Recent Advances in Optical Coherence Tomography for the Diagnoses of Lung Disorders

Randy Hou; Tho Le; Septimiu D Murgu; Zhongping Chen; Matt Brenner

Disclosures

Expert Rev Resp Med. 2011;5(5):711-724. 

In This Article

Therapeutic Applications

Optimal computed tomography is a diagnostic modality, and in itself is not a therapeutic device. However, its ability to create ultra-high resolution images in real time enables OCT to potentially be used in conjunction with therapeutic procedures as a guidance tool.

A case study was presented of a patient with severe, symptomatic tracheal stenosis. Multimodality imaging was used to assist in the endotracheal excision and dilation of the stenotic region, including rigid bronchoscopy utilizing conventional WLB high-frequency endobronchial ultrasound and OCT. Both endobronchial ultrasound and OCT were able to provide real time images differentiating normal tissue from hypertrophic and fibrotic tissue as well as cartilage. In this case, OCT was able to provide margins for the area of stenosis, and possibly prevent both excessive unresected hypertrophic and fibrotic tissue as well as excessive destruction of normal tissue.[41]

In a case series, patients with early-stage laryngeal cancer underwent minimally invasive laser surgery. Again, OCT was employed to obtain real time ultrahigh-resolution images of the larynx, and OCT was able to distinguish normal tissue from malignant tissue. With real time confirmation of tumor borders, OCT provided the surgeon with intraoperative guidance of the resection procedure. Follow-up of these patients showed good preservation of laryngeal structure and function, and the authors concluded that OCT was useful in minimizing collateral damage. It was also suggested that OCT could be useful in guiding the area of surgical biopsy in making the initial diagnosis of laryngeal cancer, although it is unclear if this technique was used in this study.[15] There are substantial limitations to the above research. The small size and lack of control groups limits the usefulness of these studies. Larger randomized control studies are needed to further validate the usefulness of OCT in guidance of therapeutic procedures.

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