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Optical coherence tomography (OCT) imaging of chronic lung allograft dysfunction (CLAD)
Author(s): Jeanie Malone; Anthony M. D. Lee; Geoffrey Hohert; Roland Nador; Pierre Lane
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Paper Abstract

This study explores endobronchial optical coherence tomography (OCT) imaging of lung transplant patients with chronic lung allograft dysfunction (CLAD). Optical coherence tomography (OCT), the optical analog of ultrasonography with superior resolution (10μm) but shallow (2mm) penetration, allows for the visualization of the early structural changes in the small airways, which is of interest in CLAD progression. Imaging was conducted with a catheter-based rotary OCT probe during routine bronchoscopy procedures, resulting in three-dimension pullbacks of three subsegmental airways per patient (n=9). A scoring rubric for visualized features of interest was used to quantify characteristics of the image set: loss of alveolar visualization, emphysema-like alveolar enlargement, alveolar hyperinflation, airway dilation, excessive mucous, excessive duct-like structures, and an unidentified structure. Four raters, blinded to clinical status, scored the set. Statistical analysis including Pearson correlation coefficients (R), Fleiss’ Kappa (κ) were used on this score set to assess preliminary potential of these features. 3/9 patients met the diagnostic criteria for both obstructive (BOS) and restrictive (RAS) phenotypes of CLAD and 6/9 for solely the obstructive phenotype. The airway dilation feature was found to be significantly associated (p<0.05) with the BOS+RAS diagnosis for three raters (R=0.72-0.94), with fairly consistent rater reliability (κinterrater = 0.25, κintrarater = 0.59). No OCT features were significantly correlated with infection status. Small airway dilation, as measured through catheterized OCT imaging, shows potential for use in detection of CLAD and distinguishing between CLAD phenotypes.

Paper Details

Date Published: 19 July 2019
PDF: 5 pages
Proc. SPIE 11073, Clinical and Preclinical Optical Diagnostics II, 110731J (19 July 2019); doi: 10.1117/12.2527205
Show Author Affiliations
Jeanie Malone, British Columbia Cancer Research Ctr. (Canada)
Anthony M. D. Lee, British Columbia Cancer Research Ctr. (Canada)
Geoffrey Hohert, British Columbia Cancer Research Ctr. (Canada)
Roland Nador, The Univ. of British Columbia (Canada)
Pierre Lane, British Columbia Cancer Research Ctr. (Canada)


Published in SPIE Proceedings Vol. 11073:
Clinical and Preclinical Optical Diagnostics II
J. Quincy Brown; Ton G. van Leeuwen, Editor(s)

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