1. Articles in category: Pulmonology

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    1. Evaluation of the normal airway morphology using optical coherence tomography

      Evaluation of the normal airway morphology using optical coherence tomography

      Background The anatomical location of small airways, the distribution of airway cartilage and their correlation with ageing have not been well elucidated. Objective To explore the morphological characteristics of small airways in vivo , and how airway structural changes correlate with age using endobronchial optical coherence tomography (EB-OCT). Methods We recruited 112 subjects with peripheral pulmonary nodules. Participants underwent computed tomography, spirometry, and EB-OCT measurements. We measured the airway internal diamaeter (D mean ), inner area (Ai), airway wall area percentage (Aw%) and the thickness of airway cartilage. EB-OCT airway structural characteristics at different age intervals were analyzed, and the association between ...

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    2. En-face optical coherence tomography/fluorescence endomicroscopy for minimally invasive imaging using a robotic scanner

      En-face optical coherence tomography/fluorescence endomicroscopy for minimally invasive imaging using a robotic scanner

      We report a compact rigid instrument capable of delivering en-face optical coherence tomography (OCT) images alongside (epi)-fluorescence endomicroscopy (FEM) images by means of a robotic scanning device. Two working imaging channels are included: one for a one-dimensional scanning, forward-viewing OCT probe and another for a fiber bundle used for the FEM system. The robotic scanning system provides the second axis of scanning for the OCT channel while allowing the field of view (FoV) of the FEM channel to be increased by mosaicking. The OCT channel has resolutions of 25  /  60  μm (axial/lateral) and can provide en-face images with ...

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    3. Localized compliance measurement of the airway wall using anatomic optical coherence elastography

      Localized compliance measurement of the airway wall using anatomic optical coherence elastography

      We describe an elastographic method to circumferentially-resolve airway wall compliance using endoscopic, anatomic optical coherence tomography (aOCT) combined with an intraluminal pressure catheter. The method was first demonstrated on notched silicone phantoms of known elastic modulus under respiratory ventilation, where localized compliance measurements were validated against those predicted by finite element modeling. Then, ex vivo porcine tracheas were scanned, and the pattern of compliance was found to be consistent with histological identification of the locations of (stiff) cartilage and (soft) muscle. This quantitative method may aid in diagnosis and monitoring of collapsible airway wall tissues in obstructive respiratory disorders.

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    4. In vivo multifunctional optical coherence tomography at the periphery of the lungs

      In vivo multifunctional optical coherence tomography at the periphery of the lungs

      Remodeling of tissue, such as airway smooth muscle (ASM) and extracellular matrix, is considered a key feature of airways disease. No clinically accepted diagnostic method is currently available to assess airway remodeling or the effect of treatment modalities such as bronchial thermoplasty in asthma, other than invasive airway biopsies. Optical coherence tomography (OCT) generates cross-sectional, near-histological images of airway segments and enables identification and quantification of airway wall layers based on light scattering properties only. In this study, we used a custom motorized OCT probe that combines standard and polarization sensitive OCT (PS-OCT) to visualize birefringent tissue in vivo in ...

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    5. Automatic Proximal Airway Volume Segmentation Using Optical Coherence Tomography for Assessment of Inhalation Injury

      Automatic Proximal Airway Volume Segmentation Using Optical Coherence Tomography for Assessment of Inhalation Injury

      Background Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury with a mortality rate of up to 40%. Early management of ARDS has been difficult due to the lack of sensitive imaging tools and robust analysis software. We previously designed an optical coherence tomography (OCT) system to evaluate mucosa thickness (MT) post smoke inhalation, but the analysis relied on manual segmentation. The aim of this study is to assess in vivo proximal airway volume (PAV) after inhalation injury using automated OCT segmentation and correlate the PAV to lung function for rapid indication of ARDS. Methods Anesthetized ...

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    6. Geometric Validation of Continuous, Finely Sampled 3-D Reconstructions From aOCT and CT in Upper Airway Models

      Geometric Validation of Continuous, Finely Sampled 3-D Reconstructions From aOCT and CT in Upper Airway Models

      Identification and treatment of obstructive airway disorders (OADs) are greatly aided by imaging of the geometry of the airway lumen. Anatomical optical coherence tomography (aOCT) is a promising high-speed and minimally invasive endoscopic imaging modality for providing micrometer-resolution scans of the upper airway. Resistance to airflow in OADs is directly caused by the reduction in luminal cross-sectional area (CSA). It is hypothesized that aOCT can produce airway CSA measurements as accurate as that from computed tomography (CT). Scans of machine hollowed cylindrical tubes were used to develop methods for segmentation and measurement of airway lumen in CT and aOCT. Simulated ...

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    7. MUcociliary Clearance IN Stroke

      MUcociliary Clearance IN Stroke

      Survival and functional outcome of stroke is strongly depending on the occurence of pneumonia (stroke-associated pneumonia, SAP). Early diagnose and treatment of SAP is paramount in the treatment of stroke patients. While dysphagia strongly contributes to its pathogenesis, recent years have also shown a strong risk-modulation by CNS injury induced immunosuppression, making stroke patients more susceptible to SAP. Additionally, murine models of stroke showed changes in mucociliary clearance as possible contributors to SAP. It remains unclear, whether structural integrity and mucociliary clearance of the respiratory epithel change in stroke patients, and whether these changes might contribute to the occurence of ...

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    8. Optical Coherence Tomography for Assessment of the Treatment Effect of Tiotropium in Early Stage of COPD

      Optical Coherence Tomography for Assessment of the Treatment Effect of Tiotropium in Early Stage of COPD

      The study aims to explore the reversibility of airway remodeling by Endobronchial Optical Coherence Tomography (EB-OCT). In this study, EB-OCT is used to assess the treatment effect of Tiotropium in early stage of COPD. Investigators recruit COPD patients in Grade A and Grade C according to GOLD 2019. Patients in Grade A will begin to use Tiotropium once daily, and EB-OCT, pulmonary function test and chest CT will be performed in baseline, 6 months, 1 year and 2 year. Patients in Grade C will begin to use LABA+LAMA (including but not limited to Olodaterol / Tiotropium) or LAMA (Tiotropium) , same ...

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    9. University of Alabama Receives NIH Grant for The Mechanisms Underlying Abnormal Mucus and Its Clearance in the Cystic Fibrosis Rat

      University of Alabama Receives NIH Grant for The Mechanisms Underlying Abnormal Mucus and Its Clearance in the Cystic Fibrosis Rat

      University of Alabama at Birmingham Receives a 2019 NIH Grant for $135,841 for The Mechanisms Underlying Abnormal Mucus and Its Clearance in the Cystic Fibrosis Rat. The principal investigator is Susan Birket. The program began in 2017 and ends in 2022. Below is a summary of the proposed work. Abnormal mucociliary clearance (MCC) is a critical component of cystic fibrosis (CF) lung disease, especially in the presence of infection; however, the mechanisms responsible for the defect are not well understood. Until recently, evaluation of this question has been primarily limited to cell culture models which do not replicate the ...

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    10. Redox imaging and optical coherence tomography of the respiratory ciliated epithelium

      Redox imaging and optical coherence tomography of the respiratory ciliated epithelium

      Optical coherence tomography (OCT) is an emerging technology for in vivo< airway and lung imaging. However, OCT lacks sensitivity to the metabolic changes caused by inflammation, which drives chronic respiratory diseases such as asthma and chronic obstructive pulmonary disorder. Redox imaging (RI) is a label-free technique that uses the autofluorescence of the metabolic coenzymes NAD(P)H and flavin adenine dinucleotide (FAD) to probe cellular metabolism and could provide complimentary information to OCT for airway and lung imaging. We demonstrate OCT and RI of respiratory ciliated epithelial function in ex vivo mouse tracheae. We applied RI to measure cellular metabolism ...

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    11. University of Alabama Receives NIH Grant for Functional Categorization of Ciliary Motion in PCD

      University of Alabama Receives NIH Grant for Functional Categorization of Ciliary Motion in PCD

      University of Alabama at Birmingham Receives a 2019 NIH Grant for $159,882 for Functional Categorization of Ciliary Motion in PCD. The principal investigator is George Solomon. The program began in 2019 and ends in 2023. Below is a summary of the proposed work. Primary Ciliary Dyskinesia (PCD) is a genetically heterogeneous disorder of motile cilia that results in progressive lung disease due to abrogated mucociliary clearance. While new understandings of the genetics have been helpful for clinical diagnostics, functional testing of cilia are needed to understand and predict phenotypic variation and response to therapy. Recent work in our laboratory ...

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    12. Integrated ultrasound, OCT, PA and/or florescence imaging endoscope for diagnosing cancers in gastrointestinal, respiratory, and urogenital tracts

      Integrated ultrasound, OCT, PA and/or florescence imaging endoscope for diagnosing cancers in gastrointestinal, respiratory, and urogenital tracts

      A multimodality imaging system including ultrasound, optical coherence tomography (OCT), photoacoustic (PA) imaging, florescence imaging and endoscopic catheter for imaging inside the gastrointestinal tract with real-time automatic image co-registration capability, including: an ultrasound subsystem for imaging; an optical coherence tomography (OCT) subsystem for imaging, a PA microscopy or tomography subsystem for imaging and a florescence imaging subsystem for imaging. An invasive interventional imaging device is included with an instrumentality to take a tissue biopsy from a location visible on the ultrasound subsystem for imaging, on the optical coherence tomography (OCT) subsystem for imaging, photoacoustic (PA) subsystem for imaging and florescence ...

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    13. Mapping the human pulmonary venoatrial junction with optical coherence tomography

      Mapping the human pulmonary venoatrial junction with optical coherence tomography

      Imaging guidance provided by optical coherence tomography (OCT) could improve the outcomes of atrial fibrillation (AF) ablation by providing detailed structural information of the pulmonary veins, which are critical targets during ablation. In this study, stitched volumetric OCT images of venoatrial junctions from post-mortem human hearts were acquired and compared to histology. Image features corresponding to venous media and myocardial sleeves, as well as fiber orientation and fibrosis, were identified and found to vary between veins. Imaging of detailed tissue architecture could improve understanding of the AF structural substrate within the pulmonary veins and assist the guidance of ablation procedures.

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    14. Acute Airway Effects of Bronchial Thermoplasty Assessed by Optical Coherence Tomography (OCT)

      Acute Airway Effects of Bronchial Thermoplasty Assessed by Optical Coherence Tomography (OCT)

      Background: Bronchial Thermoplasty (BT) is an endoscopic treatment for severe asthma targeting airway smooth muscle (ASM) with thermal energy. The extent of treatment effect is largely unknown. Optical coherence tomography (OCT) is a high resolution imaging technique, using near-infrared light, that generates near-histology cross sectional images of the airway wall. Aim: Assess the extent of acute airway wall effects of BT with OCT and compare these to the untreated right middle lobe (RML). Methods: 15 severe asthma patients were treated with BT. During the third procedure, OCT imaging was performed in BT treated (sub)segmental airways in the upper lobes ...

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    15. Point-of-care endoscopic optical coherence tomography detects changes in mucosal thickness in ARDS due to smoke inhalation and burns

      Point-of-care endoscopic optical coherence tomography detects changes in mucosal thickness in ARDS due to smoke inhalation and burns

      Background The prevalence of acute respiratory distress syndrome (ARDS) in mechanically ventilated burn patients is 33%, with mortality varying from 11–46% depending on ARDS severity. Despite the new Berlin definition for ARDS, prompt bedside diagnosis is lacking. We developed and tested a bedside technique of fiberoptic-bronchoscopy-based optical coherence tomography (OCT) measurement of airway mucosal thickness (MT) for diagnosis of ARDS following smoke inhalation injury (SII) and burns. Methods 16 female Yorkshire pigs received SII and 40% thermal burns. OCT MT and PaO 2 -to-FiO 2 ratio (PFR) measurements were taken at baseline, after injury, and at 24, 48, and ...

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    16. Optical coherence tomography in the diagnosis of sarcoidosis of lung and other organs

      Optical coherence tomography in the diagnosis of sarcoidosis of lung and other organs

      Sarcoidosis is a disease involving abnormal collections of inflammatory cells that form lumps known as granulomas. The disease can affect the lungs, skin, lymph nodes, eyes, liver, heart, and brain. As for the eyes it occupies 3-4 place among organs-target. Diagnosis of eye sarcoidosis is quite complicated and is usually found in ophthalmologic examination. Objective: Studying of diagnostic significance of additional methods of ophthalmology examination for sarcoidosis of lung and other localizations. Methods: It was a prospective investigation. The study group consisted of patients with the first identified sarcoidosis in different organs. The control group consisted of patients with tuberculosis ...

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    17. Combined anatomical optical coherence tomography and intraluminal pressure reveal viscoelasticity of the in vivo airway

      Combined anatomical optical coherence tomography and intraluminal pressure reveal viscoelasticity of the in vivo airway

      It is hypothesized that the local, viscoelastic (time-dependent) properties of the airway are important to accurately model and ultimately predict dynamic airway collapse in airway obstruction. Toward this end, we present a portable, endoscopic, swept-source anatomical optical coherence tomography (aOCT) system combined with a pressure catheter to capture local airway dynamics in vivo during respiration. aOCT scans were performed in the airways of a mechanically ventilated pig under paralysis with dynamic and static ventilation protocols. Validation of dynamic aOCT luminal cross-sectional area (CSA) measurements against Cine CT, obtained during the same exam, showed an aggregate difference of 15  %    ±  3  %  . aOCT-derived ...

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    18. Geometric Validation of Continuous, Finely-Sampled 3D Reconstructions from aOCT and CT in Upper Airway Models

      Geometric Validation of Continuous, Finely-Sampled 3D Reconstructions from aOCT and CT in Upper Airway Models

      Identification and treatment of obstructive airway disorders (OADs) is greatly aided by imaging of the geometry of the airway lumen. Anatomical optical coherence tomography (aOCT) is a promising high-speed and minimally-invasive endoscopic imaging modality for providing micrometer-resolution scans of the upper airway. Resistance to airflow in OADs is directly caused by reduction in luminal cross-sectional area (CSA). It is hypothesized that aOCT can produce airway CSA measurements as accurate as that from computed tomography (CT). Scans of machine hollowed cylindrical tubes were used to develop methods for segmentation and measurement of airway lumen in CT and aOCT. Simulated scans of ...

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    19. Significances of spirometry and impulse oscillometry for detecting small airway disorders assessed with endobronchial optical coherence tomography in COPD

      Significances of spirometry and impulse oscillometry for detecting small airway disorders assessed with endobronchial optical coherence tomography in COPD

      Background: Spirometry confers limited value for identifying small-airway disorders (SADs) in early-stage COPD, which can be detected with impulse oscillometry (IOS) and endobronchial optical coherence tomography (EB-OCT). Whether IOS is useful for reflecting small-airway morphological abnormalities in COPD remains unclear. Objectives: To compare the diagnostic value of spirometry and IOS for identifying SADs in heavy-smokers and COPD based on the objective assessment with EB-OCT. Methods: We recruited 59 COPD patients (stage I, n=17; stage II, n=18; stage III–IV, n=24), 26 heavy-smokers and 21 never-smokers. Assessments of clinical characteristics, spirometry, IOS and EB-OCT were performed. Receiver operation ...

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    20. Bronchial Thermoplasty-Induced Acute Airway Effects Assessed with Optical Coherence Tomography in Severe Asthma

      Bronchial Thermoplasty-Induced Acute Airway Effects Assessed with Optical Coherence Tomography in Severe Asthma

      Background: Bronchial thermoplasty (BT) is an endoscopic treatment for severe asthma targeting airway smooth muscle (ASM) with radiofrequent energy. Although implemented worldwide, the effect of BT treatment on the airways is unclear. Optical coherence tomography (OCT) is a novel imaging technique, based on near-infrared light, that generates high-resolution cross-sectional airway wall images. Objective: To assess the safety and feasibility of OCT in severe asthma patients and determine acute airway effects of BT by OCT and compare these to the untreated right middle lobe (RML). Methods: Severe asthma patients were treated with BT (TASMA trial). During the third BT procedure, OCT ...

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    21. Upper airway reconstruction using long‐range optical coherence tomography: Effects of airway curvature on airflow resistance

      Upper airway reconstruction using long‐range optical coherence tomography: Effects of airway curvature on airflow resistance

      Objectives Adenotonsillectomy (AT) is commonly used to treat upper airway obstruction in children, but selection of patients who will benefit most from AT is challenging. The need for diagnostic evaluation tools without sedation, radiation, or high costs has motivated the development of long‐range optical coherence tomography (LR‐OCT), providing real‐time cross‐sectional airway imaging during endoscopy. Since the endoscope channel location is not tracked in conventional LR‐OCT, airway curvature must be estimated and may affect predicted airway resistance. The study objective was to assess effects of three realistic airway curvatures on predicted airway resistance using computational fluid ...

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    22. Upper airway imaging in sleep-disordered breathing

      Upper airway imaging in sleep-disordered breathing

      Our understanding of sleep-disordered breathing has evolved considerably over the past three decades, and clinical techniques of evaluation have progressed tremendously. Myriad imaging techniques are now available for the physician to approach the dynamic features resulting in turbulent airflow, upper airway narrowing or collapse at different levels. Controversy exists in the choice of investigations, probably because the best evaluation should be a combination of different techniques. Physical, radiographic, endoscopic and acoustic evaluations could be integrated to understand the degree and the levels of airway reduction and/or obstruction in a given patient. This review focuses on cost-effective and easily implemented ...

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    23. Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy

      Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy

      Background: Transbronchial needle aspiration (TBNA), often used to sample lymph nodes for lung cancer staging , is subject to sampling error even when performed with endobronchial ultrasound. Optical coherence tomography (OCT) is a high-resolution imaging modality that rapidly generates helical cross-sectional images. We aim to determine if needle-based OCT can provide microstructural information in lymph nodes that may be used to guide TBNA, and improve sampling error. Methods: We performed ex vivo needle-based OCT on thoracic lymph nodes from patients with and without known lung cancer. OCT imaging features were compared against matched histology. Results: OCT imaging was performed in 26 ...

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    24. Optical coherence tomography (OCT) imaging of dynamic airway behavior in an asthma model

      Optical coherence tomography (OCT) imaging of dynamic airway behavior in an asthma model

      To better understand bronchoconstriction in asthma, it is critical to dynamically visualize airway behavior in vivo. However, currently available imaging techniques do not have sufficient temporal and spatial resolution to investigate airway dynamics. We propose to use endobronchial Optical Coherence Tomography (OCT) to provide real-time cross-sectional images of airway dynamics with a high spatial resolution. Our aim was to study the structure and function of spatially distinct airways during tidal breathing (TB), breath-holds (BH) at end inspiration, and in a response to single deep inspiration (DI) and multiple DI (MDI) in a preclinical sheep asthma model. Anesthetized and mechanically ventilated ...

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