Clinical trial NCT00377338: Safety and Accuracy of Alveoscopy in Interstitial Lung Diseases
Official title: Phase II Study of Broncho-Alveoscopy Using Fibered Confocal Fluorescence Microscopy
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Respiratory Tract Diseases
Keywords: Bronchoscopy
Diagnostic imaging
Laser scanning confocal microscopy
Pulmonary Alveoli
Healthy volunteers
Diffuse peripheral lung disease
Focal peripheral lung disease
Lead sponsor: University Hospital, Rouen
Sponsor class: OTHER
First posted: 2006-09-18
Enrollment: 270
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Healthy smoker and non-smoker subjects, patients with no peripheral lung disease on CT scan, Patients with focal parenchymal lung diseases, patients with diffuse parenchymal lung diseases

Brief summary: Fibered confocal fluorescence microscopy (FCFM), also referred to as Cell-Vizio® (MaunaKea Technologies, France) is a new technique that produces microscopic imaging in a living tissue, through a 1 mm fiberoptic miniprobe that can be introduced into the working channel of the bronchoscope. The system produces real-time imaging of endogenous fluorophores with a 5 µm lateral resolution and a field of view of 600 x 600 µm. FCFM is able to produce dynamic, high-resolution microimaging of the respiratory bronchiolar walls, alveolar ducts and sacs in vivo during endoscopy (a procedure termed as alveoscopy).

The hypothesis of this study is that an alveoscopy makes it possible to analyze the microstructure of the distal airways in vivo and to collect specific morphologic information in patients with interstitial lung diseases.

The goals of this French Phase II trial are:

* to evaluate the tolerance of the alveoscopy
* to describe the normal appearance of the bronchoalveolar system in spontaneous ventilation in normal subjects
* to describe specific alterations of the bronchoalveolar microstructure in focal or diffuse interstitial lung diseases

Detailed description: The study will include 40 healthy smoker or non-smoker volunteers, 20 patients with normal Chest CT scan and normal respiratory function tests, and 90 patients with focal or diffuse peripheral lung diseases.

The Alveoscopy will be performed under local anesthesia, in awake patients during a standard bronchoscopy. The Alveoscopy will be performed on one side of the bronchial tree (left or right lung). Two to ten separate bronchial areas will be explored in each patient, depending on the pathology, focal or diffuse, and the underlying respiratory function.

A continuous monitoring of the Oxygen saturation, blood pressure, EKG will be performed during the procedure. A chest X-ray will be performed after the procedure to eliminate a pneumothorax.

The morphometric parameters of the alveolar microstructure and their variability will be studied according to the age, gender, lung area explored, smoking status in healthy volunteers and "normal CT scan" subjects, as well as in patients with peripheral lung diseases.

Eligibility criteria: Inclusion Criteria:

* Healthy volunteers: normal chest X-rays and normal lung function tests
* Patients without parenchymal lung diseases: normal chest computed tomography (CT) scan, normal lung function tests, indication for a bronchoscopy
* Patients with parenchymal lung disease: indication for a bronchoscopy
* Written informed consent for the alveoscopy

Exclusion Criteria:

* Bleeding disorders
* Pulmonary hypertension
* Contraindication for a bronchoscopy
* known hypersensitivity to the fluorescent contrast agent (if required)

Primary outcomes:
measure: number of lesions localized by confocal endoscopy compared to navigational bronchoscopy
timeFrame: time of the confocal endoscopy compared to navigational bronchoscopy
measure: Positive and negative predictive values of confocal signs before and after IV fluorophore injection for the diagnosis of cancer.
timeFrame: before and after IV fluorophore injection for the diagnosis of cancer.
Secondary outcomes:
Other outcomes:
Locations:
city: Rouen
country: France
facility: Rouen University Hospital
state: Haute Normandie
Study officials:
affiliation: University Hospital, Rouen
name: Luc C Thiberville, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Salaun M, Guisier F, Dominique S, Genevois A, Jounieaux V, Bergot E, Thill C, Piton N, Thiberville L. In vivo probe-based confocal laser endomicroscopy in chronic interstitial lung diseases: Specific descriptors and correlation with chest CT. Respirology. 2019 Aug;24(8):783-791. doi: 10.1111/resp.13507. Epub 2019 Feb 27.