Endobronchial optical coherence tomography or computed tomography for evaluating progression of bronchiectasis

Area of Science:

• Pulmonary Medicine
• Radiology
• Medical Imaging

Background:

• Early radiological signs of bronchiectasis progression are not well understood.
• Chest computed tomography (CT) and endobronchial optical coherence tomography (EB-OCT) are used to evaluate bronchiectasis.
• Stratification of patients based on thickened-walled bronchioles (TW+) versus absence (TW-) surrounding dilated bronchi is key.

Purpose of the Study:

• To compare EB-OCT and CT for evaluating radiological progression of bronchiectasis.
• To identify risk factors for bronchiectasis progression.
• To stratify patients with bronchiectasis based on CT findings.

Main Methods:

• A prospective cohort study involving 75 patients.
• Chest CT and EB-OCT performed at baseline and 5-year follow-up.
• Evaluation of airway calibre metrics, bacterial microbiology, sputum MMP-9, and neutrophil elastase activity.

Main Results:

• EB-OCT metrics were significantly greater in the TW+ group at baseline.
• At 5 years, 53.1% of the TW+ group showed bronchiectasis progression via EB-OCT, versus 3.3% in the TW- group.
• Higher baseline neutrophil elastase activity and TW+ bronchioles on CT predicted progression.

Conclusions:

• Thickened-walled bronchioles surrounding dilated bronchi, identified by EB-OCT, indicate bronchiectasis progression.
• EB-OCT is a valuable tool for assessing bronchiectasis progression.
• Neutrophil elastase activity is a predictor of bronchiectasis progression.