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New optical technique for determining fibrotic tissue in lungs

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15 November 2023
An interdisciplinary research team has developed a new optical technique for determining fibrotic tissue in the lungs of interstitial lung disease patients. This groundbreaking study demonstrates that this new technique has potential to outperform fibrosis detection and quantification in the lung as compared to high resolution Computed Tomography. The team was led by VU Amsterdam physicist Prof. dr. Johannes de Boer and Amsterdam UMC lung specialists Dr. Peter Bonta and Prof. dr. Jouke Annema.

The study was recently published on BMJ open Respiratory Research and presented at the European Respiratory Society conference in Milan.  

Interstitial Lung Disease
In the Netherlands, up to 20.000 patients are diagnosed with an interstitial lung disease (ILD) each year. ILD consists of various stages of inflammation and formation of scar tissue (fibrosis) in the most outer regions of the lung. Correctly diagnosing and differentiating between inflammation and fibrosis is challenging, but of importance for effective treatment. ILD diagnosis usually uses CT scans, but often these don't give a clear result, so a more invasive lung biopsy might be needed.

New imaging technique
In their new study, De Boer, Bonta and Annema have demonstrated that a bronchoscopic imaging technique can detect fibrosis characteristics and quantify pulmonary fibrosis without the need to perform invasive biopsies. The technique is known as Endobronchial Polarization-Sensitive Optical Coherence Tomography (EB-PS-OCT). It is a minimally invasive technique, where a small catheter is advanced through the working channel of a bronchoscope reaching the airways and the most outer regions of the lung. During bronchoscopy the technique can be combined with standard broncho-alveolar lavage.

Quantify fibrosis
EB-PS-OCT creates 3D cross-sectional images of lung segments. It allows to obtain airway images with 50 times higher resolution than the current gold standard CT. And can quantify fibrosis, providing new insights on the progression of the disease and assist with the diagnosis of ILDs in cases where HR-CT is inconclusive. The use of EB-PS-OCT as add-on to standard bronchoscopy in ILD has potential to increase diagnostic confidence, reduce the proportion of invasive lung biopsies, and be cost-effective by better allocation of expensive treatments.

Department of Physics and Astronomy
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Department of Physics and Astronomy at VU Amsterdam offers an active and engaged intellectual community composed of researchers from around the world. The department is involved in teaching in the programs Physics and Astronomy (joint degree with the University of Amsterdam), Science Business and Innovation, Medical Natural Sciences (all three BSc and MSc), and the BSc program in Mechanical Engineering (together with University of Twente). 

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