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Diagnosis of subglottic stenosis in a rabbit model using long-range optical coherence tomography.

ABSTRACT: Current imaging modalities lack the necessary resolution to diagnose subglottic stenosis. The aim of this study was to use optical coherence tomography (OCT) to evaluate nascent subglottic mucosal injury and characterize mucosal thickness and structural changes using texture analysis in a simulated intubation rabbit model.Prospective animal study in rabbits.Three-centimeter-long sections of endotracheal tubes (ETT) were endoscopically placed in the subglottis and proximal trachea of New Zealand White rabbits (n = 10) and secured via suture. OCT imaging and conventional endoscopic video was performed just prior to ETT segment placement (day 0), immediately after tube removal (day 7), and 1 week later (day 14). OCT images were analyzed for airway wall thickness and textural properties.Endoscopy and histology of intubated rabbits showed a range of normal to edematous tissue, which correlated with OCT images. The mean airway mucosal wall thickness measured using OCT was 336.4 ?m (day 0), 391.3 ?m (day 7), and 420.4 ?m (day 14), with significant differences between day 0 and day 14 (P = .002). Significance was found for correlation and homogeneity texture features across all time points (P < .05).OCT is a minimally invasive endoscopic imaging modality capable of monitoring progression of subglottic mucosal injury. This study is the first to evaluate mucosal injury during simulated intubation using serial OCT imaging and texture analysis. OCT and texture analysis have the potential for early detection of subglottic mucosal injury, which could lead to better management of the neonatal airway and limit the progression to stenosis.NA Laryngoscope, 127:64-69, 2017.

SUBMITTER: Ajose-Popoola O

PROVIDER: S-EPMC5326617 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Diagnosis of subglottic stenosis in a rabbit model using long-range optical coherence tomography.

Ajose-Popoola Olubunmi O Su Erica E Hamamoto Ashley A Wang Alex A Jing Joseph C JC Nguyen Tony D TD Chen Jason J JJ Osann Kathryn E KE Chen Zhongping Z Ahuja Gurpreet S GS Wong Brian J F BJ

The Laryngoscope 20160825 1

<h4>Objectives/hypothesis</h4>Current imaging modalities lack the necessary resolution to diagnose subglottic stenosis. The aim of this study was to use optical coherence tomography (OCT) to evaluate nascent subglottic mucosal injury and characterize mucosal thickness and structural changes using texture analysis in a simulated intubation rabbit model.<h4>Study design</h4>Prospective animal study in rabbits.<h4>Methods</h4>Three-centimeter-long sections of endotracheal tubes (ETT) were endoscopi ...[more]

PMID: 27559721

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Project description:PurposeTo report diagnostic accuracy of optical coherence tomography (OCT) disc variables using both time-domain (TD) and Fourier-domain (FD) OCT, and to improve the use of OCT disc variable measurements for glaucoma diagnosis through regression analyses that adjust for optic disc size and axial length-based magnification error.DesignObservational, cross-sectional.ParticipantsIn total, 180 normal eyes of 112 participants and 180 eyes of 138 participants with perimetric glaucoma from the Advanced Imaging for Glaucoma Study.MethodsDiagnostic variables evaluated from TD-OCT and FD-OCT were: disc area, rim area, rim volume, optic nerve head volume, vertical cup-to-disc ratio (CDR), and horizontal CDR. These were compared with overall retinal nerve fiber layer thickness and ganglion cell complex. Regression analyses were performed that corrected for optic disc size and axial length. Area-under-receiver-operating curves (AUROC) were used to assess diagnostic accuracy before and after the adjustments. An index based on multiple logistic regression that combined optic disc variables with axial length was also explored with the aim of improving diagnostic accuracy of disc variables.Main outcome measureComparison of diagnostic accuracy of disc variables, as measured by AUROC.ResultsThe unadjusted disc variables with the highest diagnostic accuracies were: rim volume for TD-OCT (AUROC=0.864) and vertical CDR (AUROC=0.874) for FD-OCT. Magnification correction significantly worsened diagnostic accuracy for rim variables, and while optic disc size adjustments partially restored diagnostic accuracy, the adjusted AUROCs were still lower. Axial length adjustments to disc variables in the form of multiple logistic regression indices led to a slight but insignificant improvement in diagnostic accuracy.ConclusionsOur various regression approaches were not able to significantly improve disc-based OCT glaucoma diagnosis. However, disc rim area and vertical CDR had very high diagnostic accuracy, and these disc variables can serve to complement additional OCT measurements for diagnosis of glaucoma.

Dataset Information

Diagnosis of subglottic stenosis in a rabbit model using long-range optical coherence tomography.

Publications

Diagnosis of subglottic stenosis in a rabbit model using long-range optical coherence tomography.

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