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Published ahead of print on February 28, 2008, doi:10.1164/rccm.200712-1776OC

Am. J. Respir. Crit. Care Med., Volume 177, Number 11, June 2008, 1201-1206

A more recent version of this article appeared on June 1, 2008
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Submitted on December 3, 2007
Accepted on February 28, 2008

Airway Wall Thickness Assessed Using Computed Tomography and Optical Coherence Tomography

Harvey O Coxson1*, Brendan Quiney1, Don D Sin2, Li Xing3, Annette M McWilliams4, John R Mayo5, and Stephen Lam4

1 Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada; The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research at The Heart and Lung Center of St Paul's Hospital, Vancouver, BC, Canada, 2 The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research at The Heart and Lung Center of St Paul's Hospital, Vancouver, BC, Canada; Department of Medicine(Respiratory Division), The University of British Columbia, Vancouver, BC, Canada, 3 The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research at The Heart and Lung Center of St Paul's Hospital, Vancouver, BC, Canada, 4 British Columbia Cancer Agency, Vancouver, BC, Canada; Department of Medicine(Respiratory Division), The University of British Columbia, Vancouver, BC, Canada, 5 Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada

* To whom correspondence should be addressed. E-mail: harvey.coxson{at}vch.ca.

Rationale: Computed tomography (CT) has been shown to reliably measure the airway wall dimensions of medium to large airways. Optical coherence tomography (OCT) is a promising new micron-scale resolution imaging technique that can image small airways two millimeters in diameter or less. Objectives: To correlate OCT measurements of airway dimensions with measurements assessed using CT scans and lung function. Methods: Forty-four current and former smokers received spirometry, CT scans and OCT imaging at the time of bronchoscopy. Specific bronchial segments were identified and measured using the OCT images and three-dimensional reconstructions of the bronchial tree using CT. Measurements and Main Results: There was a strong correlation between CT and OCT measurements of lumen and wall area (r=0.84, p<0.001 and r=0.89 p<0.001 respectively). Compared to CT, OCT measurements were lower for both lumen and wall area by 31% and 66 %, respectively. The correlation between FEV1 % predicted and CT and OCT measured wall area (as percentage of the total area) of fifth generation airways was very strong (r = -0.79, r=-0.75)but the slope of the relationship was much steeper using OCT than using CT (y = -0.33x + 82, y = -0.1x + 78) indicating greater sensitivity of OCT in detecting changes in wall measurements that relate to FEV1. Conclusion: OCT can be used to measure airway wall dimensions. OCT may be more sensitive at detecting small airway wall changes that lead to FEV1 changes in individuals with obstructive airways disease.


Key words: Chronic Obstructive Pulmonary Disease




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