This study will evaluate a new imaging technology, termed optical frequency domain imaging (OFDI) for detecting and diagnosing pulmonary malignancy in the central airways.

Population

Patients referred for bronchoscopy procedures in the Pulmonary and Critical Care Department at Massachusetts General Hospital for the evaluation of known or suspected pulmonary malignancy will be enrolled in this study. Study patients will receive standard of care for pulmonary disease consistent with national guidelines.

Brief Title

Pilot Study to Evaluate Optical Frequency Domain Imaging for Diagnosis of Central Airway Disease

Official Title

Brief Summary

This study will evaluate a new imaging technology, termed optical frequency domain imaging<br /> (OFDI) for detecting and diagnosing pulmonary malignancy in the central airways.

Detailed Description

The prevalence and high mortality rate associated with lung squamous cell carcinoma and the
lack of any widely accepted screening and surveillance tools, highlights the need for new
imaging paradigms that will ultimately lead to a reduction in patient mortality.

Bronchial carcinoma-in-situ will progress to invasive cancer in over 40% of individuals, and
although the progression occurs over a long period of time, the majority of carcinomas are
detected in the later stages of disease development, offering patients only a slim chance of
cure. Although significant effort in the development of screening paradigms for the detection
of lung cancer in the central airways have been made, to date there is still no widely
accepted and validated approach. Optical frequency domain imaging (OFDI) is a recent
derivative of optical coherence tomography (OCT). OFDI can be used to conduct volumetric
microscopy of the airways at a resolution comparable with architectural histopathology. The
long term goal of this study is to use OFDI to screen the airways with the hope of detecting
squamous cell carcinoma at an early more curable stage.

Standard of care bronchoscopy preparation and procedures will be followed including moderate
sedation, pulse oximetry and blood pressure monitoring as per department protocol. A
combination of currently approved bronchoscopy techniques including standard white light
bronchoscopy, autofluorescence bronchoscopy, and narrow band imaging will be used to assess
the airways. Bronchial regions of interest (ROI) suspected to be premalignant or malignant,
will be imaged using the OFDI system and catheter prior to biopsy acquisition. It is
anticipated that a minimum of 3 OFDI-biopsy correlated pairs from each study participant will
be obtained. An additional OFDI and biopsy will be obtained from a normal ROI. It is expected
that the experimental procedure will add less than 10 minutes to the total length of the
bronchoscopy procedure, but a stopping rule will be instituted to ensure that the
experimental procedure does not exceed 20 minutes.