Page 81 - ECBIP 2021_Program

MODERATED e-POSTER SESSION 08:
Novel Imaging modalities
PP53
Introduction: Bronchial thermoplasty (BT) is an endoscopic treatment for severe asthma which targets structural
airway remodeling (AR) including airway smooth muscle and extracellular matrix (ECM) by radiofrequent energy.The gold standard to evaluate this is invasive focal airway biopsies. Bronchoscopic optical coherence tomography (OCT) generates high resolution images of the airways in 5 cm segments, enabling ECM detection in a minimally invasive way (Carpaij et al.AJRCCM 2020;202(5):762-6).
Aim: Evaluate OCT to detect airway remodelling after BT.
Methods: Bronchoscopic OCT before and after BT was performed from distal to proximal airways in 15 severe asthma patients (TASMA cohort). Segmented high intensity OCT areas of 45 airways (3 per patient, 1049 OCT images total) were evaluated. Collagen content in biopsies was assessed by histology.
Results: Comparing before and after BT (independent t-test), a reduction in segmented high intensity OCT area was measured in the proximal larger airways (P<0.05). No differences were detected in small airways. Before BT a correlation (linear regression) existed between OCT area and biopsy collagen content (R2=0.2; P-value= 0.002), which was absent after BT.
Conclusion: High intensity OCT areas are reduced after BT reflecting changes in AR including ECM content. Implication: Bronchoscopic OCT is a promising minimally invasive imaging tool to assess AR.
Figure 1: Histology and OCT images of N=15 severe asthma patients have been evaluated before and after Bronchial Thermoplasty (BT) treatment. A) OCT pullbacks of the right lower lobe are performed before (A1) and after (A2) BT.
B) OCT image to detect and quantify high intensity OCT areas before BT (B1), which is reduced after BT (B2). C) Right lower lobe airway histology of a severe asthma patient (Sirius red-stained biopsies); before BT (C1): thickened basement membrane (long arrow) and airway smooth muscle mass (ASM) (short arrow); after BT (C2): reduction in both ASM and thickening of the basement membrane is detected.
OPTICAL COHERENCE TOMOGRAPHY DETECTED CHANGES IN AIRWAY REMODELING AFTER BRONCHIAL THERMOPLASTY IN SEVERE ASTHMA
Pieta C. Wijsman1, Annika M.W. Goorsenberg1, Richard M. van den Elzen2, Nienke Hoekstra3, Julia N.S. d’Hooghe1, D. Martijn de Bruin2, Janette K. Burgess3, Jouke T. Annema1, Peter I. Bonta1
1 Department of Respiratory Medicine, Amsterdam UMC, Amsterdam, Netherlands, 2 Amsterdam University Medical Center, University of Amsterdam, Department of Biomedical Engineering & Physics, Amsterdam, Netherland,
3 University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, Netherlands
ECBIP 2021 81
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts