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Real-Time Three-Dimensional Optical Coherence Tomography Guidance for Transbronchial Biopsy: A Proof-of-Concept Ex
Takayasu Ito1, Tomoya Baba1, Hayata Kimura1
1Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Surgical Innovation
|August 12, 2026
Summary
Three-dimensional optical coherence tomography (3D-OCT) allows real-time visualization of instruments during transbronchial lung biopsy (TBB). This novel approach enhances the targeting and sampling of peripheral pulmonary lesions (PPLs).
Area of Science:
- Pulmonology
- Medical Imaging
- Interventional Pulmonology
Background:
- Conventional bronchoscopy struggles to accurately target peripheral pulmonary lesions (PPLs) due to limited visualization.
- Real-time 3D imaging of instrument-lesion spatial relationships is challenging with current methods like 2D radial endobronchial ultrasound (r-EBUS).
Purpose of the Study:
- To evaluate the feasibility of three-dimensional optical coherence tomography (3D-OCT) for guiding transbronchial lung biopsy (TBB).
- To assess 3D-OCT's ability to visualize pseudo-lesions and the spatial relationship between instruments and targets during TBB.
Main Methods:
- A 3D-OCT probe and biopsy forceps were advanced through a guide sheath to pseudo-lesions in excised pig lungs.
- Simultaneous visualization of the sampling instrument's position relative to the pseudo-lesion was performed in real time.
Main Results:
- 3D-OCT successfully visualized the spatial relationship between the sampling instrument and pseudo-lesions in real time.
- Three-dimensional optical coherence tomography-guided TBB was successfully performed in three biopsies per pseudo-lesion.
Conclusions:
- 3D-OCT-guided TBB is feasible in an ex vivo model for sampling target lesions.
- 3D-OCT shows promise for improving the targeting and sampling accuracy of PPLs during bronchoscopy.
