Diagnosing Usual Interstitial Pneumonia via Endobronchial Optical Coherence Tomography

pneumonia xray
pneumonia xray
A study compared the diagnostic accuracy of endobronchial OCT in interstitial lung disease to the clinical judgment of blinded, independent pathologists and pulmonologists.

Endobronchial optical coherence tomography (EB-OCT) is capable of safely and accurately diagnosing interstitial lung disease, according to results of a recent study published in the American Journal of Respiratory and Critical Care Medicine.

In the study, 27 patients with a low confidence interstitial lung disease diagnosis who planned to undergo surgical lung biopsy first had EB-OCT performed. A group of blinded, independent pathologists then reviewed the patients’ images and histopathology, thus allowing study researchers to evaluate the diagnostic accuracy of EB-OCT. The patient’s treating pulmonologist, who was blinded to the EB-OCT, then made a clinical diagnosis after the surgical lung biopsy.

The study included 16 men and 11 women, with an average age was 65.0 years. When diagnosis was made by the treating pulmonologist, 12 were diagnosed with usual interstitial pneumonia and 15 with interstitial lung disease that was not usual interstitial pneumonia. The sensitivity and specificity of EB-OCT was 100% for both histopathologic usual interstitial pneumonia and for clinical diagnosis of interstitial lung disease.

The study authors wrote, “This study provides evidence supporting the utility of EB-OCT as a safe, low-risk method for microscopic diagnosis of [interstitial lung disease], particularly for diagnosis of histopathologic [unusual interstitial pneumonia] and clinical [idiopathic pulmonary fibrosis].” They added, “The findings in this study support EB-OCT as a potential future part of [interstitial lung disease] diagnostic work-up, as a complement to [high-resolution computed tomography] and alternative to [surgical lung biopsy].”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Nandy S, Raphaely RA, Muniappan A, et al. Diagnostic accuracy of endobronchial optical coherence tomography for the microscopic diagnosis of usual interstitial pneumonia. Am J Respir Crit Care Med. Published online Aug 10, 2021. doi:10.1164/rccm.202104-0847OC