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J Thorac Cardiovasc Surg 2005;129:615-622
© 2005 The American Association for Thoracic Surgery

Evolving Technology

Two-dimensional and 3-dimensional optical coherence tomographic imaging of the airway, lung, and pleura

^a Beckman Laser Institute, University of California, Irvine, Irvine, Calif
^b Pulmonary and Critical Care Division
^d Cardiothoracic Surgery, UC Irvine Medical Center, Orange, Calif
^c Veterans Administration Medical Center, Long Beach, Calif

Read at the Thirtieth Annual Meeting of The Western Thoracic Surgical Association, Maui, Hawaii, June 23-26, 2004.

Received for publication June 22, 2004; revisions received October 7, 2004; accepted for publication October 15, 2004.

¹ Address for reprints: Matt Brenner, MD, Pulmonary and Critical Care Division, UC Irvine Medical Center, Bldg 53, Rm 119, 101 City Drive South, Orange, CA 92868 (E-mail: mbrenner{at}uci.edu).

² Zhongping Chen, PhD, Department of Biomedical Engineering, Beckman Laser Institute, UC Irvine, Irvine, CA 9261 (E-mail: Zchen{at}bli.uci.edu).

BACKGROUND: Methods for obtaining real-time in vivo histologic resolution by means of noninvasive endoscopic optical imaging would be a major advance for thoracic surgical diagnostics and treatment. Optical coherence tomography is a rapidly evolving technology based on near-infrared interferometry that might provide these capabilities. The purpose of this study is to investigate the feasibility of real-time 2- and 3-dimensional optical coherence tomographic imaging of airway, pleural, and subpleural lung tissues in normal, inflammatory, and malignant animal models and patients with known or suspected airway malignancy.

METHODS: Freshly excised lungs and pleural tissue obtained from rabbits with inhalation lung injury and induced empyema, metastatic sarcomas, and pleural sarcomas and from patients with airway disease were imaged by using 2- and 3-dimensional optical coherence tomography with a prototype superluminescent diode optical coherence tomographic system constructed in our laboratory. Lungs and pleural tissue were subsequently processed for standard hematoxylin and eosin histology for comparison with optical coherence tomography.

RESULTS: Optical coherence tomographic imaging achieved an ex vivo resolution of 10 µm and an in vivo resolution of about 30 µm with a depth penetration of 1 to 2 mm with 2- and 3- dimensional reconstruction capabilities. Tumors as small as 500 µm were detectable with optical coherence tomography. The acquired images closely matched histologic images, demonstrating details at the level of mucosal layers, glands, alveoli, and respiratory bronchioles.

CONCLUSIONS: Optical coherence tomography with near-infrared interferometric methods enables near real-time in vivo near-histologic resolution optical imaging. With further advances, optical coherence tomography has the potential for real-time accurate and early pleural and subpleural diagnostics by using small-diameter flexible fiberoptic endoscopic probes for a wide range of thoracic surgical applications.

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