures in real time and at higher resolution than previously possible. OCT has the potential to increase the sensitivity and specificity of biopsies, create 3D images of the airway to guide diagnostics, and may have a future role in diverse areas such as the evaluation and treatment of patients with obstructive sleep ...

We present the smallest reported side-viewing needle probe for optical coherence tomography (OCT). Design, fabrication, optical characterization, and initial application of a 30-gauge (outer diameter 0.31 mm) needle probe are demonstrated. Extreme miniaturization is achieved by using a simple all-fiber probe design incorporating an angle-polished and reflection-coated fiber-tip beam deflector. When inserted into biological tissue, aqueous interstitial fluids reduce the probe’s inherent astigmatism ratio to 1.8, resulting in a working distance of 300 μm and a depth-of-field of 550 μm with beam diameters below 30 μm. The needle probe was interfaced with an 840 nm spectral-domain OCT ...

This FOA, issued by the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, invites Research Project Grant (R01) applications that propose to investigate the early origins of cystic fibrosis (CF) lung disease and the mechanisms involved in development and progression of pulmonary abnormalities in young children with this condition. Studies may explore novel strategies for detecting early lung disease in infants and young children with CF, including minimally invasive biomarkers and/or imaging approaches, and utilize these methods to elucidate the molecular and cellular mechanisms of early lung disease onset and progression. The ultimate goal is development ...