Polarization Sensitive Optical Coherence Tomography for Bronchoscopic Airway Smooth Muscle Detection in Bronchial Thermoplasty-Treated Patients With Asthma

Margherita Vaselli,Pieta C Wijsman,Joy Willemse,Annika W.M Goorsenberg,Fabio Feroldi,Julia N.S D’Hooghe,Jouke T Annema,Johannes F De Boer,Peter I Bonta

doi:10.1016/j.chest.2021.03.042

Abstract

Asthma is a chronic inflammatory disease characterized by airway remodeling (AR), including thickening of airway smooth muscle (ASM) as a key element of this alteration.1 Patients with severe asthma may benefit from bronchial thermoplasty (BT), an endoscopic treatment that targets structural AR and induces ASM reduction.2 Assessment of AR is critical to evaluate the impact of BT and might provide a tool for patient selection for BT. Polarization sensitive optical coherence tomography (PS-OCT) imaging has been proposed as a minimally invasive diagnostic method to assess ASM mass as an alternative to focal airway biopsies.

Highlights

Asthma is a chronic inflammatory disease characterized by airway remodeling (AR), including thickening of airway smooth muscle (ASM) as a key element of this alteration.[1]
This is a substudy of the TASMA (Unravelling Targets of Therapy in Bronchial Thermoplasty in Severe Asthma) trial,[4] in which patients with severe asthma have been treated with bronchial thermoplasty (BT), except for the middle lobe.[5]
Frames acquired proximally in the airway for which with the enlarging of the lumen ASM fall beyond the imaging depth of PSOCT were excluded

Summary

Introduction

Asthma is a chronic inflammatory disease characterized by airway remodeling (AR), including thickening of airway smooth muscle (ASM) as a key element of this alteration.[1]. We measured the percentage of the ASM area over the total OCT cross section, extending from the outer sheath of the catheter to an imaging depth of 1.4 mm, and its average value along the pullback was calculated.

Results

Conclusion