Feasibility of Assessing the Abnormal Pediatric Airway Using Rotational Optical Coherence Tomography: The OCT Air Study

Sune Rubak; Anne Katrine Bak Poulsen; Signe Thim; Nagarajan Muthialu; Thomas Kjærgaard; Emil Nielsen Holck

doi:10.1016/j.chpulm.2024.100120

Feasibility of Assessing the Abnormal Pediatric Airway Using Rotational Optical Coherence Tomography: The OCT Air Study

Sune Rubak, Anne Katrine Bak Poulsen, Signe Thim, Nagarajan Muthialu, Thomas Kjærgaard, Emil Nielsen Holck

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background Methods currently used to assess and diagnose abnormalities of pediatric airways have several limitations: CT scans involve a risk of ionizing radiation and diagnostic dynamic bronchoscopies have high interobserver variability. Advanced diagnostic methods for evaluating the dynamic airway are needed to enable newer interventions (eg, airway stenting) in select children. The study objective was to investigate the feasibility of optical coherence tomography (OCT) as a measuring method that facilitates accurate, quantifiable, and real-time cross-sectional imaging of the airway. Research Question Is bronchoscopy-guided quantitative OCT of the lower pediatric airway a feasible method and does it increase diagnostic possibilities? Study Design and Methods We evaluated a series of 10 children with severe persistent respiratory symptoms with a clinical indication for diagnostic dynamic bronchoscopy (DDB). Feasibility of OCT was defined as the ability to visualize and quantify airway stenoses and dynamic airway collapse in the pediatric airway without procedural complications. Furthermore, the study included a porcine model to calculate the correction constant for the OCT measurements in air in comparison with contrast fluid. Results Ten children 0 to 14 years of age were included. In total, 34 airway segments were OCT scanned. Results showed that OCT is a feasible method for visualizing and quantifying stenoses of the lower pediatric airway by measuring the mean and minimum lumen areas. The correction constant of OCT in air was 1.3 (interquartile range, 1.29-1.31) in comparison with contrast. Visual assessment of the minimum lumen area stenosis by dynamic bronchoscopy significantly varies in comparison with OCT assessment (18.416%; 95% CI, 8.93-27.91; P = .0018). Interpretation OCT demonstrated feasibility of providing quantitative assessments of clinical manifestations including cross-sectional imaging in the pediatric airway. The correction constant for optimal quantification was calculated and provided the possibility for precise interpretation of OCT measurements. Further studies are needed to investigate safety, accuracy, and efficacy of OCT in the lower pediatric airway.

Original language	Danish
Journal	CHEST Pulmonary
ISSN	2949-7892
DOIs	https://doi.org/10.1016/j.chpulm.2024.100120
Publication status	Accepted/In press - 2024

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10.1016/j.chpulm.2024.100120

https://www.sciencedirect.com/science/article/pii/S2949789224000862

Cite this

@article{1b3115bcd46e4cc6afd2c400b8dd5402,

title = "Feasibility of Assessing the Abnormal Pediatric Airway Using Rotational Optical Coherence Tomography: The OCT Air Study",

abstract = "Background Methods currently used to assess and diagnose abnormalities of pediatric airways have several limitations: CT scans involve a risk of ionizing radiation and diagnostic dynamic bronchoscopies have high interobserver variability. Advanced diagnostic methods for evaluating the dynamic airway are needed to enable newer interventions (eg, airway stenting) in select children. The study objective was to investigate the feasibility of optical coherence tomography (OCT) as a measuring method that facilitates accurate, quantifiable, and real-time cross-sectional imaging of the airway. Research Question Is bronchoscopy-guided quantitative OCT of the lower pediatric airway a feasible method and does it increase diagnostic possibilities? Study Design and Methods We evaluated a series of 10 children with severe persistent respiratory symptoms with a clinical indication for diagnostic dynamic bronchoscopy (DDB). Feasibility of OCT was defined as the ability to visualize and quantify airway stenoses and dynamic airway collapse in the pediatric airway without procedural complications. Furthermore, the study included a porcine model to calculate the correction constant for the OCT measurements in air in comparison with contrast fluid. Results Ten children 0 to 14 years of age were included. In total, 34 airway segments were OCT scanned. Results showed that OCT is a feasible method for visualizing and quantifying stenoses of the lower pediatric airway by measuring the mean and minimum lumen areas. The correction constant of OCT in air was 1.3 (interquartile range, 1.29-1.31) in comparison with contrast. Visual assessment of the minimum lumen area stenosis by dynamic bronchoscopy significantly varies in comparison with OCT assessment (18.416%; 95% CI, 8.93-27.91; P = .0018). Interpretation OCT demonstrated feasibility of providing quantitative assessments of clinical manifestations including cross-sectional imaging in the pediatric airway. The correction constant for optimal quantification was calculated and provided the possibility for precise interpretation of OCT measurements. Further studies are needed to investigate safety, accuracy, and efficacy of OCT in the lower pediatric airway.",

keywords = "children, diagnostic dynamic bronchoscopy (DDB), optical coherence tomography (OCT), optical frequency domain imaging (OFDI), pediatric, pulmonology",

author = "Sune Rubak and Poulsen, {Anne Katrine Bak} and Signe Thim and Nagarajan Muthialu and Thomas Kj{\ae}rgaard and Holck, {Emil Nielsen}",

year = "2024",

doi = "10.1016/j.chpulm.2024.100120",

language = "Dansk",

journal = "CHEST Pulmonary",

issn = "2949-7892",

}

TY - JOUR

T1 - Feasibility of Assessing the Abnormal Pediatric Airway Using Rotational Optical Coherence Tomography

T2 - The OCT Air Study

AU - Rubak, Sune

AU - Poulsen, Anne Katrine Bak

AU - Thim, Signe

AU - Muthialu, Nagarajan

AU - Kjærgaard, Thomas

AU - Holck, Emil Nielsen

PY - 2024

Y1 - 2024

N2 - Background Methods currently used to assess and diagnose abnormalities of pediatric airways have several limitations: CT scans involve a risk of ionizing radiation and diagnostic dynamic bronchoscopies have high interobserver variability. Advanced diagnostic methods for evaluating the dynamic airway are needed to enable newer interventions (eg, airway stenting) in select children. The study objective was to investigate the feasibility of optical coherence tomography (OCT) as a measuring method that facilitates accurate, quantifiable, and real-time cross-sectional imaging of the airway. Research Question Is bronchoscopy-guided quantitative OCT of the lower pediatric airway a feasible method and does it increase diagnostic possibilities? Study Design and Methods We evaluated a series of 10 children with severe persistent respiratory symptoms with a clinical indication for diagnostic dynamic bronchoscopy (DDB). Feasibility of OCT was defined as the ability to visualize and quantify airway stenoses and dynamic airway collapse in the pediatric airway without procedural complications. Furthermore, the study included a porcine model to calculate the correction constant for the OCT measurements in air in comparison with contrast fluid. Results Ten children 0 to 14 years of age were included. In total, 34 airway segments were OCT scanned. Results showed that OCT is a feasible method for visualizing and quantifying stenoses of the lower pediatric airway by measuring the mean and minimum lumen areas. The correction constant of OCT in air was 1.3 (interquartile range, 1.29-1.31) in comparison with contrast. Visual assessment of the minimum lumen area stenosis by dynamic bronchoscopy significantly varies in comparison with OCT assessment (18.416%; 95% CI, 8.93-27.91; P = .0018). Interpretation OCT demonstrated feasibility of providing quantitative assessments of clinical manifestations including cross-sectional imaging in the pediatric airway. The correction constant for optimal quantification was calculated and provided the possibility for precise interpretation of OCT measurements. Further studies are needed to investigate safety, accuracy, and efficacy of OCT in the lower pediatric airway.

AB - Background Methods currently used to assess and diagnose abnormalities of pediatric airways have several limitations: CT scans involve a risk of ionizing radiation and diagnostic dynamic bronchoscopies have high interobserver variability. Advanced diagnostic methods for evaluating the dynamic airway are needed to enable newer interventions (eg, airway stenting) in select children. The study objective was to investigate the feasibility of optical coherence tomography (OCT) as a measuring method that facilitates accurate, quantifiable, and real-time cross-sectional imaging of the airway. Research Question Is bronchoscopy-guided quantitative OCT of the lower pediatric airway a feasible method and does it increase diagnostic possibilities? Study Design and Methods We evaluated a series of 10 children with severe persistent respiratory symptoms with a clinical indication for diagnostic dynamic bronchoscopy (DDB). Feasibility of OCT was defined as the ability to visualize and quantify airway stenoses and dynamic airway collapse in the pediatric airway without procedural complications. Furthermore, the study included a porcine model to calculate the correction constant for the OCT measurements in air in comparison with contrast fluid. Results Ten children 0 to 14 years of age were included. In total, 34 airway segments were OCT scanned. Results showed that OCT is a feasible method for visualizing and quantifying stenoses of the lower pediatric airway by measuring the mean and minimum lumen areas. The correction constant of OCT in air was 1.3 (interquartile range, 1.29-1.31) in comparison with contrast. Visual assessment of the minimum lumen area stenosis by dynamic bronchoscopy significantly varies in comparison with OCT assessment (18.416%; 95% CI, 8.93-27.91; P = .0018). Interpretation OCT demonstrated feasibility of providing quantitative assessments of clinical manifestations including cross-sectional imaging in the pediatric airway. The correction constant for optimal quantification was calculated and provided the possibility for precise interpretation of OCT measurements. Further studies are needed to investigate safety, accuracy, and efficacy of OCT in the lower pediatric airway.

KW - children

KW - diagnostic dynamic bronchoscopy (DDB)

KW - optical coherence tomography (OCT)

KW - optical frequency domain imaging (OFDI)

KW - pediatric

KW - pulmonology

U2 - 10.1016/j.chpulm.2024.100120

DO - 10.1016/j.chpulm.2024.100120

M3 - Tidsskriftartikel

SN - 2949-7892

JO - CHEST Pulmonary

JF - CHEST Pulmonary

ER -