Optical Coherence Tomography Imaging for the Diagnosis of Airway Tumors In Vivo

Abstract

SESSION TITLE: Lung Cancer Screening & Diagnosis Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: Optical Coherence Tomography (OCT) is a non-contact optical imaging modality that provides tomographic images of tissue at resolutions comparable with architectural histology (<10 microns) to a depth of approximately 3mm. Using surgical and autopsy specimens, we have previously developed and validated OCT interpretation criteria using histological features for the detection and diagnosis of pulmonary malignancy. In this study we assess the accuracy of these criteria when applied to images collected in vivo. METHODS: OCT imaging was conducted in healthy subjects and in patients with known pulmonary malignancy. Imaging was performed during bronchoscopy using a custom OCT catheter passed through the working channel of a standard bronchoscope. Images of patients with biopsy confirmed lung cancer and those of normal healthy subjects were placed in a randomized test set and were reviewed by a blinded OCT reader and pathologist trained in the interpretation criteria. The reader was asked to identify the images as adenocarcinoma, squamous cell carcinoma, poorly differentiated tumor, or normal tissue. RESULTS: Of 19 patients (2 adenocarcinoma, 5 squamous cell carcinoma, 1 poorly differentiated carcinoma, and 11 normal) that were reviewed, 89.5% were diagnosed correctly. Our reader was able to detect adenocarcinoma with a sensitivity of 100% and specificity of 94% and to detect squamous cell carcinoma with a sensitivity of 80% and specificity of 100%. The overall sensitivity and specificity in detecting lung cancer (adenocarcinoma, squamous cell, and poorly differentiated carcinoma) was 87.5% and 90.9% respectively. CONCLUSIONS: Our pilot study demonstrates that OCT has good sensitivity and specificity in the diagnosis of adenocarcinoma and squamous cell carcinoma involving airways. Further studies with a larger sample size are needed to better evaluate the true clinical potential of this imaging modality. CLINICAL IMPLICATIONS: OCT may serve a role as an adjunctive imaging modality in the detection and diagnosis of lung cancers involving airways. DISCLOSURE: Melissa Suter: Grant monies (from sources other than industry): National Institutes of Health grant numbers R01CA167827, R00CA134920. NinePoint Medical, Grant monies (from industry related sources): NinePoint Medical, Other: Dr Suter is an author on MGH owned patents that have been licensed to NinePoint Medical. The following authors have nothing to disclose: Christopher Manley, Lida Hariri, David Adams, Michael Lanuti, Colleen Channick, Colleen Keyes, Carla Lamb, John Beamis, David Riker, Josalyn Cho, R Harris, Andrew Luster, Benjamin Medoff Optical Coherence Tomography is not an approved therapy or diagnostic modality for diagnosis or treatment of lung cancer. Imaging of lung tumors in vivo with OCT is a novel technique.