title: Endoscopic narrow-band imaging-quantitative assessment of airway vascularity after lung transplantation.
abstract: In lung transplant recipients, the submucosal vascular plexus of the airway wall potentially represents one of the key structures of graft injury. Narrow band imaging is a novel endoscope technique that allows visual enhancement of the mucosa vasculature. It was our aim to investigate the ability of narrow-band imaging in combination with computerized image analysis to quantitatively assess airway vascularity in lung transplant recipients. In consecutive lung transplant recipients, in addition to the routine procedures, optical analysis of the main carina (autologous tissue) and the upper lobe carina (allogeneic tissue) were performed. From every site, three representative pictures were chosen. A total of 63 bronchoscopies were analyzed. The intraclass correlation coefficient (measure for test-retest reliability) of the three measurements were 0.69 and 0.74 for the main carina and the upper lobe carina, respectively. A mixed linear regression revealed increased vascularity in autologous tissue of patients with cystic fibrosis (p=0.06) and decreased vascularity in allogeneic tissue with time after transplantation (p=0.09). Endoscopic narrow-band imaging (NBI) in combination with computerized image analysis allows consistent assessment of airway vascularity in vivo. In lung transplant recipients, there might be differences in airway vascularity in both autologous and allogeneic large airways.
authors.affiliation: University Hospital Zurich, Clinic of Pulmonary Medicine, Ramistrasse 100, 8091 Zurich, Switzerland. sarosh.irani@usz.ch
authors.forename: Sarosh
authors.initials: S
authors.lastname: Irani
authors.forename: Irene
authors.initials: I
authors.lastname: Thuer
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Rudolf
authors.initials: R
authors.lastname: Speich
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
mesh_terms: D000465:Algorithms; D001999:Bronchoscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008168:Lung / Q000098:blood supply* / Q000473:pathology*; D016040:Lung Transplantation / Q000009:adverse effects / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000473:pathology*; D011652:Pulmonary Circulation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity