Article Text

Endoscopic advanced imaging of the respiratory tract: exploring probe-based confocal laser endomicroscopy in emphysema
  1. J Yserbyt,
  2. C Dooms,
  3. W Janssens,
  4. G M Verleden
  1. Respiratory Division, Department of Clinical and Experimental Medicine, University Hospitals Leuven, KU Leuven, Belgium
  1. Correspondence to Dr J Yserbyt, Respiratory Division, Department of Clinical and Experimental Medicine, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium; Jonas.yserbyt{at}


Probe-based confocal laser endomicroscopy (pCLE) was performed in 15 patients with emphysema and 15 healthy subjects to visualise small airways in a direct and dynamic way. Morphometry shows that the median cross-sectional area of the alveolar openings at the level of the alveolar ducts is significantly larger in emphysema (7.2×104 µm2) as compared with healthy subjects (5.2×104 µm2) (p=0.0002). Normalised autofluorescence intensity histograms show a decrease in median autofluorescence intensity (mAFI) in emphysema (p=0.001). mAFI correlates well with Tiffeneau index (r=0.66, p=0.007, 95% CI 0.21 to 0.88). Autofluorescence intensity in emphysema correlates with corresponding data of CT-based quantification. pCLE-based morphometry and autofluorescence intensity analysis in emphysema is able to detect regional changes inside the ‘quiet zone’.

Trial registration number Results, NCT01204970.

  • Emphysema
  • Bronchoscopy

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  • Contributors Substantial contributions to the conception or design of the work: JY, CD, WJ and GMV. Substantial contributions to the acquisition and analysis: JY. Substantial contributions to interpretation of data: JY, CD, WJ and GMV. Drafting of the work: JY. Substantial contributions to revising it critically for important intellectual content and final approval of the version to be published: JY, CD, WJ and GMV. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: JY, CD, WJ and GMV.

  • Funding Financially supported by the Fonds voor Wetenschappelijk Onderzoek (FWO), Belgium.

  • Competing interests None declared.

  • Ethics approval Ethics Committee of the University Hospital Leuven.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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