Diagnosing Eosinophilic Chronic Rhinosinusitis in Excised Tissue Using Optical Coherence Tomography

Area of Science:

• Otolaryngology
• Medical Imaging
• Pathology

Background:

• Diagnosing eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) currently requires invasive histologic examination of tissue eosinophilia.
• There is a need for non-invasive or less invasive methods to diagnose ECRSwNP.

Purpose of the Study:

• To quantify eosinophils in fresh sinonasal tissue using optical coherence tomography (OCT).
• To compare OCT-based eosinophil counts with traditional histologic measurements (eosinophils per high-power field, HPF).
• To evaluate OCT's potential for diagnosing ECRSwNP.

Main Methods:

• Sinonasal tissue samples were obtained from patients undergoing endoscopic sinus surgery.
• Half of each sample underwent standard histologic processing for eosinophil quantification (eosinophils/HPF).
• The other half was imaged using high-resolution OCT to count eosinophil-like globules, followed by correlation analysis.

Main Results:

• OCT successfully identified globules resembling eosinophils in sinonasal tissue.
• Significantly higher globule counts were observed in ECRSwNP patients compared to others (101.9 vs. 24.3, p<0.001).
• A strong correlation (ρ=0.90, p<0.001) was found between OCT globule counts and histologic eosinophil counts. A cutoff of 45 OCT globules demonstrated 100% sensitivity and 87.5% specificity for ECRSwNP.

Conclusions:

• Optical coherence tomography (OCT) shows promise for diagnosing ECRSwNP in excised sinonasal tissue.
• OCT measurements correlate strongly with histologic findings.
• This study serves as a proof-of-concept for developing non-invasive, intranasal OCT systems for ECRSwNP diagnosis.