1. Articles in category: Pulmonology

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    1. Birefringence microscopy platform for assessing airway smooth muscle structure and function in vivo

      Birefringence microscopy platform for assessing airway smooth muscle structure and function in vivo

      The inability to visualize airway smooth muscle (ASM) cells in vivo is a major obstacle in understanding their role in normal physiology and diseases. At present, there is no imaging modality available to assess ASM in vivo. Confocal endomicroscopy lacks the penetration depth and field of view, and conventional optical coherence tomography (OCT) does not have sufficient contrast to differentiate ASM from surrounding tissues. We have developed a birefringence microscopy platform that leverages the micro-organization of tissue to add further dimension to traditional OCT. We have used this technology to validate ASM measurements in ex vivo swine and canine studies ...

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    2. Mass. General studies identify differences underlying the airway responses of patients with asthma

      Mass. General studies identify differences underlying the airway responses of patients with asthma

      Novel imaging and other tools reveal thicker airway smooth muscle, stronger immune response to allergens in asthmatic individuals More than 300 million people worldwide are affected by asthma, 25 million in the U.S. alone, and for most of them, allergy is an underlying cause. But why do some individuals allergic to airborne allergens develop asthma while many do not? Now two research teams from Massachusetts General Hospital (MGH) have used innovative imaging technology and other novel approaches to identify some key differences in both the immune response and the sensitivity of airway cells to inflammation between allergic individuals with ...

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    3. Measuring Airway Remodeling in Patients with Different COPD Staging Using Endobronchial Optical Coherence Tomography

      Measuring Airway Remodeling in Patients with Different COPD Staging Using Endobronchial Optical Coherence Tomography

      Background Although forced expiratory volume in one second (FEV 1 ) remains the gold standard for staging COPD, the association between airway remodeling and airflow limitation remains unclear. Objective Endobronchial optical coherence tomography (EB-OCT) was performed to assess the association between disorders of large- and medium-to-small-sized airways and COPD staging. We also evaluated small-airway architecture in heavy-smokers with normal FEV 1 (S NL ) and healthy never-smokers. Methods We recruited 48 COPD patients (stage Ⅰ, n=14; stage Ⅱ, n=15; stage Ⅲ-Ⅳ, n=19), 21 S NL , and 17 healthy never-smokers. Smoking history inquiry, spirometry, chest computed tomography, bronchoscopy and EB-OCT ...

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      Mentions: Wei Wang
    4. University of North Carolina Receives NIH Grant for Imaging Nanophysical Properties of Actively Transporting Bronchial Mucus

      University of North Carolina Receives NIH Grant for Imaging Nanophysical Properties of Actively Transporting Bronchial Mucus

      University of North Carolina at Chapel Hill Receives a 2016 NIH Grant for $234,624 for Imaging Nanophysical Properties of Actively Transporting Bronchial Mucus. The principal investigator is Amy Oldenburg. The program began in 2016 and ends in 2018. Below is a summary of the proposed work. Mucus coats the lung epithelium and traps thousands of pathogens that we inhale every day. Human bronchial epithelial (hBE) cells lining the lung have cilia that propel mucus via shear forces, a mechanism known as muco-ciliary transport (MCT). MCT acts to clear mucus, providing a primary defense against trapped pathogens. In respiratory diseases ...

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    5. Drs. Campbell, Hariri, and Lehman Receive 2016 LUNGevity Career Development Awards

      Drs. Campbell, Hariri, and Lehman Receive 2016 LUNGevity Career Development Awards

      Lida Hariri , MD, Massachusetts General Hospital, who will use a novel high-resolution imaging technique called Optical Coherence Tomography to perform virtual optical biopsies to determine its value in complementing tissue biopsies in the determination of early-stage lung cancer

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    6. New aspect for systemic effects of copd: Eye findings

      New aspect for systemic effects of copd: Eye findings

      Introduction : Chronic Obstructive Pulmonary Disease (COPD) has multisystemic implications and comorbidities. Hypoxia and systemic inflammation are thought to involve oculary structures. In this study, our aim is to evaluate retinal nerve fiber and choroidal thickness and retinal vessel diameter using the Spectral-domain optical coherence tomography (SD-OCT) in COPD subjects. Methods : 43 subjects diagnosed with COPD according to the Chronic Obstructive Lung Disease criteria at the Pulmonology Department of Pamukkale University were enrolled in the study. All subjects underwent respiratory function testing and a carbon monoxide diffusion test. To determine hypoxic state, arterial blood gas analysis was performed. The control group ...

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    7. Yale University Receives NIH Grant for Quantitative Optical Imaging of Cilia-Driven Fluid Flow

      Yale University Receives NIH Grant for Quantitative Optical Imaging of Cilia-Driven Fluid Flow

      Yale University Receives a 2016 NIH Grant for $416,250 for Quantitative Optical Imaging of Cilia-Driven Fluid Flow. The principal investigator is Michael Choma. The program began in 2013 and ends in 2018. Below is a summary of the proposed work. Respiratory diseases are major causes of pediatric morbidity and mortality. These diseases are incompletely understood, which is a barrier to improving clinical care. Therefore, new mechanisms of disease need to be discovered. Optical imaging (e.g. optical coherence tomography [OCT]) will enable these discoveries since traditional imaging (e.g. x-ray, CT, MRI) cannot visualize structures smaller than ~1 mm ...

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    8. Johns Hopkins University Receives NIH Grant for Micro Coherence Imaging Technology for Assessing Obstructive Lung Disease In Vivo

      Johns Hopkins University Receives NIH Grant for Micro Coherence Imaging Technology for Assessing Obstructive Lung Disease In Vivo

      Johns Hopkins University Receives a 2016 NIH Grant for $746,856 for Micro Coherence Imaging Technology for Assessing Obstructive Lung Disease In Vivo. The principal investigator is Robert Brown. The program began in 2014 and ends in 2019. Below is a summary of the proposed work. This Biomedical Research Partnership (BRP) proposal involves a partnership among a biomedical engineering team, a pulmonary physiology team, and a clinical pulmonary medicine team. This research program will incorporate state of the art optical engineering, advanced in vivo physiologic evaluation, and direct application to human obstructive lung diseases (OLD). Optical coherence tomography (OCT) is ...

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    9. In vivo imaging of airway cilia and mucus clearance with micro-optical coherence tomography

      In vivo imaging of airway cilia and mucus clearance with micro-optical coherence tomography

      We have designed and fabricated a 4 mm diameter rigid endoscopic probe to obtain high resolution micro-optical coherence tomography (µOCT) images from the tracheal epithelium of living swine. Our common-path fiber-optic probe used gradient-index focusing optics, a selectively coated prism reflector to implement a circular-obscuration apodization for depth-of-focus enhancement, and a common-path reference arm and an ultra-broadbrand supercontinuum laser to achieve high axial resolution. Benchtop characterization demonstrated lateral and axial resolutions of 3.4 μm and 1.7 μm, respectively (in tissue). Mechanical standoff rails flanking the imaging window allowed the epithelial surface to be maintained in focus without disrupting ...

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    10. Validation of Human Small Airway Measurements Using Endobronchial Optical Coherence Tomography

      Validation of Human Small Airway Measurements Using Endobronchial Optical Coherence Tomography

      PURPOSE: To evaluate the usefulness of endobronchial optical coherence tomography (EB-OCT) in assessing small airways morphology in vivo. METHODS: Twelve patients with pulmonary nodules scheduled for lung resection underwent spirometry, multidetector computed tomography (MDCT) and EB-OCT. We measured Dmean (mean luminal diameter), Ai (inner luminal area), Aw (airway wall area) and Aw% [Aw/(Ai+Aw) ×100%] from the 3rd to 5th generation bronchi of RB9 segment by MDCT. Dmean, Ai, Aw and Aw% from the 3rd to 9th generation bronchi of RB9 segment were measured by EB-OCT and histology. The correlations of these 4 parameters, measured by the three methods ...

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    11. Optical Coherence Tomography of Pulmonary Arterial Walls in Humans and Pigs (Sus scrofa domesticus)

      Optical Coherence Tomography of Pulmonary Arterial Walls in Humans and Pigs (Sus scrofa domesticus)

      Pulmonary arterial hypertension (PAH) is a devastating disorder characterized by progressive elevation of the pulmonary pressures that, in the absence of therapy, results in chronic right-heart failure and premature death. The vascular pathology of PAH is characterized by progressive loss of small (diameter, less than 50 μm) peripheral pulmonary arteries along with abnormal medial thickening, neointimal formation, and intraluminal narrowing of the remaining pulmonary arteries. Vascular pathology correlates with disease severity, given that hemodynamic effects and disease outcomes are worse in patients with advanced compared with lower-grade lesions. Novel imaging tools are urgently needed that demonstrate the extent of vascular ...

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    12. Early lung cancer detection, mucosal, and alveolar imaging

      Early lung cancer detection, mucosal, and alveolar imaging

      Purpose of review: Lung cancer is the leading cause of cancer deaths worldwide. Early detection is essential for long-term survival. Screening of high-risk individuals with low-dose computed tomography screening has proven to increase survival. However, current radiological imaging techniques have poor specificity for lung cancer detection and poor sensitivity for detection of mucosal or alveolar preinvasive malignant lesions. Bronchoscopy allows imaging and sampling of early lung cancer, with the highest safety profile and high diagnostic accuracy. Recent findings: Available technologies, such as autofluorescence bronchoscopy, narrow band imaging, and radial ultrasound bronchoscopy can significantly increase the yield and diagnostic accuracy of ...

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    13. Combination Therapy with Cystic Fibrosis Transmembrane Conductance Regulator Modulators Augment the Airway Functional Microanatomy

      Combination Therapy with Cystic Fibrosis Transmembrane Conductance Regulator Modulators Augment the Airway Functional Microanatomy

      Recently approved therapies that modulate CFTR function have shown significant clinical benefit, but recent investigations regarding their molecular mechanism when used in combination have not been consistent with clinical results. We employed Micro-Optical Coherence Tomography (µOCT) as a novel means to assess the mechanism of action of CFTR modulators, focusing on the effects on mucociliary clearance. Primary human airway monolayers from patients with a G551D mutation responded to ivacaftor treatment with increased ion transport, airway surface liquid depth, ciliary beat frequency, and mucociliary transport rate, in addition to decreased effective viscosity of the mucus layer, a unique mechanism established by ...

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    14. Automatic airway wall segmentation and thickness measurement for long-range optical coherence tomography images

      Automatic airway wall segmentation and thickness measurement for long-range optical coherence tomography images

      We present an automatic segmentation method for the delineation and quantitative thickness measurement of multiple layers in endoscopic airway optical coherence tomography (OCT) images. The boundaries of the mucosa and the sub-mucosa layers are accurately extracted using a graph-theory-based dynamic programming algorithm. The algorithm was tested with sheep airway OCT images. Quantitative thicknesses of the mucosal layers are obtained automatically for smoke inhalation injury experiments.

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    15. Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury

      Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury

      Rationale: Subglottic edema and acquired subglottic stenosis are potentially airway-compromising sequelae in neonates following endotracheal intubation. At present, no imaging modality is capable of in vivo diagnosis of subepithelial airway wall pathology as signs of intubation-related injury. Objectives: To use Fourier domain long-range optical coherence tomography (LR-OCT) to acquire micrometer-resolution images of the airway wall of intubated neonates in a neonatal intensive care unit setting and to analyze images for histopathology and airway wall thickness. Methods: LR-OCT of the neonatal laryngotracheal airway was performed a total of 94 times on 72 subjects (age, 1–175 d; total intubation, 1–104 ...

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    16. Sex Differences in Airway Remodeling in a Mouse Model of Chronic Obstructive Pulmonary Disease

      Sex Differences in Airway Remodeling in a Mouse Model of Chronic Obstructive Pulmonary Disease

      Rationale: Adjusting for the amount of smoking, women have a 50% increased risk of COPD compared with men. It is not known what the anatomic basis/mechanism(s) of these sex-related differences in COPD might be. Objective: To characterize the impact of female sex hormones on chronic cigarette smoke-induced airway remodeling and emphysema in a mouse model of COPD. Methods: Airway remodeling and emphysema were determined morphometrically in male, female, and ovariectomized mice exposed to 6 months of cigarette smoke. Antioxidant- and transforming growth factor (TGFβ)-related genes were profiled in airway tissues. The selective estrogen receptor modulator, tamoxifen, was ...

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    17. Validation of human small-airway measurements using endobronchial optical coherence tomography: an observational study

      Validation of human small-airway measurements using endobronchial optical coherence tomography: an observational study

      Background Small-airway remodelling is the cardinal pathological feature underlying chronic obstructive pulmonary disease (COPD). Identification of early-stage pathological changes is crucial for the diagnosis, treatment, and prognosis of respiratory diseases. Our study aimed to investigate the usefulness of endobronchial optical coherence tomography (EB-OCT) in assessment of small-airways morphology in patients with pulmonary nodules who were scheduled for lung resection surgery (four had COPD, four were smokers with normal lung function, and four were life-long non-smokers). Patients with respiratory diseases other than COPD were excluded. Methods 12 patients with pulmonary nodules scheduled for lung resection underwent spirometry, multidetector CT (MDCT), and ...

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      Mentions: Yu Chen Wei Wang
    18. Reproducibility of optical coherence tomography airway imaging

      Reproducibility of optical coherence tomography airway imaging

      Optical coherence tomography (OCT) is a promising imaging technique to evaluate small airway remodeling. However, the short-term insertion-reinsertion reproducibility of OCT for evaluating the same bronchial pathway has yet to be established. We evaluated 74 OCT data sets from 38 current or former smokers twice within a single imaging session. Although the overall insertion-reinsertion airway wall thickness (WT) measurement coefficient of variation (CV) was moderate at 12%, much of the variability between repeat imaging was attributed to the observer; CV for repeated measurements of the same airway (intra-observer CV) was 9%. Therefore, reproducibility may be improved by introduction of automated ...

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    19. Endoscopic Doppler optical coherence tomography and autofluorescence imaging of peripheral pulmonary nodules and vasculature

      Endoscopic Doppler optical coherence tomography and autofluorescence imaging of peripheral pulmonary nodules and vasculature

      We present the first endoscopic Doppler optical coherence tomography and co-registered autofluorescence imaging (DOCT-AFI) of peripheral pulmonary nodules and vascular networks in vivo using a small 0.9 mm diameter catheter. Using exemplary images from volumetric data sets collected from 31 patients during flexible bronchoscopy, we demonstrate how DOCT and AFI offer complementary information that may increase the ability to locate and characterize pulmonary nodules. AFI offers a sensitive visual presentation for the rapid identification of suspicious airway sites, while co-registered OCT provides detailed structural information to assess the airway morphology. We demonstrate the ability of AFI to visualize vascular ...

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    20. Validation of human small airway measurements using endobronchial optical coherence tomography

      Validation of human small airway measurements using endobronchial optical coherence tomography

      Background Small airway remodeling is the cardinal feature underlying chronic airway diseases. There is no modality which identifies small airway pathological changes, which is crucial for early diagnosis, efficacy and prognostic assessment. Objective To evaluate the usefulness of endobronchial optical coherence tomography (EB-OCT) in assessing small airways morphology in vivo . Methods Twelve patients with pulmonary nodules scheduled for lung resection underwent spirometry, multi-detector computed tomography (MDCT) and EB-OCT. We measured D mean (mean luminal diameter), Ai (inner luminal area), Aw (airway wall area) and Aw% [Aw/(Ai + Aw) × 100%] from the 3rd to 5th generation bronchi of RB9 segment by ...

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    21. Spatiotemporal correlation of optical coherence tomography in-vivo images of rabbit airway for the diagnosis of edema

      Spatiotemporal correlation of optical coherence tomography in-vivo images of rabbit airway for the diagnosis of edema

      Detection of an early stage of subglottic edema is vital for airway management and prevention of stenosis, a life-threatening condition in critically ill neonates. As an observer for the task of diagnosing edema in vivo , we investigated spatiotemporal correlation (STC) of full-range optical coherence tomography (OCT) images acquired in the rabbit airway with experimentally simulated edema. Operating the STC observer on OCT images generates STC coefficients as test statistics for the statistical decision task. Resulting from this, the receiver operating characteristic (ROC) curves for the diagnosis of airway edema with full-range OCT in-vivo images were extracted and areas under ROC ...

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    22. University of Alabama at Birmingham Receives NIH Grant to Study Functional Anatomic Imaging of Cystic Fibrosis Patients with Early Lung Disease using Micro-OCT.

      University of Alabama at Birmingham Receives NIH Grant to Study Functional Anatomic Imaging of Cystic Fibrosis Patients with Early Lung Disease using Micro-OCT.

      The University of Alabama at Birmingham Receives a 2015 NIH Grant for $498,330 to Study Functional Anatomic Imaging of Cystic Fibrosis Patients with Early Lung Disease using Micro-OCT. The principal investigator is Steven Mark Rowe. The program began in 2012 and elndsi nin 2016. Below is a summary of the proposed work. Cystic fibrosis (CF) is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR), an anion transporter of chloride and bicarbonate. Defective or deficient CFTR leads to severe mucoobstructive lung disease and severe morbidity and early mortality due to lung infections. Even though substantial advances in ...

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