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The Proceedings of the American Thoracic Society 6:439-443 (2009)
© 2009 The American Thoracic Society
doi: 10.1513/pats.200904-015AW
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Quantitative Assessment of the Airway Wall Using Computed Tomography and Optical Coherence Tomography

Harvey O. Coxson1 and Stephen Lam2

1 Department of Radiology, Vancouver General Hospital, James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, and 2 British Columbia Cancer Agency, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Correspondence and requests for reprints should be addressed to Harvey O. Coxson, Ph.D., Department of Radiology, Vancouver General Hospital, 855 West 12th Ave, Room 3350 JPN, Vancouver, BC, V5Z 1M9 Canada. E-mail: harvey.coxson{at}vch.ca

ABSTRACT

Ever since the site and nature of airflow obstruction in chronic obstructive pulmonary disease was described by Hogg, Thurlbeck, and Macklem, investigators have been looking for methods to noninvasively measure the airway wall dimensions. Recent advances in computed tomography technology and new computer algorithms have made it possible to visualize and measure the airway wall and lumen without the need for tissue. However, while there is great hope for computed tomographic assessment of airways, it is well known that the spatial resolution does not allow small airways to be visualized and there are still concerns about the sensitivity of these measurements obtained from these airways. Optical coherence tomography is a new bronchoscopic imaging technique that has generated considerable interest because the spatial resolution is much higher than computed tomography. While relatively more invasive than computed tomography, it has the advantage of not exposing the patient to ionizing radiation. This review discusses some of the data surrounding these two imaging techniques in patients with chronic obstructive pulmonary disease. These imaging techniques are extremely important in the assessment of patients with chronic obstructive pulmonary disease because therapy that is designed to modulate the inflammation in airways may be contraindicated in subjects with the emphysema phenotype and visa versa. Therefore, these new imaging techniques are very likely to play a front-line role in the study of chronic obstructive pulmonary disease and will, hopefully, allow clinicians to phenotype individuals, thereby personalizing their treatment.

Key Words: computed tomography • airways • optical coherence tomography • chronic obstructive pulmonary disease


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Vladimir R. Muzykantov
Proceedings of the American Thoracic Society 2009 6: 398-402. [Full Text]  





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