Abstract
Background The early radiologic signs of progression in bronchiectasis remain unclear.
Objectives To compare endobronchial optical coherence tomography (EB-OCT) and chest computed tomography (CT) for evaluating radiological progression of bronchiectasis via stratifyng the presence (TW+) or absence (TW-) of thickened-walled bronchioles surrounding dilated bronchi among patients with bronchiectasis based on CT, and determine the risk factors.
Methods In this prospective cohort study, we performed both chest CT and EB-OCT at baseline and 5-year follow-up, to compare changes in airway caliber metrics. We evaluated bacterial microbiology, sputum matrix metalloproteinase-9 levels and free neutrophil elastase activity at baseline. We compared clinical characteristics and airway caliber metrics between group TW+ and TW-. We ascertained radiological progression at 5 years via CT and EB-OCT.
Results We 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 7th-9th generation bronchioles were significantly greater in group TW+ than in group TW-. Meanwhile, EB-OCT did not reveal bronchiole dilatation (compared with the same segment of normal bronchioles) surrounding non-dilated bronchi on CT in group TW-. At 5 years, 53.1% of patients in group TW+ progressed to have bronchiectasis measured with EB-OCT, compared with only 3.3% in group TW- (p<0.05). 34 patients in group TW+ demonstrated marked dilatation of medium-sized and small airways. Higher baseline neutrophil elastase activity and TW+ bronchioles on CT predicted progression of bronchiectasis.
Conclusion Thickened-walled bronchioles surrounding the dilated bronchi, identified with EB-OCT, indicates progression of bronchiectasis.
Footnotes
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Conflict of interest: None declared.
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- Received October 7, 2022.
- Accepted April 30, 2023.
- Copyright ©The authors 2023
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