The ability to monitor disease progression over time is critical to inform patient care and prognosis, especially in usual interstitial pneumonia (UIP), the histopathological pattern seen in idiopathic pulmonary fibrosis (IPF). HRCT is limited in resolution to detect disease changes on a microscopic level, and surgical lung biopsy (SLB) has high risk of morbidity and mortality precluding its use to assess progression. Endobronchial optical coherence tomography (EB-OCT) is a bronchoscopic, minimally-invasive, high-resolution imaging method that accurately detects microscopic ILD features and is repeatable. Here, we evaluate the utility of repeat EB-OCT for monitoring microscopic disease progression in UIP/IPF.
Idiopathic pulmonary fibrosis (IPF) is a fatal form of fibrotic interstitial lung disease (ILD). Early diagnosis of IPF is essential, but often requires invasive surgery. We conduct a prospective study evaluating the diagnostic accuracy of endobronchial optical coherence tomography (EB-OCT) for IPF diagnosis as compared to concurrent surgical lung biopsy (SLB) and clinical follow-up diagnosis. EB-OCT was performed immediately prior to SLB in 27 ILD patients. EB-OCT was 100% sensitive and 100% specific for both histologic and clinical follow up diagnosis of IPF. The results demonstrate the potential of EB-OCT as minimally-invasive, low-risk in vivo method for microscopic IPF diagnosis.
Early, accurate diagnosis of interstitial lung disease (ILD) is critical for clinical management and therapeutic decision-making, especially distinguishing idiopathic pulmonary fibrosis (IPF) from non-IPF ILD. Unfortunately, current diagnostic imaging methods are limited in resolution and surgical biopsy methods are invasive. In this study, we evaluate the accuracy of endobronchial optical coherence tomography (EB-OCT) as a low-risk method for in vivo ILD diagnosis in patients undergoing surgical biopsy. EB-OCT was able to distinguish diagnostic microanatomical features of IPF from non-IPF ILDs, independently compared against surgical biopsy. These findings support the potential of OCT as a minimally-invasive method for IPF diagnosis.
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