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. 2022 Oct 1;206(7):905-910.
doi: 10.1164/rccm.202112-2832LE.

Polarization-Sensitive Endobronchial Optical Coherence Tomography for Microscopic Imaging of Fibrosis in Interstitial Lung Disease

Sreyankar Nandy  1   2 , Sarita R Berigei  1 , Colleen M Keyes  1   2 , Ashok Muniappan  1   2 , Hugh G Auchincloss  1   2 , Michael Lanuti  1   2 , Benjamin W Roop  1 , Angela R Shih  1   2 , Thomas V Colby  3 , Benjamin D Medoff  1   2 , Melissa J Suter  1   2 , Martin Villiger  1   2 , Lida P Hariri  1   2
Affiliations

Polarization-Sensitive Endobronchial Optical Coherence Tomography for Microscopic Imaging of Fibrosis in Interstitial Lung Disease

Sreyankar Nandy et al. Am J Respir Crit Care Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
Polarization-sensitive endobronchial optical coherence tomography (PS-EB-OCT) visualization of fibrosis distribution in ILD. Volumetric in vivo PS-EB-OCT birefringence images from (A) UIP, showing spatially heterogeneous, dense, destructive, highly birefringent fibrosis (F) with subpleural prominence and embedded honeycombing (HC). (B) NSIP, showing spatially homogeneous, nondestructive, moderately birefringent interstitial fibrosis within alveolar walls (interstitial fibrosis [IF]). (C) ACF, showing proximal, bronchiolocentric, dense, highly birefringent fibrosis (F), distal moderately birefringent IF, and admixed nonbirefringent inflammation (*). (D) Normal lung parenchyma appears as evenly spaced, round alveoli (a) and lattice-like alveolar walls with low-birefringence (aw). Birefringence colormap (lower right) in degrees per 100 μm (blue = no birefringence [0 degrees per 100 μm] to orange = high birefringence [65 degrees per 100 μm]) is overlaid onto conventional EB-OCT images in displayed volumetric reconstructions. ACF = airway-centered fibrosis; ILD = interstitial lung disease; NSIP = nonspecific interstitial pneumonia; UIP = usual interstitial pneumonia.
Figure 2.
Figure 2.
Quantitative measurement of birefringence in fibrosis. (A) Boxplot of birefringence values from destructive fibrosis (tissue with destruction of underlying lung architecture with birefringence present; n = 15 subjects), nondestructive interstitial fibrosis (thickening of alveolar walls with birefringence present; n = 13 subjects), and normal lung parenchyma (thin, lattice-like alveoli with birefringence present; n = 9 subjects). One-way ANOVA showed statistically significant differences between mean birefringence across the tissue types for individual subjects (P < 0.0001). Destructive fibrosis had the highest mean birefringence, followed by interstitial fibrosis. Normal lung had the lowest mean birefringence. Subsequent post hoc Bonferroni tests confirmed statistically significant differences (P < 0.0001) between each pair of tissue types. (B) Further t test analysis comparing mean birefringence from destructive fibrosis in histologically confirmed UIP (n = 8 subjects) versus destructive fibrosis in non-UIP fILD (n = 7 subjects) showed no statistically significant difference (P = 0.18). In each boxplot, the data points corresponding to each subject are represented by dots; the horizontal line in the middle of the box denotes the median value; the bottom and top edges of the box denote the 25th and 75th percentiles, respectively; and the whiskers represent the range of data. ***P < 0.0001. fILD = fibrotic interstitial lung disease; N.S. = not statistically significant; UIP = usual interstitial pneumonia.
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