Advances in methods for diagnosis of airway malignancy are needed. Optical Coherence Tomography (OCT) is an evolving technology, capable of generating high-resolution cross-sectional images at near histological levels of complex tissue in real-time. Analogous to ultrasound, OCT measures backscattered light intensity using coherence interferometery to construct topographical images and has the potential to image airways during flexible fiberoptic bronchoscopy. Lung Imaging Fluorescence Endoscopy (LIFE) uses the endogenous fluorescence properties of malignant and dysplastic tissue to obtain low-resolution surveillance imaging to localize suspicious airways for further investigation. This study demonstrates how low resolution localization with LIFE can be combined with high-resolution OCT bronchoscopic evaluation in patients to delineate proximal airway microstructures in trachea and bronchi.
In-vivo airways were imaged in patients in real time using LIFE followed by flexible fiberoptic bronchoscopic imaging of suspicious areas using a prototype 1300 nm broadband super-luminescent diode based OCT system constucted in our laboratory. The OCT system produced high-resolution structural images during bronchoscopy. The conventional white light bronchoscopic images, LIFE, and OCT images were compared to hematoxilin and eosin (H&E) stained histological sections from these regions.
Combined LIFE and OCT imaging was readily obtained via flexible fiberoptic bronchoscopy of the airways in patients. OCT was able to delineate microstructures such as the epithelium, mucosa, cartilage, and glands.
This is the first study to demonstrate the feasibility of high resolution bronchoscopic OCT guided by LIFE. These findings suggest that the integration of high resolution OCT with flexible fiberoptic bronchoscopy and LIFE could enhance pulmonary diagnostic medicine and detection of pathologic tissue changes in respiratory diseases.
In the future OCT with near histologic resolution can be used with LIFE for flexible fiberoptic bronchoscopic diagnostic imaging.
T.W. Waddington, None.