This Article Full Text Full Text (PDF) Online Supplement All Versions of this Article: 200507-1148OCv1 173/2/226    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Armstrong, J. J. Articles by Eastwood, P. R. Search for Related Content PubMed PubMed Citation Articles by Armstrong, J. J. Articles by Eastwood, P. R.

Quantitative Upper Airway Imaging with Anatomic Optical Coherence Tomography

Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic, and Computer Engineering, and School of Anatomy and Human Biology, University of Western Australia, Crawley; and West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia

Correspondence and requests for reprints should be addressed to Julian Armstrong, B.Sc., B.E. (Hons), Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic, and Computer Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009. E-mail: julian-a{at}ee.uwa.edu.au

Background: Measurements of upper airway size and shape are important in investigating the pathophysiology of obstructive sleep apnea (OSA) and in devising, applying, and determining the effectiveness of treatment modalities. We describe an endoscopic optical technique (anatomic optical coherence tomography, aOCT) that provides quantitative real-time imaging of the internal anatomy of the human upper airway.

Methods: Validation studies were performed by comparing aOCT- and computed tomography (CT)–derived measurements of cross-sectional area (CSA) in (1) conduits in a wax phantom and (2) the velo-, oro-, and hypopharynx during wakefulness in five volunteers. aOCT scanning was performed during sleep in one subject with OSA.

Results: aOCT generated images of pharyngeal shape and measurements of CSA and internal dimensions that were comparable to radiographic CT images. The mean difference between aOCT- and CT-derived measurements of CSA in (1) the wax phantom was 2.1 mm² with limits of agreement (2 SD) from –13.2 to 17.4 mm² and intraclass correlation coefficient of 0.99 (p < 0.001) and (2) the pharyngeal airway was 14.1 mm² with limits of agreement from –43.7 to 57.8 mm² and intraclass correlation coefficient of 0.89 (p < 0.001). aOCT generated quantitative images of changes in upper airway size and shape before, during, and after an apneic event in an individual with OSA.

Conclusions: aOCT generates quantitative, real-time measurements of upper airway size and shape with minimal invasiveness, allowing study over lengthy periods during both sleep and wakefulness. These features should make it useful for study of upper airway behavior to investigate OSA pathophysiology and aid clinical management.

Key Words: optical coherence tomography • sleep apnea • upper airway anatomy

This article has been cited by other articles:

				P. B. Noble, A. R. West, R. A. McLaughlin, J. J. Armstrong, S. Becker, P. K. McFawn, J. P. Williamson, P. R. Eastwood, D. R. Hillman, D. D. Sampson, et al. Airway narrowing assessed by anatomical optical coherence tomography in vitro: dynamic airway wall morphology and function J Appl Physiol, February 1, 2010; 108(2): 401 - 411. [Abstract] [Full Text] [PDF]

				J. P. Williamson, J. J. Armstrong, R. A. McLaughlin, P. B. Noble, A. R. West, S. Becker, A. Curatolo, W. J. Noffsinger, H. W. Mitchell, M. J. Phillips, et al. Measuring airway dimensions during bronchoscopy using anatomical optical coherence tomography Eur. Respir. J., January 1, 2010; 35(1): 34 - 41. [Abstract] [Full Text] [PDF]

				C. L. Marcus, R. J. H. Smith, L. A. Mankarious, R. Arens, G. S. Mitchell, R. G. Elluru, V. Forte, S. Goudy, E. W. Jabs, A. A. Kane, et al. Developmental Aspects of the Upper Airway: Report from an NHLBI Workshop, March 5-6, 2009 Proceedings of the ATS, September 15, 2009; 6(6): 513 - 520. [Abstract] [Full Text] [PDF]

				J. P. Williamson, A. L. James, M. J. Phillips, D. D. Sampson, D. R. Hillman, and P. R. Eastwood Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques Eur. Respir. J., July 1, 2009; 34(1): 42 - 55. [Abstract] [Full Text] [PDF]

				J. P. Williamson, R. A. McLaughlin, M. J. Phillips, J. J. Armstrong, S. Becker, J. H. Walsh, D. D. Sampson, D. R. Hillman, and P. R. Eastwood Using Optical Coherence Tomography To Improve Diagnostic and Therapeutic Bronchoscopy Chest, July 1, 2009; 136(1): 272 - 276. [Abstract] [Full Text] [PDF]

				K. Kairaitis, L. Howitt, J. R. Wheatley, and T. C. Amis Mass loading of the upper airway extraluminal tissue space in rabbits: effects on tissue pressure and pharyngeal airway lumen geometry J Appl Physiol, March 1, 2009; 106(3): 887 - 892. [Abstract] [Full Text] [PDF]

				S. Cheng, J. E. Butler, S. C. Gandevia, and L. E. Bilston Movement of the tongue during normal breathing in awake healthy humans J. Physiol., September 1, 2008; 586(17): 4283 - 4294. [Abstract] [Full Text] [PDF]

				H. O. Coxson, B. Quiney, D. D. Sin, L. Xing, A. M. McWilliams, J. R. Mayo, and S. Lam Airway Wall Thickness Assessed Using Computed Tomography and Optical Coherence Tomography Am. J. Respir. Crit. Care Med., June 1, 2008; 177(11): 1201 - 1206. [Abstract] [Full Text] [PDF]

				R. L. Horner and T. D. Bradley Update in Sleep and Control of Ventilation 2006 Am. J. Respir. Crit. Care Med., March 1, 2007; 175(5): 426 - 431. [Full Text] [PDF]