Anatomic Optical Coherence Tomography for Quantitative Bronchoscopy

用于定量支气管镜检查的解剖光学相干断层扫描

• 批准号: 8903568
• 负责人: Amy L Oldenburg
• 金额: $ 55.59万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8903568
• 关键词: Address; Adult; Affect; Air; Anatomy; Animals; Area; Biomedical Engineering; Breathing; Bronchi; Bronchoscopes; Bronchoscopy; Child; Clinical; Computational Geometry; Computer Simulation; Computer software; Computing Methodologies; Conscious; Data; Decision Making; Diagnosis; Diagnostic; Dimensions; Disease; Electromagnetics; Endoscopy; Engineering; Environmental air flow; Evaluation; Family suidae; Fiber Optics; Future; Geometry; Goals; Gold; Health; Image; Imaging technology; In Situ; Infant; Ionizing radiation; Laryngoscopy; Lead; Life; Light; Liquid substance; Lung; Magnetic Resonance Imaging; Measures; Medical; Methods; Metric; Microscopic; Modality; Modeling; Morbidity - disease rate; Newborn Infant; Noise; Obstructive Lung Diseases; Obstructive Sleep Apnea; Operative Surgical Procedures; Optical Coherence Tomography; Patients; Phase; Physiological; Positioning Attribute; Predictive Value; Radiation; Resistance; Resolution; Respiration; Respiratory Insufficiency; Risk; Robin bird; Rotation; Sampling; Scanning; Sedation procedure; Signal Transduction; Smooth Muscle Myocytes; Source; Speed; Stenosis; Structure; Surface; System; Technology; Time; Translations; Validation; X-Ray Computed Tomography; airway obstruction; base; bioimaging; carina; elastography; flexibility; imaging modality; improved; in vivo; in vivo imaging; minimally invasive; mortality; new technology; optical imaging; pre-clinical; predictive modeling; pressure; respiratory; sensor; stem; success; tissue phantom; treatment planning; virtual

DESCRIPTION (provided by applicant): Children commonly suffer from structural abnormalities of the upper airway that result in insufficient respiration and problems ranging from simple obstructive sleep apnea to imminent, life-threatening airway obstruction. In many cases dynamic airway collapse significantly contributes to airway obstruction, but methods for quantitative assessment of the dynamic airway are lacking. Quantitative imaging and computational modeling of the dynamic airway could prove very beneficial not only for the diagnosis of airway obstruction but also for aiding in medical and surgical decision-making, and could be utilized for predictive modeling and subsequent treatment planning. Current clinical methods for quantitative airway imaging, including MRI and CT, suffer from several limitations. Infants and young children may need to be sedated or anesthetized for long scan times, which can be quite hazardous for patients with airway obstruction. In the case of CT, there are risks associated with ionizing radiation exposure. These methods also do not readily offer real-time imaging to study airway dynamics. Airway endoscopy (laryngoscopy and bronchoscopy) is the gold standard for the evaluation of airway obstruction and is widely used to provide qualitative diagnostic information. We propose to address the need for quantitative, real-time, dynamic upper airway imaging by developing a technology based upon anatomic Optical Coherence Tomography (aOCT) delivered via standard bronchoscopes. The data acquired from this new technology will be manipulatable into 3D computational models of the airway upon which computational fluid dynamic (CFD) modeling will be performed. Our first Specific Aim will be to validate aOCT as a functionally equivalent substitute for CT for creating 3D virtual airway geometries for CFD. Our hypothesis is that the upper airway luminal geometries obtained by bronchoscopic aOCT can predict equivalent air flow resistance as that obtained by CT in cadaveric pigs. As an exploratory aspect of this Aim, we will perform imaging of adult human cadaveric lungs to evaluate the capability for quantitative imaging beyond the carina into the main stem, segmental, and smaller bronchi. Our second Specific Aim will be to incorporate technological advances into the aOCT system to enable dynamic, real-time (3+1) dimensional imaging to capture phases of the respiratory cycle in an in vivo pig model. Our third Specific Aim will be to perform elastography of the airway wall by collecting simultaneous in situ pressure and aOCT imaging data of pigs in vivo to during spontaneous respiration and while under variable positive airway pressure. This data will inform a dynamic flexible airway model for CFD computations that model the fluid-structure interaction (FSI). These pre-clinical steps of validation, technological advancement, and association with physiologic parameters of obstructive airway diseases will position the aOCT technology for rapid translation to clinical airway imaging.

描述（由申请人提供）：儿童通常患有上呼吸道结构异常，导致呼吸不足和从简单的阻塞性睡眠呼吸暂停到迫在眉睫的危及生命的气道阻塞的问题。在许多情况下，动态气道萎陷显着有助于气道阻塞，但缺乏动态气道的定量评估方法。动态气道的定量成像和计算建模可以证明不仅对于气道阻塞的诊断而且对于辅助医疗和手术决策是非常有益的，并且可以用于预测建模和随后的治疗计划。当前用于定量气道成像的临床方法（包括MRI和CT）存在一些局限性。婴幼儿可能需要长时间的镇静或麻醉扫描，这对气道阻塞的患者来说是相当危险的。在CT的情况下，存在与电离辐射暴露相关的风险。这些方法也不容易提供实时成像来研究气道动力学。气道内窥镜检查（喉镜检查和支气管镜检查）是评估气道阻塞的金标准，广泛用于提供定性诊断信息。我们建议通过开发一种基于解剖光学相干断层扫描（aOCT）的技术，通过标准支气管镜提供定量、实时、动态上气道成像。从这项新技术中获得的数据将被处理成气道的3D计算模型，在该模型上将进行计算流体动力学（CFD）建模。我们的第一个具体目标是验证aOCT作为CT的功能等效替代品，用于创建CFD的3D虚拟气道几何形状。我们的假设是，通过支气管镜aOCT获得的上气道管腔几何形状可以预测与尸体猪中通过CT获得的气流阻力相当的气流阻力。作为该目标的探索性方面，我们将对成人尸体肺进行成像，以评价超出隆突进入主干、节段和较小支气管的定量成像能力。我们的第二个具体目标是将技术进步纳入aOCT系统，以实现动态、实时（3+1）维成像，从而捕获活体猪模型中呼吸周期的阶段。我们的第三个具体目标是通过在自主呼吸期间和可变气道正压下同时收集猪体内的原位压力和aOCT成像数据，对气道壁进行弹性成像。这些数据将为CFD计算提供动态柔性气道模型，该模型模拟了流体-结构相互作用（FSI）。这些临床前验证步骤、技术进步以及与阻塞性气道疾病生理参数的关联将使aOCT技术能够快速转化为临床气道成像。