Abstract
Optical coherence tomography (OCT) is a promising imaging technique to evaluate small airway remodeling. However, the short-term insertion-reinsertion reproducibility of OCT for evaluating the same bronchial pathway has yet to be established. We evaluated 74 OCT data sets from 38 current or former smokers twice within a single imaging session. Although the overall insertion-reinsertion airway wall thickness (WT) measurement coefficient of variation (CV) was moderate at 12%, much of the variability between repeat imaging was attributed to the observer; CV for repeated measurements of the same airway (intra-observer CV) was 9%. Therefore, reproducibility may be improved by introduction of automated analysis approaches suggesting that OCT has potential to be an in-vivo method for evaluating airway remodeling in future longitudinal and intervention studies.
Highlights
The structural changes and thickening of the airway wall components that occur in individuals with chronic respiratory diseases – known as airway remodeling – are thought to be responsible for many of the adverse outcomes associated with disease
We demonstrated that insertion-reinsertion reproducibility of the Optical coherence tomography (OCT) probe was greatest in the right lung than the left (74% vs. 29%)
We demonstrated that while the overall insertion-reinsertion airway wall thickness measurement reproducibility was moderate in the peripheral airways (CV = 12%), much of the variability between repeat imaging was attributed to the observer
Summary
The structural changes and thickening of the airway wall components that occur in individuals with chronic respiratory diseases – known as airway remodeling – are thought to be responsible for many of the adverse outcomes associated with disease. Our understanding of airway wall remodeling is based on studies that directly examine lung tissue, typically post-mortem, or indirectly make inferences about structure by investigating the functional effects of airway remodeling, such as spirometry measurements of airflow limitation. To understand airway remodeling direct measurements of the airway wall in living subjects are required. Airway diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are known to be highly regional affecting only certain airways in the lung, and, as such, global functional measurements cannot provide us with any detailed structural or regional information to better understand, characterize and possibly treat the specific remodeled airway walls. Investigations using OCT demonstrated that airway wall measurements correlated significantly with CT and spirometry [5], but OCT can identify airway wall components in vivo that until now have only been visualized using histology [3, 4]
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