Premium
Multimodality bronchoscopic imaging of recurrent respiratory papillomatosis
Author(s) -
Colt Henri G.,
Murgu Septimiu D.,
Jung Bockhyun,
Ahn YehChan,
Brenner Matt
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20780
Subject(s) - recurrent respiratory papillomatosis , multimodality , medicine , papillomatosis , respiratory system , radiology , papilloma , dermatology , pathology , computer science , world wide web
Objectives/Hypothesis. Recurrent respiratory papillomatosis (RRP) of the central airways requires removal to potentially reduce recurrence and risk for malignant transformation. Analogous to the principles of treatment for early lung cancer, a precise determination of the extent of cartilage invasion could help guide therapeutic decisions and monitor response to treatment. The purpose of this study was to determine whether a bronchoscopy platform comprised of white light bronchoscopy (WLB), endobronchial ultrasound (EBUS), and optical coherence tomography (OCT) could identify layered microstructure of RRP and underlying cartilage. Study Design. Case study. Methods. A bronchoscopy platform consisting of commercially available WLB, EBUS using a 7.5 MHz convex probe (BF‐UC 160F; Olympus Optical Co. Ltd, Tokyo, Japan), and a time‐domain OCT with front imaging and inside actuation (Niris Imaging System; Imalux Corp., Cleveland, OH) was used in a patient with tracheal stenosis from RRP. Findings are compared with results of histology and the characteristics of imaging modalities are discussed. Results. WLB revealed tracheal pedunculated lesions. EBUS showed a 1‐cm hypoechogenic density corresponding to the papilloma, visualized above a hyperechogenic density corresponding to tracheal cartilage. There was no sonographic evidence of cartilage disruption or adjacent lymphadenopathy. OCT revealed a layer of heterogeneous light backscattering suggesting the mucosal papilloma, and a layer of high‐degree scattering, corresponding to the central fibrovascular core noted on histology. Conclusions. Layered microstructures of RRP and underlying airway cartilage can be identified using a combination of acoustic and optical bronchoscopic imaging modalities with different resolution and depth of penetration characteristics. Laryngoscope, 2010