University of Twente Student Theses


Optical Innovations in Endobronchial Diagnostics

Geraats, Renée Milou (2019) Optical Innovations in Endobronchial Diagnostics.

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Abstract:Bronchoscopy is a pulmonary intervention in which a flexible endoscope is inserted in the central airways to perform diagnosis or execute interventions. Optical enhancement is the emittance of specific wavelengths of light to illuminate the tissue. The aim of this research is to assess the value of optical enhancement techniques in endobronchial diagnostics and interventions. This research consists of three parts. First, a technique validation of optical enhancement for bronchoscopy was done. Based on this technique assessment, commercially available optical enhancement spectra seem suitable for clinical application in bronchoscopy. Secondly, the possibilities of direct improvement of bronchoscopy interpretation by the application of optical enhancement was investigated. A patient file analysis resulted in a list of complication causes in the Radboudumc hospital (Nijmegen, the Netherlands) and a list of imaging pitfalls for which optical enhancement can improve the visualisation. A prospective case series of endobronchial images of fourteen patients either with or without central airway lesions were analysed. Optical enhancement images contain additional information about bronchial arches, vascular beds and bronchial abnormalities. Lastly, the starting steps for automatic detection of systemic disease were taken. A literature research was carried out to determine the tissue properties of tissue affected by lung cancer, nontuberculous mycobacteria and sarcoidosis. A research proposal for a prospective database registry for bronchoscopy images was submitted and approved (CMO 2019-5583). The applications of the bronchoscopy database and the required future research that is needed to accomplish these applications were described. Optical enhancement is an innovation that has potential for endobronchial application in routine practice. Improved vessel, arch and bronchial abnormality visualisation can prevent bronchial bleeding and perforation, and detect pathological lesions in an early stage. The first step for future research in optical enhancement is filling the prospective database of endobronchial images to allow for automatic distinction between healthy and affected airways.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
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