Imaging of the Pediatric Airway Using Optical Coherence Tomography

Objectives: Optical coherence tomography (OCT) is an imaging modality that uses a broadband light source to produce high-resolution cross-sectional images in liv-ing tissue (8–20!m). A prospective study of normal, benign, and pathologic tissues in the pediatric airwaywas conducted to assess the utility of OCT technology in char-acterizing the microanatomy of the pediatric upper aero-digestive tract in vivo. Study Design: Prospective clinical trial. Materials and Methods: Fifteen patients from 1 to 17 years of age underwent surgical endoscopy and OCT for various airway disorders. OCT imaging was per-formed at a frame rate of 1 Hz using a 1.3-!m broadband light source to produce images 1.6! 6 mm in vertical and horizontal dimensions. The epithelium, lamina propria, and unique tissue microstructures were visualized and then measured using digital micrometry. Direct compar-ison of OCT images with endoscopic photography was performed. Results: Systematic imaging of the oral cavity, oro-pharynx, hypopharynx, and larynx was performed in all 15 patients. Normal microstructures identified included papillae, ducts, glands, and vessels, whereas pathologic conditions included distinct zones of mature scar, granu-lation tissue, edema, ulceration, and papillomatosis. En-doscopic photographs were well correlated with OCT images. Conclusions: OCT is capable of obtaining high-resolution microanatomy images of pediatric airway in vivo tissue. OCT clearly identifies the epithelium and lamina propria while providing detailed structural infor-mation on normal and diseased tissues. OCT is a promising emerging imaging modality for use in current pediatric patient populations