Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal interstitial lung disease (ILD) that requires diagnostic certainty to stratify prognosis and therapeutic decision-making, especially in light of available therapies that slow disease progression. Approximately 50% of patients require invasive surgery for diagnosis to resect tissue and look for microscopic features not seen on HRCT (i.e. honeycombing), but this carries risks of morbidity and mortality. There is a clear need for a low-risk, non-surgical method for microscopic IPF diagnosis. We aim to determine whether bronchoscopic optical coherence tomography (OCT) can meet this essential need. OCT rapidly images large tissue volumes with microscopic resolutions (<10μm) well beyond HRCT capabilities. We developed OCT catheters, compatible with bronchoscopes, that access peripheral lung. We performed bronchoscopic OCT imaging ex vivo in lungs...

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