Detection of Fibrotic Interstitial Lung Disease by Bronchoscopic Probe Based Confocal Laser Endomicroscopy (Pcle)

Current classification of diffuse pulmonary lung diseases suggest differentiation between of fibrotic versus non- fibrotic interstitial lung diseases (ILD). Treatment of ILD has been recently expanded by introduction of antifibrotic treatment in fibrotic lung diseases beyond IPF. PCLE allows in vivo visualisation of the lung parenchyma during bronchoscopy. We used pCLE (Cellvizio®, Mauna Kea) to characterise imaging pattern in patients with fibrotic versus non fibrotic ILD . We analysed pCLE images of 46 patients (32 male, mean age 71 years) with ILD, diagnosed according to HR- CT scan, bronchoscopy with transbronchial cryobiopsy and multidisciplinary team discussion. PCLE patterns were semi-quantitatively assess on a four-item-four-degree scale as previously described (1). In fibrotic ILD (n=31), pCLE showed a high degree of distortion. In non-fibrotic ILD (n=15) pCLE pattern showed more loaded AM. The presence of consolidation and density did not discriminate between both entities. Presence of a high degree of distortion in pCLE is suggestive for a fibrotic ILD.