Abstract
BackgroundThe early radiological signs of progression in bronchiectasis remain unclear. The objective of the present study was to compare endobronchial optical coherence tomography (EB-OCT) and chest computed tomography (CT) for the evaluation of radiological progression of bronchiectasisviastratification of the presence (TW+) or absence (TW−) of thickened-walled bronchioles surrounding dilated bronchi in patients with bronchiectasis based on CT, and determine the risk factors.MethodsIn this prospective cohort study, we performed both chest CT and EB-OCT at baseline and 5-year follow-up, to compare changes in airway calibre metrics. We evaluated bacterial microbiology, sputum matrix metalloproteinase-9 levels and free neutrophil elastase activity at baseline. We compared clinical characteristics and airway calibre metrics between the TW+and TW−groups. We ascertained radiological progression at 5 yearsviaCT and EB-OCT.ResultsWe recruited 75 patients between 2014 and 2017. At baseline, EB-OCT metrics (mean luminal diameter (p=0.017), inner airway area (p=0.005) and airway wall area (p=0.009) of seventh- to ninth-generation bronchioles) were significantly greater in the TW+group than in the TW−group. Meanwhile, EB-OCT did not reveal bronchiole dilatation (compared with the same segment of normal bronchioles) surrounding nondilated bronchi on CT in the TW−group. At 5 years, 53.1% of patients in the TW+group progressed to have bronchiectasis measured with EB-OCT, compared with only 3.3% in TW−group (p<0.05). 34 patients in the TW+group demonstrated marked dilatation of medium-sized and small airways. Higher baseline neutrophil elastase activity and TW+bronchioles on CT predicted progression of bronchiectasis.ConclusionThickened-walled bronchioles surrounding the dilated bronchi, identified with EB-OCT, indicates progression of bronchiectasis.
Funder
Plan on enhancing scientific research in Guangzhou Medical University
Zhongnanshan Medical Foundation of Guangdong Province
Guangzhou Science and Technology Plans
The Study of the Common Key Technologies of Large-scale Development of Novel Inhaled Preparations
National Natural Science Foundation of China
Guangdong Science and Technology Foundation
Publisher
European Respiratory Society (ERS)
Subject
Pulmonary and Respiratory Medicine