The Authors: Keishi Ohtani, MD, is a thoracic surgeon at Tokyo Medical University. He is currently a visiting fellow conducting optical imaging research at the BC Cancer Research Centre.
Frontiers in bronchoscopic imaging
Version of Record online: 24 JAN 2012
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology
Volume 17, Issue 2, pages 261–269, February 2012
How to Cite
OHTANI, K., LEE, A. M.D. and LAM, S. (2012), Frontiers in bronchoscopic imaging. Respirology, 17: 261–269. doi: 10.1111/j.1440-1843.2011.02108.x
Anthony M.D. Lee, PhD, is a postdoctoral fellow at Cancer Imaging Unit, Integrative Oncology Department, British Columbia Cancer Agency Research Centre. His area of research is optical coherence tomography.
Stephen Lam, MD, FRCPC, is Professor of Medicine at the University of British Columbia and Chair of the Lung Tumor Group at the British Columbia Cancer Agency. His interest is in early detection of lung cancer and endoscopic optical imaging.
SERIES EDITORS: JOHN E HEFFNER AND DAVID CL LAM
- Issue online: 24 JAN 2012
- Version of Record online: 24 JAN 2012
- Accepted manuscript online: 29 NOV 2011 10:31AM EST
- Received 18 October 2011; invited to revise 4 November 2011; revised 6 November 2011; accepted 14 November 2011.
- confocal endomicroscopy;
- narrow-band imaging;
- optical coherence tomography;
- Raman spectroscopy
Bronchoscopy is a minimally invasive method for diagnosis of diseases of the airways and the lung parenchyma. Standard bronchoscopy uses the reflectance/scattering properties of white light from tissue to examine the macroscopic appearance of airways. It does not exploit the full spectrum of the optical properties of bronchial tissues. Advances in optical imaging such as optical coherence tomography (OCT), confocal endomicroscopy, autofluorescence imaging and laser Raman spectroscopy are at the forefront to allow in vivo high-resolution probing of the microscopic structure, biochemical compositions and even molecular alterations in disease states. OCT can visualize cellular and extracellular structures at and below the tissue surface with near histological resolution, as well as to provide three-dimensional imaging of the airways. Cellular and subcellular imaging can be achieved using confocal endomicroscopy or endocytoscopy. Contrast associated with light absorption by haemoglobin can be used to highlight changes in microvascular structures in the subepithelium using narrow-band imaging. Blood vessels in the peribronchial space can be displayed using Doppler OCT. Biochemical compositions can be analysed with laser Raman spectroscopy, autofluorescence or multispectral imaging. Clinically, autofluorescence and narrow-band imaging have been found to be useful for localization of preneoplastic and neoplastic bronchial lesions. OCT can differentiate carcinoma in situ versus microinvasive cancer. Endoscopic optical imaging is a promising technology that can expand the horizon for studying the pathogenesis and progression of airway diseases such as COPD and asthma, as well as to evaluate the effect of novel therapy.