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Tweel JED, Ecclestone BR, Boktor M, Dinakaran D, Mackey JR, Reza PH. Automated Whole Slide Imaging for Label-Free Histology Using Photon Absorption Remote Sensing Microscopy. IEEE Trans Biomed Eng 2024; 71:1901-1912. [PMID: 38231822 DOI: 10.1109/tbme.2024.3355296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Pathologists rely on histochemical stains to impart contrast in thin translucent tissue samples, revealing tissue features necessary for identifying pathological conditions. However, the chemical labeling process is destructive and often irreversible or challenging to undo, imposing practical limits on the number of stains that can be applied to the same tissue section. Here we present an automated label-free whole slide scanner using a PARS microscope designed for imaging thin, transmissible samples. METHODS Peak SNR and in-focus acquisitions are achieved across entire tissue sections using the scattering signal from the PARS detection beam to measure the optimal focal plane. Whole slide images (WSI) are seamlessly stitched together using a custom contrast leveling algorithm. Identical tissue sections are subsequently H&E stained and brightfield imaged. The one-to-one WSIs from both modalities are visually and quantitatively compared. RESULTS PARS WSIs are presented at standard 40x magnification in malignant human breast and skin samples. We show correspondence of subcellular diagnostic details in both PARS and H&E WSIs and demonstrate virtual H&E staining of an entire PARS WSI. The one-to-one WSI from both modalities show quantitative similarity in nuclear features and structural information. CONCLUSION PARS WSIs are compatible with existing digital pathology tools, and samples remain suitable for histochemical, immunohistochemical, and other staining techniques. SIGNIFICANCE This work is a critical advance for integrating label-free optical methods into standard histopathology workflows.
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Bahudhanapati H, Tan J, Apel RM, Seeliger B, Schupp J, Li X, Sullivan DI, Sembrat J, Rojas M, Tabib T, Valenzi E, Lafyatis R, Mitash N, Hernandez Pineda R, Jawale C, Peroumal D, Biswas P, Tedrow J, Adams T, Kaminski N, Wuyts WA, McDyer JF, Gibson KF, Alder JK, Königshoff M, Zhang Y, Nouraie M, Prasse A, Kass DJ. Increased expression of CXCL6 in secretory cells drives fibroblast collagen synthesis and is associated with increased mortality in idiopathic pulmonary fibrosis. Eur Respir J 2024; 63:2300088. [PMID: 37918852 DOI: 10.1183/13993003.00088-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023]
Abstract
RATIONALE Recent data suggest that the localisation of airway epithelial cells in the distal lung in idiopathic pulmonary fibrosis (IPF) may drive pathology. We set out to discover whether chemokines expressed in these ectopic airway epithelial cells may contribute to the pathogenesis of IPF. METHODS We analysed whole lung and single-cell transcriptomic data obtained from patients with IPF. In addition, we measured chemokine levels in blood, bronchoalveolar lavage (BAL) of IPF patients and air-liquid interface cultures. We employed ex vivo donor and IPF lung fibroblasts and an animal model of pulmonary fibrosis to test the effects of chemokine signalling on fibroblast function. RESULTS By analysis of whole-lung transcriptomics, protein and BAL, we discovered that CXCL6 (a member of the interleukin-8 family) was increased in patients with IPF. Elevated CXCL6 levels in the BAL of two cohorts of patients with IPF were associated with poor survival (hazard ratio of death or progression 1.89, 95% CI 1.16-3.08; n=179, p=0.01). By immunostaining and single-cell RNA sequencing, CXCL6 was detected in secretory cells. Administration of mCXCL5 (LIX, murine CXCL6 homologue) to mice increased collagen synthesis with and without bleomycin. CXCL6 increased collagen I levels in donor and IPF fibroblasts 4.4-fold and 1.7-fold, respectively. Both silencing of and chemical inhibition of CXCR1/2 blocked the effects of CXCL6 on collagen, while overexpression of CXCR2 increased collagen I levels 4.5-fold in IPF fibroblasts. CONCLUSIONS CXCL6 is expressed in ectopic airway epithelial cells. Elevated levels of CXCL6 are associated with IPF mortality. CXCL6-driven collagen synthesis represents a functional consequence of ectopic localisation of airway epithelial cells in IPF.
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Affiliation(s)
- Harinath Bahudhanapati
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Denotes equal contribution
| | - Jiangning Tan
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Denotes equal contribution
| | - Rosa Marie Apel
- Fraunhofer ITEM, Hannover, Germany
- DZL BREATH, Hannover, Germany
| | - Benjamin Seeliger
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- German Centre for Lung Research (DZL), Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover, Germany
| | - Jonas Schupp
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- German Centre for Lung Research (DZL), Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover, Germany
| | - Xiaoyun Li
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel I Sullivan
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - John Sembrat
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mauricio Rojas
- Pulmonary, Critical Care and Sleep Medicine, College of Medicine, Ohio State University, Columbus, OH, USA
| | - Tracy Tabib
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eleanor Valenzi
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert Lafyatis
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nilay Mitash
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ricardo Hernandez Pineda
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chetan Jawale
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Partha Biswas
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - John Tedrow
- Norman Regional Health System, Norman, OK, USA
| | - Taylor Adams
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Naftali Kaminski
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, Leuven, Belgium
| | - John F McDyer
- Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kevin F Gibson
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jonathan K Alder
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Melanie Königshoff
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yingze Zhang
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mehdi Nouraie
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Antje Prasse
- Fraunhofer ITEM, Hannover, Germany
- DZL BREATH, Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- German Centre for Lung Research (DZL), Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover, Germany
- Denotes equal contribution
| | - Daniel J Kass
- Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Denotes equal contribution
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Rabindran B, Corben AD. Wide-field optical coherence tomography for microstructural analysis of key tissue types: a proof-of-concept evaluation. Pathol Oncol Res 2023; 29:1611167. [PMID: 37521364 PMCID: PMC10374948 DOI: 10.3389/pore.2023.1611167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023]
Abstract
Introduction: The presence of positive margins following tumor resection is a frequent cause of re-excision surgery. Nondestructive, real-time intraoperative histopathological imaging methods may improve margin status assessment at the time of surgery; optical coherence tomography (OCT) has been identified as a potential solution but has not been tested with the most common tissue types in surgical oncology using a single, standardized platform. Methods: This was a proof-of-concept evaluation of a novel device that employs wide-field OCT (WF-OCT; OTIS 2.0 System) to image tissue specimens. Various cadaveric tissues were obtained from a single autopsy and were imaged with WF-OCT then processed for permanent histology. The quality and resolution of the WF-OCT images were evaluated and compared to histology and with images in previous literature. Results: A total of 30 specimens were collected and tissue-specific microarchitecture consistent with previous literature were identified on both WF-OCT images and histology slides for all specimens, and corresponding sections were correlated. Application of vacuum pressure during scanning did not affect specimen integrity. On average, specimens were scanned at a speed of 10.3 s/cm2 with approximately three features observed per tissue type. Conclusion: The WF-OCT images captured in this study displayed the key features of the most common human tissue types encountered in surgical oncology with utility comparable to histology, confirming the utility of an FDA-cleared imaging platform. With further study, WF-OCT may have the potential to bridge the gap between the immediate information needs of the operating room and the longer timeline inherent to histology workflow.
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Affiliation(s)
| | - Adriana D. Corben
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, United States
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Long H, Ji J, Chen L, Feng J, Liao J, Yang Y. EB-OCT: a potential strategy on early diagnosis and treatment for lung cancer. Front Oncol 2023; 13:1156218. [PMID: 37182131 PMCID: PMC10168178 DOI: 10.3389/fonc.2023.1156218] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related death in China and the world, mainly attributed to delayed diagnosis, given that currently available early screening strategies exhibit limited value. Endobronchial optical coherence tomography (EB-OCT) has the characteristics of non-invasiveness, accuracy, and repeatability. Importantly, the combination of EB-OCT with existing technologies represents a potential approach for early screening and diagnosis. In this review, we introduce the structure and strengths of EB-OCT. Furthermore, we provide a comprehensive overview of the application of EB-OCT on early screening and diagnosis of lung cancer from in vivo experiments to clinical studies, including differential diagnosis of airway lesions, early screening for lung cancer, lung nodules, lymph node biopsy and localization and palliative treatment of lung cancer. Moreover, the bottlenecks and difficulties in developing and popularizing EB-OCT for diagnosis and treatment during clinical practice are analyzed. The characteristics of OCT images of normal and cancerous lung tissues were in good agreement with the results of pathology, which could be used to judge the nature of lung lesions in real time. In addition, EB-OCT can be used as an assistant to biopsy of pulmonary nodules and improve the success rate of biopsy. EB-OCT also plays an auxiliary role in the treatment of lung cancer. In conclusion, EB-OCT is non-invasive, safe and accurate in real-time. It is of great significance in the diagnosis of lung cancer and suitable for clinical application and is expected to become an important diagnostic method for lung cancer in the future.
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Affiliation(s)
- Hang Long
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jiaqi Ji
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Lijuan Chen
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jiayue Feng
- Department of Cardiology, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jie Liao
- Department of Cardiology, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Yang Yang
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
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Advances in bronchoscopic optical coherence tomography and confocal laser endomicroscopy in pulmonary diseases. Curr Opin Pulm Med 2023; 29:11-20. [PMID: 36474462 PMCID: PMC9780043 DOI: 10.1097/mcp.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Imaging techniques play a crucial role in the diagnostic work-up of pulmonary diseases but generally lack detailed information on a microscopic level. Optical coherence tomography (OCT) and confocal laser endomicroscopy (CLE) are imaging techniques which provide microscopic images in vivo during bronchoscopy. The purpose of this review is to describe recent advancements in the use of bronchoscopic OCT- and CLE-imaging in pulmonary medicine. RECENT FINDINGS In recent years, OCT- and CLE-imaging have been evaluated in a wide variety of pulmonary diseases and demonstrated to be complementary to bronchoscopy for real-time, near-histological imaging. Several pulmonary compartments were visualized and characteristic patterns for disease were identified. In thoracic malignancy, OCT- and CLE-imaging can provide characterization of malignant tissue with the ability to identify the optimal sampling area. In interstitial lung disease (ILD), fibrotic patterns were detected by both (PS-) OCT and CLE, complementary to current HRCT-imaging. For obstructive lung diseases, (PS-) OCT enables to detect airway wall structures and remodelling, including changes in the airway smooth muscle and extracellular matrix. SUMMARY Bronchoscopic OCT- and CLE-imaging allow high resolution imaging of airways, lung parenchyma, pleura, lung tumours and mediastinal lymph nodes. Although investigational at the moment, promising clinical applications are on the horizon.
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Zhu Q, Yu H, Liang Z, Zhao W, Zhu M, Xu Y, Guo M, Jia Y, Zou C, Yang Z, Chen L. Novel image features of optical coherence tomography for pathological classification of lung cancer: Results from a prospective clinical trial. Front Oncol 2022; 12:870556. [PMID: 36338729 PMCID: PMC9634220 DOI: 10.3389/fonc.2022.870556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/27/2022] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to explore the characteristics of optical coherence tomography (OCT) imaging for differentiating between benign and malignant lesions and different pathological types of lung cancer in bronchial lesions and to preliminarily evaluate the clinical value of OCT. Methods Patients who underwent bronchoscopy biopsy and OCT between February 2019 and December 2019 at the Chinese PLA General Hospital were enrolled in this study. White-light bronchoscopy (WLB), auto-fluorescence bronchoscopy (AFB), and OCT were performed at the lesion location. The main characteristics of OCT imaging for the differentiation between benign and malignant lesions and the prediction of the pathological classification of lung cancer in bronchial lesions were identified, and their clinical value was evaluated. Results A total of 135 patients were included in this study. The accuracy of OCT imaging for differentiating between benign and malignant bronchial lesions was 94.1%, which was significantly higher than that of AFB (67.4%). For the OCT imaging of SCC, adenocarcinoma, and small-cell lung cancer, the accuracies were 95.6, 94.3, and 92%, respectively. The accuracy, sensitivity, and specificity of OCT were higher than those of WLB. In addition, these main OCT image characteristics are independent influencing factors for predicting the corresponding diseases through logistic regression analysis between the main OCT image characteristics in the study and the general clinical features of patients (p<0.05). Conclusion As a non-biopsy technique, OCT can be used to improve the diagnosis rate of lung cancer and promote the development of non-invasive histological biopsy.
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Affiliation(s)
- Qiang Zhu
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Hang Yu
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Zhixin Liang
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Wei Zhao
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Minghui Zhu
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yi Xu
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Mingxue Guo
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Yanhong Jia
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Chenxi Zou
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
| | - Zhen Yang
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Zhen Yang, ; Liangan Chen,
| | - Liangan Chen
- Department of Respiratory Medicine, The First Medical Center of Chinese People Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Zhen Yang, ; Liangan Chen,
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7
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Lee HN, Kim S, Park S, Jung W, Kang JS. Quantification and visualization of metastatic lung tumors in mice. Toxicol Res 2022; 38:503-510. [PMID: 36277365 PMCID: PMC9532496 DOI: 10.1007/s43188-022-00134-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
Histopathological examination is important for the diagnosis of various diseases. Conventional histopathology provides a two-dimensional view of the tissues, and requires the tissue to be extracted, fixed, and processed using histotechnology techniques. However, there is an increasing need for three-dimensional (3D) images of structures in biomedical research. The objective of this study was to develop reliable, objective tools for visualizing and quantifying metastatic tumors in mouse lung using micro-computed tomography (micro-CT), optical coherence tomography (OCT), and field emission-scanning electron microscopy (FE-SEM). Melanoma cells were intravenously injected into the tail vein of 8-week-old C57BL/6 mice. The mice were euthanized at 2 or 4 weeks after injection. Lungs were fixed and examined by micro-CT, OCT, FE-SEM, and histopathological observation. Micro-CT clearly distinguished between tumor and normal cells in surface and deep lesions, thereby allowing 3D quantification of the tumor volume. OCT showed a clear difference between the tumor and surrounding normal tissues. FE-SEM clearly showed round tumor cells, mainly located in the alveolar wall and growing inside the alveoli. Therefore, whole-tumor 3D imaging successfully visualized the metastatic tumor and quantified its volume. This promising approach will allow for fast and label-free 3D phenotyping of diverse tissue structures.
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Affiliation(s)
- Ha Neul Lee
- Department of Biomedical Laboratory Science, Namseoul University, 91 Daehak-ro, Seonghwan-eup, Seobuk-gu, Cheonan-si, 31020 South Korea
| | - Seyl Kim
- Ferramed Inc., National Nanofab Center, KAIST, 291 Deahak-ro, Yuseong-gu, Deajeon, 34141 South Korea
| | - Sooah Park
- In Vivo Research Center, UNIST Central Research Facilities, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Ulju-gun, Ulsan, 44919 South Korea
| | - Woonggyu Jung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Ulju-gun, Ulsan, 44919 South Korea
| | - Jin Seok Kang
- Department of Biomedical Laboratory Science, Namseoul University, 91 Daehak-ro, Seonghwan-eup, Seobuk-gu, Cheonan-si, 31020 South Korea
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Bouma B, de Boer J, Huang D, Jang I, Yonetsu T, Leggett C, Leitgeb R, Sampson D, Suter M, Vakoc B, Villiger M, Wojtkowski M. Optical coherence tomography. NATURE REVIEWS. METHODS PRIMERS 2022; 2:79. [PMID: 36751306 PMCID: PMC9901537 DOI: 10.1038/s43586-022-00162-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Optical coherence tomography (OCT) is a non-contact method for imaging the topological and internal microstructure of samples in three dimensions. OCT can be configured as a conventional microscope, as an ophthalmic scanner, or using endoscopes and small diameter catheters for accessing internal biological organs. In this Primer, we describe the principles underpinning the different instrument configurations that are tailored to distinct imaging applications and explain the origin of signal, based on light scattering and propagation. Although OCT has been used for imaging inanimate objects, we focus our discussion on biological and medical imaging. We examine the signal processing methods and algorithms that make OCT exquisitely sensitive to reflections as weak as just a few photons and that reveal functional information in addition to structure. Image processing, display and interpretation, which are all critical for effective biomedical imaging, are discussed in the context of specific applications. Finally, we consider image artifacts and limitations that commonly arise and reflect on future advances and opportunities.
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Affiliation(s)
- B.E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Institute for Medical Engineering and Physics, Massachusetts Institute of Technology, Cambridge, MA, USA,Harvard Medical School, Boston, MA, USA,Corresponding author:
| | - J.F. de Boer
- Department of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D. Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
| | - I.K. Jang
- Harvard Medical School, Boston, MA, USA,Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - T. Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - C.L. Leggett
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - R. Leitgeb
- Institute of Medical Physics, University of Vienna, Wien, Austria
| | - D.D. Sampson
- School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - M. Suter
- Harvard Medical School, Boston, MA, USA,Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - B. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - M. Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - M. Wojtkowski
- Institute of Physical Chemistry and International Center for Translational Eye Research, Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland,Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland
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Jagadeesh KA, Dey KK, Montoro DT, Mohan R, Gazal S, Engreitz JM, Xavier RJ, Price AL, Regev A. Identifying disease-critical cell types and cellular processes across the human body by integration of single-cell profiles and human genetics. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.03.19.436212. [PMID: 34845454 PMCID: PMC8629197 DOI: 10.1101/2021.03.19.436212] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Genome-wide association studies (GWAS) provide a powerful means to identify loci and genes contributing to disease, but in many cases the related cell types/states through which genes confer disease risk remain unknown. Deciphering such relationships is important for identifying pathogenic processes and developing therapeutics. Here, we introduce sc-linker, a framework for integrating single-cell RNA-seq (scRNA-seq), epigenomic maps and GWAS summary statistics to infer the underlying cell types and processes by which genetic variants influence disease. We analyzed 1.6 million scRNA-seq profiles from 209 individuals spanning 11 tissue types and 6 disease conditions, and constructed gene programs capturing cell types, disease progression, and cellular processes both within and across cell types. We evaluated these gene programs for disease enrichment by transforming them to SNP annotations with tissue-specific epigenomic maps and computing enrichment scores across 60 diseases and complex traits (average N= 297K). Cell type, disease progression, and cellular process programs captured distinct heritability signals even within the same cell type, as we show in multiple complex diseases that affect the brain (Alzheimer’s disease, multiple sclerosis), colon (ulcerative colitis) and lung (asthma, idiopathic pulmonary fibrosis, severe COVID-19). The inferred disease enrichments recapitulated known biology and highlighted novel cell-disease relationships, including GABAergic neurons in major depressive disorder (MDD), a disease progression M cell program in ulcerative colitis, and a disease-specific complement cascade process in multiple sclerosis. In autoimmune disease, both healthy and disease progression immune cell type programs were associated, whereas for epithelial cells, disease progression programs were most prominent, perhaps suggesting a role in disease progression over initiation. Our framework provides a powerful approach for identifying the cell types and cellular processes by which genetic variants influence disease.
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Marinescu DC, Ryerson CJ. Endobronchial Optical Coherence Tomography for the Diagnosis of Fibrotic Interstitial Lung Disease: A Light at the End of the Tunnel? Am J Respir Crit Care Med 2021; 204:1122-1124. [PMID: 34473937 PMCID: PMC8759298 DOI: 10.1164/rccm.202108-1899ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Daniel-Costin Marinescu
- Department of Medicine University of British Columbia Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation St. Paul's Hospital Vancouver, British Columbia, Canada
| | - Christopher J Ryerson
- Department of Medicine University of British Columbia Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation St. Paul's Hospital Vancouver, British Columbia, Canada
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Doubkova M, Kriegova E, Littnerova S, Schneiderova P, Sterclova M, Bartos V, Plackova M, Zurkova M, Bittenglova R, Lostaková V, Siskova L, Lisa P, Suldova H, Doubek M, Psikalova J, Snizek T, Musilova P, Vasakova M. DSP rs2076295 variants influence nintedanib and pirfenidone outcomes in idiopathic pulmonary fibrosis: a pilot study. Ther Adv Respir Dis 2021; 15:17534666211042529. [PMID: 34515605 DOI: 10.1177/17534666211042529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The antifibrotic drugs nintedanib and pirfenidone are used for the treatment of idiopathic pulmonary fibrosis (IPF). We analysed the association of common profibrotic polymorphisms in MUC5B (mucin 5B, rs35705950) and DSP (desmoplakin, rs2076295) on antifibrotic treatment outcomes in IPF. METHODS MUC5B rs35705950 and DSP rs2076295 were assessed in IPF patients (n = 210, 139 men/71 women) from the Czech EMPIRE registry and age- or sex-matched healthy individuals (n = 205, 125 men/80 women). Genetic data were collated with overall survival (OS), acute exacerbation episodes, worsening lung function and antifibrotic treatment. RESULTS We confirmed overexpression of the MUC5B rs35705950*T allele (55.2% versus 20.9%, p < 0.001) and the DSP rs2076295*G allele (80.4% versus 68.3%, p < 0.001) in IPF compared with controls. On antifibrotic drugs, lower mortability was observed in IPF patients with DSP G* allele (p = 0.016) and MUC5B T* allele (p = 0.079). Carriers of the DSP rs2076295*G allele benefitted from nintedanib treatment compared with TT genotype by a longer OS [hazard ratio (HR) = 7.99; 95% confidence interval (CI) = 1.56-40.90; p = 0.013] and a slower decline in lung function (HR = 8.51; 95% CI = 1.68-43.14; p = 0.010). Patients with a TT genotype (rs2076295) benefitted from treatment with pirfenidone by prolonged OS (p = 0.040; HR = 0.35; 95% CI = 0.13-0.95) compared with nintedanib treatment. Both associations were confirmed by cross-validation analysis. After stratifying by MUC5B rs35705950*T allele carriage, no difference in treatment outcome was observed for nintedanib or pirfenidone (p = 0.784). In the multivariate model, smoking, age, forced vital capacity (FVC) and DLCO (diffuse lung capacity) at the IPF diagnosis were associated with survival. CONCLUSION Our real-world study showed that IPF patients with MUC5B T* allele or DSP G* allele profit from antifibrotic treatment by lower mortability. Moreover, carriers of the DSP rs2076295*G allele benefit from treatment with nintedanib, and TT genotype from treatment with pirfenidone. MUC5B rs35705950 did not impact the outcome of treatment with either nintedanib or pirfenidone. Our single-registry pilot study should be confirmed with an independent patient cohort.
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Affiliation(s)
- Martina Doubkova
- Department of Pulmonology and Physiology, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Eva Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Petra Schneiderova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martina Sterclova
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Vladimir Bartos
- Department of Pneumology, Faculty of Medicine in Hradec Králové, Charles University, Prague, Czech Republic
| | - Martina Plackova
- Department of Pneumology, Faculty of Medicine, University Hospital in Ostrava, Ostrava, Czech Republic
| | - Monika Zurkova
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Radka Bittenglova
- Department of Respiratory Diseases, Faculty of Medicine in Pilsen, Charles University and University Hospital Pilsen, Pilsen, Czech Republic
| | - Vladimira Lostaková
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Lenka Siskova
- Department of Respiratory Diseases, Tomáš Baťa Regional Hospital, Zlín, Czech Republic
| | - Pavlina Lisa
- Department of Pneumology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Hana Suldova
- Pulmonary Department, České Budějovice Hospital, Ceske Budejovice, Czech Republic
| | - Michael Doubek
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Jana Psikalova
- PneumoAllergology Department, Kroměříž Hospital, Kromeriz, Czech Republic
| | - Tomas Snizek
- Department of Respiratory Diseases, Jihlava Hospital, Jihlava, Czech Republic
| | - Pavlina Musilova
- Department of Respiratory Diseases, Jihlava Hospital, Jihlava, Czech Republic
| | - Martina Vasakova
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
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Hata A, Schiebler ML, Lynch DA, Hatabu H. Interstitial Lung Abnormalities: State of the Art. Radiology 2021; 301:19-34. [PMID: 34374589 DOI: 10.1148/radiol.2021204367] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The clinical importance of interstitial lung abnormality (ILA) is increasingly recognized. In July 2020, the Fleischner Society published a position paper about ILA. The purposes of this article are to summarize the definition, existing evidence, clinical management, and unresolved issues for ILA from a radiologic standpoint and to provide a practical guide for radiologists. ILA is a common incidental finding at CT and is often progressive and associated with worsened clinical outcomes. The hazard ratios for mortality range from 1.3 to 2.7 in large cohorts. Risk factors for ILA include age, smoking status, other inhalational exposures, and genetic factors (eg, gene encoding mucin 5B variant). Radiologists should systematically record the presence, morphologic characteristics, distribution, and subcategories of ILA (ie, nonsubpleural, subpleural nonfibrotic, and subpleural fibrotic), as these are informative for predicting progression and mortality. Clinically significant interstitial lung disease should not be considered ILA. Individuals with ILA are triaged into higher- and lower-risk groups depending on their risk factors for progression, and systematic follow-up, including CT, should be considered for the higher-risk group. Artificial intelligence-based automated analysis for ILA may be helpful, but further validation and improvement are needed. Radiologists have a central role in clinical management and research on ILA.
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Affiliation(s)
- Akinori Hata
- From the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (A.H., H.H.); Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (A.H.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Mark L Schiebler
- From the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (A.H., H.H.); Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (A.H.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - David A Lynch
- From the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (A.H., H.H.); Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (A.H.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Hiroto Hatabu
- From the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (A.H., H.H.); Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (A.H.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
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13
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Malone J, Lee AMD, Hohert G, Nador RG, Lane P. Small airway dilation measured by endoscopic optical coherence tomography correlates with chronic lung allograft dysfunction. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210057R. [PMID: 34263577 PMCID: PMC8278781 DOI: 10.1117/1.jbo.26.7.076005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Chronic lung allograft dysfunction (CLAD) is the leading cause of death in transplant patients who survive past the first year post-transplant. Current diagnosis is based on sustained decline in lung function; there is a need for tools that can identify CLAD onset. AIM Endoscopic optical coherence tomography (OCT) can visualize structural changes in the small airways, which are of interest in CLAD progression. We aim to identify OCT features in the small airways of lung allografts that correlate with CLAD status. APPROACH Imaging was conducted with an endoscopic rotary pullback OCT catheter during routine bronchoscopy procedures (n = 54), collecting volumetric scans of three segmental airways per patient. Six features of interest were identified, and four blinded raters scored the dataset on the presence and intensity of each feature. RESULTS Airway dilation (AD) was the only feature found to significantly (p < 0.003) correlate with CLAD diagnosis (R = 0.40 to 0.61). AD could also be fairly consistently scored between raters (κinter-rater = 0.48, κintra-rater = 0.64). There is a stronger relationship between AD and the combined obstructive and restrictive (BOS + RAS) phenotypes than the obstructive-only (BOS) phenotype for two raters (R = 0.92 , 0.94). CONCLUSIONS OCT examination of small AD shows potential as a diagnostic indicator for CLAD and CLAD phenotype and merits further exploration.
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Affiliation(s)
- Jeanie Malone
- British Columbia Cancer Research Institute, Department of Integrative Oncology, Imaging Unit, Vancouver, BC, Canada
| | - Anthony M. D. Lee
- British Columbia Cancer Research Institute, Department of Integrative Oncology, Imaging Unit, Vancouver, BC, Canada
| | - Geoffrey Hohert
- British Columbia Cancer Research Institute, Department of Integrative Oncology, Imaging Unit, Vancouver, BC, Canada
| | - Roland G. Nador
- University of British Columbia, Division of Respiratory Medicine, Faculty of Medicine, Vancouver, BC, Canada
- Vancouver General Hospital, Lung Transplant Program, Vancouver, BC, Canada
| | - Pierre Lane
- British Columbia Cancer Research Institute, Department of Integrative Oncology, Imaging Unit, Vancouver, BC, Canada
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Ptasinski V, Stegmayr J, Belvisi MG, Wagner DE, Murray LA. Targeting Alveolar Repair in Idiopathic Pulmonary Fibrosis. Am J Respir Cell Mol Biol 2021; 65:347-365. [PMID: 34129811 PMCID: PMC8525210 DOI: 10.1165/rcmb.2020-0476tr] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Idiopathic pulmonary fibrosis is a fatal interstitial lung disease with limited therapeutic options. Current evidence suggests that IPF may be initiated by repeated epithelial injury in the distal lung followed by abnormal wound healing responses which occur due to intrinsic and extrinsic factors. Mechanisms contributing to chronic damage of the alveolar epithelium in IPF include dysregulated cellular processes such as apoptosis, senescence, abnormal activation of developmental pathways, aging, as well as genetic mutations. Therefore, targeting the regenerative capacity of the lung epithelium is an attractive approach in the development of novel therapies for IPF. Endogenous lung regeneration is a complex process involving coordinated cross-talk between multiple cell types and re-establishment of a normal extracellular matrix environment. This review will describe the current knowledge of reparative epithelial progenitor cells in the alveolar region of the lung and discuss potential novel therapeutic approaches for IPF focusing on endogenous alveolar repair. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Affiliation(s)
- Victoria Ptasinski
- Lund University Faculty of Medicine, 59568, Lund, Sweden.,AstraZeneca R&D Gothenburg, 128698, Goteborg, Sweden
| | - John Stegmayr
- Lunds University Faculty of Medicine, 59568, Lund, Sweden
| | - Maria G Belvisi
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Darcy E Wagner
- Lunds Universitet, 5193, Experimental Medical Sciences, Lund, Sweden
| | - Lynne A Murray
- AstraZeneca PLC, 4625, Cambridge, United Kingdom of Great Britain and Northern Ireland;
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15
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Biondini D, Cocconcelli E, Bernardinello N, Lorenzoni G, Rigobello C, Lococo S, Castelli G, Baraldo S, Cosio MG, Gregori D, Saetta M, Balestro E, Spagnolo P. Prognostic role of MUC5B rs35705950 genotype in patients with idiopathic pulmonary fibrosis (IPF) on antifibrotic treatment. Respir Res 2021; 22:98. [PMID: 33794872 PMCID: PMC8017848 DOI: 10.1186/s12931-021-01694-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/24/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND A common variant located in the promoter region of MUC5B (rs35705950) is the strongest risk factor for sporadic and familiar IPF, as well as a predictor of outcome. However, there are no data on the effect of MUC5B rs35705950 genotype on the prognosis of IPF patients on antifibrotic treatment. The aim of this study is to determine, in a phenotypically well-characterized population of patients with IPF treated with antifibrotics, the impact of MUC5B rs35705950 genotype on disease progression and survival. METHODS 88 IPF patients on antifibrotic treatment were followed-up from 2014 until transplantation, death or end of follow-up (December 2019). Disease progression was defined as a forced vital capacity (FVC) loss ≥ 5% per year. All patients were genotyped for MUC5B rs35705950 by PCR amplification and Sanger sequencing. RESULTS Out of 88 patients, 61 (69%) carried the mutant T allele (TT or TG) and 27 (31%) did not (GG). Carriage of the MUC5B rs35705950 T allele was not associated with a faster decline in FVC. Conversely, at the end of the follow-up, overall survival in carriers of the TT/TG genotype was longer compared to that of the GG genotype carriers. FVC (L) at baseline and time to respiratory failure at rest were independent predictors of worse prognosis. CONCLUSIONS In IPF patients on antifibrotic treatment, carriage of the MUC5B rs35705950 T allele is associated with longer survival, highlighting the usefulness of MUC5B genetic data in clinical decision making.
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Affiliation(s)
- Davide Biondini
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Elisabetta Cocconcelli
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Nicol Bernardinello
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128, Padova, Italy
| | - Chiara Rigobello
- Department of Women's and Children's Health, University of Padova, 35128, Padova, Italy
| | - Sara Lococo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Gioele Castelli
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Simonetta Baraldo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Manuel G Cosio
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.,Meakins Christie Laboratories, Respiratory Division, McGill University, Montreal, Canada
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128, Padova, Italy
| | - Marina Saetta
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Elisabetta Balestro
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
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16
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Bell K, Abbasi S, Dinakaran D, Taher M, Bigras G, van Landeghem FKH, Mackey JR, Haji Reza P. Reflection-mode virtual histology using photoacoustic remote sensing microscopy. Sci Rep 2020; 10:19121. [PMID: 33154496 PMCID: PMC7644651 DOI: 10.1038/s41598-020-76155-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/23/2020] [Indexed: 12/30/2022] Open
Abstract
Histological visualizations are critical to clinical disease management and are fundamental to biological understanding. However, current approaches that rely on bright-field microscopy require extensive tissue preparation prior to imaging. These processes are both labor intensive and contribute to creating significant delays in clinical feedback for treatment decisions that can extend to 2-3 weeks for standard paraffin-embedded tissue preparation and interpretation, especially if ancillary testing is needed. Here, we present the first comprehensive study on the broad application of a novel label-free reflection-mode imaging modality known as photoacoustic remote sensing (PARS) for visualizing salient subcellular structures from various common histopathological tissue preparations and for use in unprocessed freshly resected tissues. The PARS modality permits non-contact visualizations of intrinsic endogenous optical absorption contrast to be extracted from thick and opaque biological targets with optical resolution. The technique was examined both as a rapid assessment tool that is capable of managing large samples (> 1 cm2) in under 10 min, and as a high contrast imaging modality capable of extracting specific biological contrast to simulate conventional histological stains such as hematoxylin and eosin (H&E). The capabilities of the proposed method are demonstrated in a variety of human tissue preparations including formalin-fixed paraffin-embedded tissue blocks and unstained slides sectioned from these blocks, including normal and neoplastic human brain, and breast epithelium involved with breast cancer. Similarly, PARS images of human skin prepared by frozen section clearly demonstrated basal cell carcinoma and normal human skin tissue. Finally, we imaged unprocessed murine kidney and achieved histologically relevant subcellular morphology in fresh tissue. This represents a vital step towards an effective real-time clinical microscope that overcomes the limitations of standard histopathologic tissue preparations and enables real-time pathology assessment.
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Affiliation(s)
- Kevan Bell
- Department of Systems Design Engineering, PhotoMedicine Labs, University of Waterloo, E7-6416 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
- Department of Systems Design Engineering, illumiSonics, Inc., University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Saad Abbasi
- Department of Systems Design Engineering, PhotoMedicine Labs, University of Waterloo, E7-6416 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Deepak Dinakaran
- Department of Systems Design Engineering, illumiSonics, Inc., University of Waterloo, Waterloo, ON, N2L 3G1, Canada
- Department of Oncology, University of Alberta, Edmonton, AB, T6G 1Z2, Canada
| | - Muba Taher
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, T6G 2V1, Canada
| | - Gilbert Bigras
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, T6G 2V1, Canada
| | - Frank K H van Landeghem
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, T6G 2V1, Canada
| | - John R Mackey
- Department of Oncology, University of Alberta, Edmonton, AB, T6G 1Z2, Canada
| | - Parsin Haji Reza
- Department of Systems Design Engineering, PhotoMedicine Labs, University of Waterloo, E7-6416 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
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Pipeline for Advanced Contrast Enhancement (PACE) of Chest X-ray in Evaluating COVID-19 Patients by Combining Bidimensional Empirical Mode Decomposition and Contrast Limited Adaptive Histogram Equalization (CLAHE). SUSTAINABILITY 2020. [DOI: 10.3390/su12208573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
COVID-19 is a new pulmonary disease which is driving stress to the hospitals due to the large number of cases worldwide. Imaging of lungs can play a key role in the monitoring of health status. Non-contrast chest computed tomography (CT) has been used for this purpose, mainly in China, with significant success. However, this approach cannot be massively used, mainly for both high risk and cost, also in some countries, this tool is not extensively available. Alternatively, chest X-ray, although less sensitive than CT-scan, can provide important information about the evolution of pulmonary involvement during the disease; this aspect is very important to verify the response of a patient to treatments. Here, we show how to improve the sensitivity of chest X-ray via a nonlinear post-processing tool, named PACE (Pipeline for Advanced Contrast Enhancement), combining properly Fast and Adaptive Bidimensional Empirical Mode Decomposition (FABEMD) and Contrast Limited Adaptive Histogram Equalization (CLAHE). The results show an enhancement of the image contrast as confirmed by three widely used metrics: (i) contrast improvement index, (ii) entropy, and (iii) measure of enhancement. This improvement gives rise to a detectability of more lung lesions as identified by two radiologists, who evaluated the images separately, and confirmed by CT-scans. The results show this method is a flexible and an effective approach for medical image enhancement and can be used as a post-processing tool for medical image understanding and analysis.
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18
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Hohert G, Meyers R, Lam S, Vertikov A, Lee A, Lam S, Lane P. Feasibility of combined optical coherence tomography and autofluorescence imaging for visualization of needle biopsy placement. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200078RR. [PMID: 33084256 PMCID: PMC7573340 DOI: 10.1117/1.jbo.25.10.106003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Diagnosis of suspicious lung nodules requires precise collection of relevant biopsies for histopathological analysis. Using optical coherence tomography and autofluorescence imaging (OCT-AFI) to improve diagnostic yield in parts of the lung inaccessible to larger imaging methods may allow for reducing complications related to the alternative of computed tomography-guided biopsy. AIM Feasibility of OCT-AFI combined with a commercially available lung biopsy needle was demonstrated for visualization of needle puncture sites in airways with diameters as small as 1.9 mm. APPROACH A miniaturized OCT-AFI imaging stylet was developed to be inserted through an 18G biopsy needle. We present design considerations and procedure development for image-guided biopsy. Ex vivo and in vivo porcine studies were performed to demonstrate the feasibility of the procedure and the device. RESULTS OCT-AFI scans were obtained ex vivo and in vivo. Discrimination of pullback site is clear. CONCLUSIONS Use of the device is shown to be feasible in vivo. Images obtained show the stylet is effective at providing structural information at the puncture site that can be used to assess the diagnostic potential of the sample prior to collection.
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Affiliation(s)
- Geoffrey Hohert
- BC Cancer Research Centre, Integrative Oncology, Vancouver, British Columbia, Canada
| | - Renelle Meyers
- University of British Columbia, Department of Medicine, Vancouver, British Columbia, Canada
| | - Sylvia Lam
- BC Cancer Research Centre, Integrative Oncology, Vancouver, British Columbia, Canada
| | - Andrei Vertikov
- LX Medical Corporation, Westwood, Massachusetts, United States
| | - Anthony Lee
- BC Cancer Research Centre, Integrative Oncology, Vancouver, British Columbia, Canada
| | - Stephen Lam
- BC Cancer Research Centre, Integrative Oncology, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Medicine, Vancouver, British Columbia, Canada
| | - Pierre Lane
- BC Cancer Research Centre, Integrative Oncology, Vancouver, British Columbia, Canada
- Simon Fraser University, School of Engineering Science, Burnaby, British Columbia, Canada
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Ni S, Song M, Guo W, Guo T, Shen Q, Peng H. Biomarkers and their potential functions in idiopathic pulmonary fibrosis. Expert Rev Respir Med 2020; 14:593-602. [PMID: 32187497 DOI: 10.1080/17476348.2020.1745066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, and progressive lung disease that is characterized by fibrosis and respiratory failure. IPF holds high morbidity and poor prognosis and still faces considerable problems of reliable diagnosis and valid prognosis. A growing body of literature have reported changes in the level of various biomarkers in IPF patients, which means that they are expected to become a new tool for the clinical practice of IPF.Areas covered: We reviewed the recent literature about biomarkers and focus on the role they play in IPF. We systematically searched Medline/PubMed through February 2020. Many works of literature have shown that a variety of biomolecules and genomics played multiple roles in the diagnosis or differential diagnosis, prognosis, and indication of acute deterioration of IPF and so on.Expert opinion: Significant advances have been made in the role of biomarkers for IPF these years; however, current data indicate that a single biomarker is unlikely to have a transformative effect on clinical practice; therefore, the combined effect of various biomarkers can be considered to improve the accuracy of diagnosis and prognosis. Further research of biomarkers may provide new insights for the diagnosis, prognosis, and even therapy of IPF.
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Affiliation(s)
- Shanshan Ni
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University; Research Unit of Respiratory Disease, Central South University; The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan, China
| | - Min Song
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University; Research Unit of Respiratory Disease, Central South University; The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan, China
| | - Wei Guo
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University; Research Unit of Respiratory Disease, Central South University; The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan, China
| | - Ting Guo
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University; Research Unit of Respiratory Disease, Central South University; The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan, China
| | - Qinxue Shen
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University; Research Unit of Respiratory Disease, Central South University; The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan, China
| | - Hong Peng
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University; Research Unit of Respiratory Disease, Central South University; The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan, China
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Papayan G, Goncharov S, Kazakov N, Strui A, Akopov A. Clinical potential of photodynamic diagnosis and therapy of tracheobronchial malignancies in the visible and infrared spectral ranges. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.201900019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Garry Papayan
- Pavlov First State Medical University Saint‐Petersburg Russia
- Almazov Federal Medical Research Center Saint‐Petersburg Russia
| | | | - Nikita Kazakov
- Pavlov First State Medical University Saint‐Petersburg Russia
| | - Andrey Strui
- Pavlov First State Medical University Saint‐Petersburg Russia
| | - Andrey Akopov
- Pavlov First State Medical University Saint‐Petersburg Russia
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21
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Zeng Y, Xu S, Chapman WC, Li S, Alipour Z, Abdelal H, Chatterjee D, Mutch M, Zhu Q. Real-time colorectal cancer diagnosis using PR-OCT with deep learning. Theranostics 2020; 10:2587-2596. [PMID: 32194821 PMCID: PMC7052898 DOI: 10.7150/thno.40099] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/08/2019] [Indexed: 12/24/2022] Open
Abstract
Prior reports have shown optical coherence tomography (OCT) can differentiate normal colonic mucosa from neoplasia, potentially offering an alternative technique to endoscopic biopsy - the current gold-standard colorectal cancer screening and surveillance modality. To help clinical translation limited by processing the large volume of generated data, we designed a deep learning-based pattern recognition (PR) OCT system that automates image processing and provides accurate diagnosis potentially in real-time. Method: OCT is an emerging imaging technique to obtain 3-dimensional (3D) "optical biopsies" of biological samples with high resolution. We designed a convolutional neural network to capture the structure patterns in human colon OCT images. The network is trained and tested using around 26,000 OCT images acquired from 20 tumor areas, 16 benign areas, and 6 other abnormal areas. Results: The trained network successfully detected patterns that identify normal and neoplastic colorectal tissue. Experimental diagnoses predicted by the PR-OCT system were compared to the known histologic findings and quantitatively evaluated. A sensitivity of 100% and specificity of 99.7% can be reached. Further, the area under the receiver operating characteristic (ROC) curves (AUC) of 0.998 is achieved. Conclusions: Our results demonstrate that PR-OCT can be used to give an accurate real-time computer-aided diagnosis of colonic neoplastic mucosa. Future development of this system as an "optical biopsy" tool to assist doctors in real-time for early mucosal neoplasms screening and treatment evaluation following initial oncologic therapy is planned.
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Affiliation(s)
- Yifeng Zeng
- Department of Biomedical Engineering, Washington University in St. Louis
| | - Shiqi Xu
- Department of Electrical & System Engineering, Washington University in St. Louis
| | - William C. Chapman
- Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine
| | - Shuying Li
- Department of Biomedical Engineering, Washington University in St. Louis
| | - Zahra Alipour
- Department of Pathology and Immunology, Washington University School of Medicine
| | - Heba Abdelal
- Department of Pathology and Immunology, Washington University School of Medicine
| | - Deyali Chatterjee
- Department of Pathology and Immunology, Washington University School of Medicine
| | - Matthew Mutch
- Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine
| | - Quing Zhu
- Department of Biomedical Engineering, Washington University in St. Louis
- Department of Radiology, Washington University School of Medicine
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22
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Goorsenberg A, Kalverda KA, Annema J, Bonta P. Advances in Optical Coherence Tomography and Confocal Laser Endomicroscopy in Pulmonary Diseases. Respiration 2019; 99:190-205. [PMID: 31593955 DOI: 10.1159/000503261] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022] Open
Abstract
Diagnosing and monitoring pulmonary diseases is highly dependent on imaging, physiological function tests and tissue sampling. Optical coherence tomography (OCT) and confocal laser endomicroscopy (CLE) are novel imaging techniques with near-microscopic resolution that can be easily and safely combined with conventional bronchoscopy. Disease-related pulmonary anatomical compartments can be visualized, real time, using these techniques. In obstructive lung diseases, airway wall layers and related structural remodelling can be identified and quantified. In malignant lung disease, normal and malignant areas of the central airways, lung parenchyma, lymph nodes and pleura can be discriminated. A growing number of interstitial lung diseases (ILDs) have been visualized using OCT or CLE. Several ILD-associated structural changes can be imaged: fibrosis, cellular infiltration, bronchi(ol)ectasis, cysts and microscopic honeycombing. Although not yet implemented in clinical practice, OCT and CLE have the potential to improve detection and monitoring pulmonary diseases and can contribute in unravelling the pathophysiology of disease and mechanism of action of novel treatments. Indeed, assessment of the airway wall layers with OCT might be helpful when evaluating treatments targeting airway remodelling. By visualizing individual malignant cells, CLE has the potential as a real-time lung cancer detection tool. In the future, both techniques could be combined with laser-enhanced fluorescent-labelled tracer detection. This review discusses the value of OCT and CLE in pulmonary medicine by summarizing the current evidence and elaborating on future perspectives.
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Affiliation(s)
- Annika Goorsenberg
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands,
| | - Kirsten A Kalverda
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jouke Annema
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Bonta
- Department of Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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23
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Borie R, Le Guen P, Ghanem M, Taillé C, Dupin C, Dieudé P, Kannengiesser C, Crestani B. The genetics of interstitial lung diseases. Eur Respir Rev 2019; 28:28/153/190053. [PMID: 31554702 PMCID: PMC9488931 DOI: 10.1183/16000617.0053-2019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/01/2019] [Indexed: 12/21/2022] Open
Abstract
Interstitial lung diseases (ILDs) are a set of heterogeneous lung diseases characterised by inflammation and, in some cases, fibrosis. These lung conditions lead to dyspnoea, cough, abnormalities in gas exchange, restrictive physiology (characterised by decreased lung volumes), hypoxaemia and, if progressive, respiratory failure. In some cases, ILDs can be caused by systemic diseases or environmental exposures. The ability to treat or cure these ILDs varies based on the subtype and in many cases lung transplantation remains the only curative therapy. There is a growing body of evidence that both common and rare genetic variants contribute to the development and clinical manifestation of many of the ILDs. Here, we review the current understanding of genetic risk and ILD. Common and rare genetic variants contribute to the development and clinical manifestation of many interstitial lung diseaseshttp://bit.ly/31loHLh
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Affiliation(s)
- Raphael Borie
- Service de Pneumologie A, Hôpital Bichat, AP-HP, Paris, France.,INSERM U1152, Paris, France
| | - Pierre Le Guen
- Service de Pneumologie A, Hôpital Bichat, AP-HP, Paris, France.,INSERM U1152, Paris, France
| | - Mada Ghanem
- Service de Pneumologie A, Hôpital Bichat, AP-HP, Paris, France.,INSERM U1152, Paris, France
| | - Camille Taillé
- Service de Pneumologie A, Hôpital Bichat, AP-HP, Paris, France.,INSERM U1152, Paris, France
| | - Clairelyne Dupin
- Service de Pneumologie A, Hôpital Bichat, AP-HP, Paris, France.,INSERM U1152, Paris, France
| | - Philippe Dieudé
- INSERM U1152, Paris, France.,Département de Génétique, Hôpital Bichat, AP-HP, Paris, France
| | - Caroline Kannengiesser
- INSERM U1152, Paris, France.,Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France
| | - Bruno Crestani
- Service de Pneumologie A, Hôpital Bichat, AP-HP, Paris, France .,INSERM U1152, Paris, France
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24
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Yanagihara T, Sato S, Upagupta C, Kolb M. What have we learned from basic science studies on idiopathic pulmonary fibrosis? Eur Respir Rev 2019; 28:28/153/190029. [PMID: 31511255 PMCID: PMC9488501 DOI: 10.1183/16000617.0029-2019] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/11/2019] [Indexed: 12/29/2022] Open
Abstract
Idiopathic pulmonary fibrosis is a fatal age-related lung disease characterised by progressive and irreversible scarring of the lung. Although the details are not fully understood, there has been tremendous progress in understanding the pathogenesis of idiopathic pulmonary fibrosis, which has led to the identification of many new potential therapeutic targets. In this review we discuss several of these advances with a focus on genetic susceptibility and cellular senescence primarily affecting epithelial cells, activation of profibrotic pathways, disease-enhancing fibrogenic cell types and the role of the remodelled extracellular matrix. This review provides a summary of the most important findings in basic science investigations in pulmonary fibrosis and how they affect drug development and future patient management.http://bit.ly/2RjGMFZ
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Affiliation(s)
- Toyoshi Yanagihara
- Firestone Institute for Respiratory Health, Research Institute at St Joseph's Healthcare, Dept of Medicine, McMaster University, Hamilton, ON, Canada.,Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Both authors contributed equally
| | - Seidai Sato
- Dept of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Both authors contributed equally
| | - Chandak Upagupta
- Firestone Institute for Respiratory Health, Research Institute at St Joseph's Healthcare, Dept of Medicine, McMaster University, Hamilton, ON, Canada
| | - Martin Kolb
- Firestone Institute for Respiratory Health, Research Institute at St Joseph's Healthcare, Dept of Medicine, McMaster University, Hamilton, ON, Canada
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25
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Abstract
Gabor-domain optical coherence microscopy (GDOCM) is a high-definition imaging technique leveraging principles of low-coherence interferometry, liquid lens technology, high-speed imaging, and precision scanning. GDOCM achieves isotropic 2 μm resolution in 3D, effectively breaking the cellular resolution limit of optical coherence tomography (OCT). In the ten years since its introduction, GDOCM has been used for cellular imaging in 3D in a number of clinical applications, including dermatology, oncology and ophthalmology, as well as to characterize materials in industrial applications. Future developments will enhance the structural imaging capability of GDOCM by adding functional modalities, such as fluorescence and elastography, by estimating thicknesses on the nano-scale, and by incorporating machine learning techniques.
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26
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Feroldi F, Willemse J, Davidoiu V, Gräfe MGO, van Iperen DJ, Goorsenberg AWM, Annema JT, Daniels JMA, Bonta PI, de Boer JF. In vivo multifunctional optical coherence tomography at the periphery of the lungs. BIOMEDICAL OPTICS EXPRESS 2019; 10:3070-3091. [PMID: 31259075 PMCID: PMC6583343 DOI: 10.1364/boe.10.003070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 05/04/2023]
Abstract
Remodeling of tissue, such as airway smooth muscle (ASM) and extracellular matrix, is considered a key feature of airways disease. No clinically accepted diagnostic method is currently available to assess airway remodeling or the effect of treatment modalities such as bronchial thermoplasty in asthma, other than invasive airway biopsies. Optical coherence tomography (OCT) generates cross-sectional, near-histological images of airway segments and enables identification and quantification of airway wall layers based on light scattering properties only. In this study, we used a custom motorized OCT probe that combines standard and polarization sensitive OCT (PS-OCT) to visualize birefringent tissue in vivo in the airway wall of a patient with severe asthma in a minimally invasive manner. We used optic axis uniformity (OAxU) to highlight the presence of uniformly arranged fiber-like tissue, helping visualizing the abundance of ASM and connective tissue structures. Attenuation coefficient images of the airways are presented for the first time, showing superior architectural contrast compared to standard OCT images. A novel segmentation algorithm was developed to detect the surface of the endoscope sheath and the surface of the tissue. PS-OCT is an innovative imaging technique that holds promise to assess airway remodeling including ASM and connective tissue in a minimally invasive, real-time manner.
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Affiliation(s)
- Fabio Feroldi
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| | - Joy Willemse
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
- These authors contributed equally
| | - Valentina Davidoiu
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
- These authors contributed equally
| | - Maximilian G. O. Gräfe
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| | - Dirck J. van Iperen
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| | - Annika W. M. Goorsenberg
- Amsterdam University Medical Center, Department of Pulmonology, University of Amsterdam, Amsterdam, the Netherlands
| | - Jouke T. Annema
- Amsterdam University Medical Center, Department of Pulmonology, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes M. A. Daniels
- Amsterdam University Medical Center, Department of Pulmonology, VUmc Location, Amsterdam, the Netherlands
| | - Peter I. Bonta
- Amsterdam University Medical Center, Department of Pulmonology, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes F. de Boer
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
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27
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Gaydou V, Polette M, Gobinet C, Kileztky C, Angiboust JF, Birembaut P, Vuiblet V, Piot O. New insights into spectral histopathology: infrared-based scoring of tumour aggressiveness of squamous cell lung carcinomas. Chem Sci 2019; 10:4246-4258. [PMID: 31057753 PMCID: PMC6471539 DOI: 10.1039/c8sc04320e] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/01/2019] [Indexed: 12/25/2022] Open
Abstract
Spectral histopathology, based on infrared interrogation of tissue sections, proved a promising tool for helping pathologists in characterizing histological structures in a quantitative and automatic manner.
Spectral histopathology, based on infrared interrogation of tissue sections, proved a promising tool for helping pathologists in characterizing histological structures in a quantitative and automatic manner. In cancer diagnosis, the use of chemometric methods permits establishing numerical models able to detect cancer cells and to characterize their tissular environment. In this study, we focused on exploiting multivariate infrared data to score the tumour aggressiveness in preneoplastic lesions and squamous cell lung carcinomas. These lesions present a wide range of aggressive phenotypes; it is also possible to encounter cases with various degrees of aggressiveness within the same lesion. Implementing an infrared-based approach for a more precise histological determination of the tumour aggressiveness should arouse interest among pathologists with direct benefits for patient care. In this study, the methodology was developed from a set of samples including all degrees of tumour aggressiveness and by constructing a chain of data processing steps for an automated analysis of tissues currently manipulated in routine histopathology.
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Affiliation(s)
- Vincent Gaydou
- BioSpecT Unit , EA 7506 , University of Reims Champagne-Ardenne , Pharmacy Department , 51 rue Cognacq-Jay , 51096 Reims , France .
| | - Myriam Polette
- INSERM UMR-S 1250 , University of Reims Champagne-Ardenne , 45, rue Cognacq-Jay , 51092 Reims , France.,Biopathology Laboratory , Centre Hospitalier et Universitaire de Reims , 45 Rue Cognacq-Jay , 51092 Reims , France
| | - Cyril Gobinet
- BioSpecT Unit , EA 7506 , University of Reims Champagne-Ardenne , Pharmacy Department , 51 rue Cognacq-Jay , 51096 Reims , France .
| | - Claire Kileztky
- INSERM UMR-S 1250 , University of Reims Champagne-Ardenne , 45, rue Cognacq-Jay , 51092 Reims , France
| | - Jean-François Angiboust
- BioSpecT Unit , EA 7506 , University of Reims Champagne-Ardenne , Pharmacy Department , 51 rue Cognacq-Jay , 51096 Reims , France .
| | - Philippe Birembaut
- INSERM UMR-S 1250 , University of Reims Champagne-Ardenne , 45, rue Cognacq-Jay , 51092 Reims , France.,Biopathology Laboratory , Centre Hospitalier et Universitaire de Reims , 45 Rue Cognacq-Jay , 51092 Reims , France
| | - Vincent Vuiblet
- BioSpecT Unit , EA 7506 , University of Reims Champagne-Ardenne , Pharmacy Department , 51 rue Cognacq-Jay , 51096 Reims , France . .,Biopathology Laboratory , Centre Hospitalier et Universitaire de Reims , 45 Rue Cognacq-Jay , 51092 Reims , France
| | - Olivier Piot
- BioSpecT Unit , EA 7506 , University of Reims Champagne-Ardenne , Pharmacy Department , 51 rue Cognacq-Jay , 51096 Reims , France . .,Platform of Cellular and Tissular Imaging (PICT) , University of Reims Champagne-Ardenne , 51 rue Cognacq-Jay , 51096 Reims , France
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28
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Wells WA, Thrall M, Sorokina A, Fine J, Krishnamurthy S, Haroon A, Rao B, Shevchuk MM, Wolfsen HC, Tearney GJ, Hariri LP. In Vivo and Ex Vivo Microscopy: Moving Toward the Integration of Optical Imaging Technologies Into Pathology Practice. Arch Pathol Lab Med 2018; 143:288-298. [PMID: 30525931 DOI: 10.5858/arpa.2018-0298-ra] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The traditional surgical pathology assessment requires tissue to be removed from the patient, then processed, sectioned, stained, and interpreted by a pathologist using a light microscope. Today, an array of alternate optical imaging technologies allow tissue to be viewed at high resolution, in real time, without the need for processing, fixation, freezing, or staining. Optical imaging can be done in living patients without tissue removal, termed in vivo microscopy, or also in freshly excised tissue, termed ex vivo microscopy. Both in vivo and ex vivo microscopy have tremendous potential for clinical impact in a wide variety of applications. However, in order for these technologies to enter mainstream clinical care, an expert will be required to assess and interpret the imaging data. The optical images generated from these imaging techniques are often similar to the light microscopic images that pathologists already have expertise in interpreting. Other clinical specialists do not have this same expertise in microscopy, therefore, pathologists are a logical choice to step into the developing role of microscopic imaging expert. Here, we review the emerging technologies of in vivo and ex vivo microscopy in terms of the technical aspects and potential clinical applications. We also discuss why pathologists are essential to the successful clinical adoption of such technologies and the educational resources available to help them step into this emerging role.
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Affiliation(s)
- Wendy A Wells
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Michael Thrall
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Anastasia Sorokina
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jeffrey Fine
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Savitri Krishnamurthy
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Attiya Haroon
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Babar Rao
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Maria M Shevchuk
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Herbert C Wolfsen
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Guillermo J Tearney
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lida P Hariri
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
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29
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Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy. J Bronchology Interv Pulmonol 2018; 25:189-197. [PMID: 29659420 DOI: 10.1097/lbr.0000000000000491] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Transbronchial needle aspiration (TBNA), often used to sample lymph nodes for lung cancer staging, is subject to sampling error even when performed with endobronchial ultrasound. Optical coherence tomography (OCT) is a high-resolution imaging modality that rapidly generates helical cross-sectional images. We aim to determine if needle-based OCT can provide microstructural information in lymph nodes that may be used to guide TBNA, and improve sampling error. METHODS We performed ex vivo needle-based OCT on thoracic lymph nodes from patients with and without known lung cancer. OCT imaging features were compared against matched histology. RESULTS OCT imaging was performed in 26 thoracic lymph nodes, including 6 lymph nodes containing metastatic carcinoma. OCT visualized lymphoid follicles, adipose tissue, pigment-laden histiocytes, and blood vessels. OCT features of metastatic carcinoma were distinct from benign lymph nodes, with microarchitectural features that reflected the morphology of the carcinoma subtype. OCT was also able to distinguish lymph node from adjacent airway wall. CONCLUSIONS Our results demonstrate that OCT provides critical microstructural information that may be useful to guide TBNA lymph node sampling, as a complement to endobronchial ultrasound. In vivo studies are needed to further evaluate the clinical utility of OCT in thoracic lymph node assessment.
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van Manen L, Dijkstra J, Boccara C, Benoit E, Vahrmeijer AL, Gora MJ, Mieog JSD. The clinical usefulness of optical coherence tomography during cancer interventions. J Cancer Res Clin Oncol 2018; 144:1967-1990. [PMID: 29926160 PMCID: PMC6153603 DOI: 10.1007/s00432-018-2690-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/16/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Tumor detection and visualization plays a key role in the clinical workflow of a patient with suspected cancer, both in the diagnosis and treatment. Several optical imaging techniques have been evaluated for guidance during oncological interventions. Optical coherence tomography (OCT) is a technique which has been widely evaluated during the past decades. This review aims to determine the clinical usefulness of OCT during cancer interventions focussing on qualitative features, quantitative features and the diagnostic value of OCT. METHODS A systematic literature search was performed for articles published before May 2018 using OCT in the field of surgical oncology. Based on these articles, an overview of the clinical usefulness of OCT was provided per tumor type. RESULTS A total of 785 articles were revealed by our search, of which a total of 136 original articles were available for analysis, which formed the basis of this review. OCT is currently utilised for both preoperative diagnosis and intraoperative detection of skin, oral, lung, breast, hepatobiliary, gastrointestinal, urological, and gynaecological malignancies. It showed promising results in tumor detection on a microscopic level, especially using higher resolution imaging techniques, such as high-definition OCT and full-field OCT. CONCLUSION In the near future, OCT could be used as an additional tool during bronchoscopic or endoscopic interventions and could also be implemented in margin assessment during (laparoscopic) cancer surgery if a laparoscopic or handheld OCT device will be further developed to make routine clinical use possible.
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Affiliation(s)
- Labrinus van Manen
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Alexander L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Michalina J Gora
- ICube Laboratory, CNRS, Strasbourg University, Strasbourg, France
| | - J Sven D Mieog
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
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Abstract
PURPOSE OF REVIEW As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications. RECENT FINDINGS The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures. Bronchial thermoplasty is now offered as endoscopic treatment of severe asthma. Endobronchial lung volume reduction procedures are currently undergoing clinical trials and may become more commonplace. Interventional pulmonologists are performing medical thoracoscopy for the treatment and diagnosis of pleural disorders. Interventional radiologists are performing complex pulmonary procedures, often requiring anesthesia. SUMMARY The review summarizes the procedures now commonly performed by interventional pulmonologists and interventional radiologists. It discusses the anesthetic considerations for and common complications of these procedures to prepare anesthesiologists to safely care for these patients. Investigational techniques are also described.
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Abstract
INTRODUCTION The field of interventional pulmonology (IP) is a rapidly maturing subspecialty of pulmonary medicine, which emphasizes advanced diagnostic and therapeutic bronchoscopy for the evaluation and management of central airway obstruction, mediastinal/hilar adenopathy and lung nodules/masses, as well as minimally invasive diagnostic and therapeutic pleural procedures. Areas covered: This review describes advances in diagnostic and therapeutic bronchoscopic techniques. Expert commentary: In the past decade, there has been a remarkable growth in available technology and equipment, as well as clinical and translational research efforts focused on patient-centered outcomes. Furthermore, the recent establishment of a uniform accreditation standard for all IP fellowship programs in the United States was an important step in the continued evolution of this subspecialty of pulmonary medicine.
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Affiliation(s)
- Diana H Yu
- a School of Medicine, Division of Pulmonary/Critical Care Medicine, Section of Interventional Pulmonology , Johns Hopkins University , Baltimore , USA
| | - David Feller-Kopman
- a School of Medicine, Division of Pulmonary/Critical Care Medicine, Section of Interventional Pulmonology , Johns Hopkins University , Baltimore , USA
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Bydlon TM, Langhout GC, Lalezari F, Hartemink KJ, Nijkamp J, Brouwer de Koning SG, Burgers S, Hendriks BHW, Ruers TJM. Optimal endobronchial tool sizes for targeting lung lesions based on 3D modeling. PLoS One 2017; 12:e0189963. [PMID: 29261769 PMCID: PMC5736231 DOI: 10.1371/journal.pone.0189963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022] Open
Abstract
Background For patients with suspicious lung lesions found on chest x-ray or CT, endo/trans- bronchial biopsy of the lung is the preferred method for obtaining a diagnosis. With the addition of new screening programs, a higher number of patients will require diagnostic biopsy which will prove even more challenging due to the small size of lesions found with screening. There are many endobronchial tools available on the market today and a wide range of new tools under investigation to improve diagnostic yield. However, there is little information available about the optimal tool size required to reach the majority of lesions, especially peripheral ones. In this manuscript we investigate the percentage of lesions that can be reached for various diameter tools if the tools remain inside the airways (i.e. endobronchial biopsy) and the distance a tool must travel “off-road” (or outside of the airways) to reach all lesions. Methods and findings To further understand the distribution of lung lesions with respect to airway sizes and distances from the airways, six 3D models of the lung were generated. The airways were modeled at two different respiratory phases (inspiration and expiration). Three sets of 1,000 lesions were randomly distributed throughout the lung for each respiratory phase. The simulations showed that the percentage of reachable lesions decreases with increasing tool diameter and decreasing lesion diameter. A 1mm diameter tool will reach <25% of 1cm lesions if it remains inside the airways. To reach all 1cm lesions this 1mm tool would have to navigate through the parenchyma up to 8.5mm. CT scans of 21 patient lesions confirm these results reasonably well. Conclusions The smaller the tool diameter the more likely it will be able to reach a lung lesion, whether it be for diagnostic biopsy, ablation, or resection. However, even a 1mm tool is not small enough to reach the majority of small (1-2cm) lesions. Therefore, it is necessary for endobronchial tools to be able to navigate through the parenchyma to reach the majority of lesions.
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Affiliation(s)
- Torre M. Bydlon
- Philips Research, 2 Canal Park, Third Floor, Cambridge, MA, United States of America
- Philips Research, High Tech Campus 34, AE Eindhoven, The Netherlands
- * E-mail:
| | - Gerrit C. Langhout
- Department of Surgery, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - Ferry Lalezari
- Department of Radiology, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - Koen J. Hartemink
- Department of Surgery, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - Jasper Nijkamp
- Department of Surgery, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - Susan G. Brouwer de Koning
- Department of Surgery, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - Sjaak Burgers
- Department of Thoracic Oncology, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - Benno H. W. Hendriks
- Philips Research, High Tech Campus 34, AE Eindhoven, The Netherlands
- Biomechanical Engineering Department, Technical University of Delft, Mekelweg 2, CD Delft, The Netherlands
| | - Theodoor J. M. Ruers
- Department of Surgery, Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, CX Amsterdam, The Netherlands
- MIRA Institute, University of Twente, AE Enschede, The Netherlands
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Affiliation(s)
- Michael P Keane
- 1 Department of Medicine St. Vincent's University Hospital Dublin, Ireland and.,2 University College Dublin Dublin, Ireland
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Wang J, Xu Y, Boppart SA. Review of optical coherence tomography in oncology. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-23. [PMID: 29274145 PMCID: PMC5741100 DOI: 10.1117/1.jbo.22.12.121711] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/04/2017] [Indexed: 05/06/2023]
Abstract
The application of optical coherence tomography (OCT) in the field of oncology has been prospering over the past decade. OCT imaging has been used to image a broad spectrum of malignancies, including those arising in the breast, brain, bladder, the gastrointestinal, respiratory, and reproductive tracts, the skin, and oral cavity, among others. OCT imaging has initially been applied for guiding biopsies, for intraoperatively evaluating tumor margins and lymph nodes, and for the early detection of small lesions that would often not be visible on gross examination, tasks that align well with the clinical emphasis on early detection and intervention. Recently, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This paper reviews the evolution of OCT technologies for the clinical application of OCT in surgical and noninvasive interventional oncology procedures and concludes with a discussion of the future directions for OCT technologies, with particular emphasis on their applications in oncology.
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Affiliation(s)
- Jianfeng Wang
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Yang Xu
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
| | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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Weng S, Xu X, Li J, Wong STC. Combining deep learning and coherent anti-Stokes Raman scattering imaging for automated differential diagnosis of lung cancer. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-10. [PMID: 29086544 PMCID: PMC5661703 DOI: 10.1117/1.jbo.22.10.106017] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/04/2017] [Indexed: 05/05/2023]
Abstract
Lung cancer is the most prevalent type of cancer and the leading cause of cancer-related deaths worldwide. Coherent anti-Stokes Raman scattering (CARS) is capable of providing cellular-level images and resolving pathologically related features on human lung tissues. However, conventional means of analyzing CARS images requires extensive image processing, feature engineering, and human intervention. This study demonstrates the feasibility of applying a deep learning algorithm to automatically differentiate normal and cancerous lung tissue images acquired by CARS. We leverage the features learned by pretrained deep neural networks and retrain the model using CARS images as the input. We achieve 89.2% accuracy in classifying normal, small-cell carcinoma, adenocarcinoma, and squamous cell carcinoma lung images. This computational method is a step toward on-the-spot diagnosis of lung cancer and can be further strengthened by the efforts aimed at miniaturizing the CARS technique for fiber-based microendoscopic imaging.
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Affiliation(s)
- Sheng Weng
- Translational Biophotonics Laboratory, Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas, United States
- Rice University, Department of Electrical and Computer Engineering, Houston, Texas, United States
| | - Xiaoyun Xu
- Translational Biophotonics Laboratory, Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas, United States
| | - Jiasong Li
- Translational Biophotonics Laboratory, Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas, United States
| | - Stephen T. C. Wong
- Translational Biophotonics Laboratory, Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas, United States
- Rice University, Department of Electrical and Computer Engineering, Houston, Texas, United States
- Address all correspondence to: Stephen T. C. Wong, E-mail:
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Ling Y, Yao X, Hendon CP. Highly phase-stable 200 kHz swept-source optical coherence tomography based on KTN electro-optic deflector. BIOMEDICAL OPTICS EXPRESS 2017; 8:3687-3699. [PMID: 29082103 PMCID: PMC5560834 DOI: 10.1364/boe.8.003687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/08/2017] [Accepted: 07/08/2017] [Indexed: 05/04/2023]
Abstract
The rapid advance in swept-source optical coherence tomography (SS-OCT) technology has enabled exciting new applications in elastography, angiography, and vibrometry, where both high temporal resolution and phase stability are highly sought-after. In this paper, we present a 200 kHz SS-OCT system centered at 1321 nm by using an electro-optically tuned swept source. The proposed system's performance was fully characterized, and it possesses superior phase stability (0.0012% scanning variability and <1 ns timing jitter) that is promising for many phase-sensitive imaging applications. Biological experiments were demonstrated within ex vivo human tracheobronchial ciliated epithelium where both the ciliary motion and ciliary beat frequency were successfully extracted.
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Carrasco-Zevallos OM, Viehland C, Keller B, Draelos M, Kuo AN, Toth CA, Izatt JA. Review of intraoperative optical coherence tomography: technology and applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:1607-1637. [PMID: 28663853 PMCID: PMC5480568 DOI: 10.1364/boe.8.001607] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/09/2017] [Accepted: 02/09/2017] [Indexed: 05/19/2023]
Abstract
During microsurgery, en face imaging of the surgical field through the operating microscope limits the surgeon's depth perception and visualization of instruments and sub-surface anatomy. Surgical procedures outside microsurgery, such as breast tumor resections, may also benefit from visualization of the sub-surface tissue structures. The widespread clinical adoption of optical coherence tomography (OCT) in ophthalmology and its growing prominence in other fields, such as cancer imaging, has motivated the development of intraoperative OCT for real-time tomographic visualization of surgical interventions. This article reviews key technological developments in intraoperative OCT and their applications in human surgery. We focus on handheld OCT probes, microscope-integrated OCT systems, and OCT-guided laser treatment platforms designed for intraoperative use. Moreover, we discuss intraoperative OCT adjuncts and processing techniques currently under development to optimize the surgical feedback derivable from OCT data. Lastly, we survey salient clinical studies of intraoperative OCT for human surgery.
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Affiliation(s)
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Mark Draelos
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Anthony N. Kuo
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
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Andolfi M, Potenza R, Capozzi R, Liparulo V, Puma F, Yasufuku K. The role of bronchoscopy in the diagnosis of early lung cancer: a review. J Thorac Dis 2016; 8:3329-3337. [PMID: 28066614 PMCID: PMC5179455 DOI: 10.21037/jtd.2016.11.81] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/20/2016] [Indexed: 12/25/2022]
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide with an overall 5-year survival rate of 17% after diagnoses. Indeed many patients tend to have a very poor prognosis, due to being diagnosed at an advanced stage. Conversely patients who are diagnosed at an early stage have a 5-year survival >70%, indicating that early detection of lung cancer is crucial to improve survival. Although flexible bronchoscopy is a relatively non-invasive procedure for patients suspected of having lung cancer, only 29% of carcinoma in situ (CIS) and 69% of microinvasive tumors were detectable using white light bronchoscopy (WLB) alone. As a result, in the past two decades, new bronchoscopic techniques have been developed to increase the yield and diagnostic accuracy, such as autofluorescence bronchoscopy (AFB), narrow band imaging (NBI) and high magnification bronchovideoscopy (HMB). However, due to the low specificity and the limitation to detect only proximal bronchial tree, new probe-based technologies have been introduced: radial endobronchial ultrasound (R-EBUS), optical coherence tomography (OCT), confocal laser endomicroscopy (CLE) and laser Raman spectroscopy (LRS). To date, although tissue biopsy remains the gold standard for diagnosing malignant/premalignant airway disease and some techniques are still investigational, bronchoscopic technologies can be considered the safest and most accurate tools to evaluate both central and distal airway mucosa.
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Affiliation(s)
- Marco Andolfi
- Division of Thoracic Surgery, S. Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy
| | - Rossella Potenza
- Division of Thoracic Surgery, S. Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy
| | - Rosanna Capozzi
- Division of Thoracic Surgery, S. Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy
| | - Valeria Liparulo
- Division of Thoracic Surgery, S. Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy
| | - Francesco Puma
- Division of Thoracic Surgery, S. Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy
| | - Kazuhiro Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
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Abstract
PURPOSE OF REVIEW Lung cancer is the leading cause of cancer deaths worldwide. Early detection is essential for long-term survival. Screening of high-risk individuals with low-dose computed tomography screening has proven to increase survival. However, current radiological imaging techniques have poor specificity for lung cancer detection and poor sensitivity for detection of mucosal or alveolar preinvasive malignant lesions. Bronchoscopy allows imaging and sampling of early lung cancer, with the highest safety profile and high diagnostic accuracy. RECENT FINDINGS Available technologies, such as autofluorescence bronchoscopy, narrow band imaging, and radial ultrasound bronchoscopy can significantly increase the yield and diagnostic accuracy of bronchoscopy for early cancer detection in the central airways. Newer technologies such as optical coherence tomography, confocal bronchoscopy, and Raman spectroscopy may significantly increase the diagnostic yield of both central and parenchymal early cancer lesions. SUMMARY Although some of these technologies are still investigational and are not readily available in most centers, they may identify early mucosal and alveolar cancer lesions accurately in the least invasive manner to provide appropriate therapy and prolong patient survival from lung cancer.
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O'Dwyer DN, Ashley SL, Moore BB. Influences of innate immunity, autophagy, and fibroblast activation in the pathogenesis of lung fibrosis. Am J Physiol Lung Cell Mol Physiol 2016; 311:L590-601. [PMID: 27474089 DOI: 10.1152/ajplung.00221.2016] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/23/2016] [Indexed: 12/13/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease characterized by accumulation of extracellular matrix (ECM) and impaired gas exchange. The pathobiological mechanisms that account for disease progression are poorly understood but likely involve alterations in innate inflammatory cells, epithelial cells, and fibroblasts. Thus we seek to review the most recent literature highlighting the complex roles of neutrophils and macrophages as both promoters of fibrosis and defenders against infection. With respect to epithelial cells and fibroblasts, we review the data suggesting that defective autophagy promotes the fibrogenic potential of both cell types and discuss new evidence related to matrix metalloproteinases, growth factors, and cellular metabolism in the form of lactic acid generation that may have consequences for promoting fibrogenesis. We discuss potential cross talk between innate and structural cell types and also highlight literature that may help explain the limitations of current IPF therapies.
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Affiliation(s)
- David N O'Dwyer
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Shanna L Ashley
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Graduate Program in Immunology, University of Michigan, Ann Arbor, Michigan; and
| | - Bethany B Moore
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan
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Pahlevaninezhad H, Lee AMD, Ritchie A, Shaipanich T, Zhang W, Ionescu DN, Hohert G, MacAulay C, Lam S, Lane P. Endoscopic Doppler optical coherence tomography and autofluorescence imaging of peripheral pulmonary nodules and vasculature. BIOMEDICAL OPTICS EXPRESS 2015; 6:4191-9. [PMID: 26504665 PMCID: PMC4605074 DOI: 10.1364/boe.6.004191] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/10/2015] [Accepted: 09/27/2015] [Indexed: 05/18/2023]
Abstract
We present the first endoscopic Doppler optical coherence tomography and co-registered autofluorescence imaging (DOCT-AFI) of peripheral pulmonary nodules and vascular networks in vivo using a small 0.9 mm diameter catheter. Using exemplary images from volumetric data sets collected from 31 patients during flexible bronchoscopy, we demonstrate how DOCT and AFI offer complementary information that may increase the ability to locate and characterize pulmonary nodules. AFI offers a sensitive visual presentation for the rapid identification of suspicious airway sites, while co-registered OCT provides detailed structural information to assess the airway morphology. We demonstrate the ability of AFI to visualize vascular networks in vivo and validate this finding using Doppler and structural OCT. Given the advantages of higher resolution, smaller probe size, and ability to visualize vasculature, DOCT-AFI has the potential to increase diagnostic accuracy and minimize bleeding to guide biopsy of pulmonary nodules compared to radial endobronchial ultrasound, the current standard of care.
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