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Using Optical Coherence Tomography To Improve Diagnostic and Therapeutic Bronchoscopy

Jonathan P. Williamson, MBBS; Robert A. McLaughlin, PhD; Martin J. Phillips, MBBS; Julian J. Armstrong, PhD; Sven Becker, MSc; Jennifer H. Walsh, PhD; David D. Sampson, PhD; David R. Hillman, MBBS; Peter R. Eastwood, PhD
Author and Funding Information

From the Department of Pulmonary Physiology (Drs. Williamson, Phillips, Hillman, and Eastwood), Sir Charles Gairdner Hospital, Perth, WA, Australia; West Australian Sleep Disorders Research Institute (Dr. Walsh), Perth, WA, Australia; and the Optical + Biomedical Engineering Laboratory (Drs. McLaughlin, Armstrong, and Sampson, and Mr. Becker), School of Electrical, Electronic & Computer Engineering, University of Western Australia, Perth, WA, Australia.

Correspondence to: Jonathan Williamson, MBBS, Sir Charles Gairdner Hospital, Department of Pulmonary Physiology, Hospital Ave, Nedlands, Perth, WA 6009, Australia; Jonathan.Williamson@health.wa.gov.au


This research has been funded by an Australian National Health and Medical Research Council (NHMRC) project grant (No. 513854). Dr. Williamson was funded by an Australian NHMRC Postgraduate Medical Scholarship (No. 463926), a Sir Charles Gairdner Hospital Research Grant, and a University of Western Australia top-up grant.

Drs. Williamson, McLaughlin, Phillips, Armstrong, Walsh, Sampson, Hillman, and Eastwood are listed as inventors on a provisional patent application associated with clinical applications of anatomical optical coherence tomography. Dr. McLaughlin's salary is currently funded by university grant monies provided by the Raine Medical Research Foundation, which has no commercial interest in anatomical optical coherence tomography. Dr. McLaughlin was employed by Siemens Medical Solutions from 2006 to 2007 in an unrelated medical field; his employment ceased in 2007. Mr. Becker has no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(1):272-276. doi:10.1378/chest.08-2800
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Flexible bronchoscopy is a common procedure that is used in both diagnostic and therapeutic settings but does not readily permit measurement of central airway dimensions. Anatomic optical coherence tomography (a OCT), a modification of conventional optical coherence tomography (OCT), is a novel light-based imaging tool with the capacity to measure the diameter and lumen area of the central airways accurately during bronchoscopy. This study describes the first clinical use of aOCT imaging in the lower airways in three individuals with common endobronchial pathologies. During bronchoscopy, a specialized fiberoptic probe was passed through the biopsy channel of a standard flexible bronchoscope to the site of airway pathology. Airway dimensions were measured from the generated cross-sectional images in three subjects, one with subglottic tracheal stenosis (subject 1), one with malignant left main bronchus (LMB) obstruction (subject 2), and another with severe tracheomalacia (subject 3). Measured dimensions included internal airway diameter, cross-sectional area, and, in subject 1, stenosis length. Tracheal stenosis dimensions, measured using aOCT imaging, correlated with chest CT scan findings and guided the choice of airway stent (subject 1). The airway beyond a malignant obstruction of the LMB, and beyond bronchoscopic view, could be imaged using aOCT, and the distal extent of obstructing tumor identified (subject 2). The severity of newly diagnosed tracheomalacia was able to be quantified using aOCT imaging (subject 3). aOCT imaging during bronchoscopy allows accurate real-time airway measurements and may assist bronchoscopic assessment.

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