OBJECTIVE: Reducing pulmonary volume through implantation of endobronchial valves is a major interest to improve exercise tolerance and survival in patients with severe emphysema. The primary aim of this study was to evaluate how well CT-determined fissure integrity predicts interlobar collateral ventilation. The secondary objective was to show whether there is a relationship between the size of fissural defects and the presence of collateral ventilation. MATERIALS AND METHODS: Thirty patients with heterogeneous emphysema (postbronchodilator forced expiratory volume in 1 second [FEV1] = 20-50% predicted and > 50% of emphysema in a lobe) underwent collateral ventilation measurements with a catheter through an occlusive balloon within this target lobe during flexible endoscopy. Two senior thoracic radiologists studied the fissures on thoracic high-resolution CT. RESULTS: Collateral ventilation was successfully measured in 37 target lobes in 25 patients. The fissures surrounding the 37 target lobes were evaluated on CT. For the detection of collateral ventilation, the presence of a fissural defect on CT has a sensitivity, specificity, positive predictive value, and negative predictive value of 95%, 44%, 69%, and 88%, respectively. There was a statistically significant difference in the area of the defect between patients with collateral ventilation and those without collateral ventilation (p = 0.04). CONCLUSION: Analysis of pulmonary fissures using CT is useful before endoscopic volume reduction because results are well correlated to endoscopic measurements of collateral ventilation. Further study with clinical outcomes is mandatory to determine if and when one test or the other or both should be used in patient selection.
OBJECTIVE: Reducing pulmonary volume through implantation of endobronchial valves is a major interest to improve exercise tolerance and survival in patients with severe emphysema. The primary aim of this study was to evaluate how well CT-determined fissure integrity predicts interlobar collateral ventilation. The secondary objective was to show whether there is a relationship between the size of fissural defects and the presence of collateral ventilation. MATERIALS AND METHODS: Thirty patients with heterogeneous emphysema (postbronchodilator forced expiratory volume in 1 second [FEV1] = 20-50% predicted and > 50% of emphysema in a lobe) underwent collateral ventilation measurements with a catheter through an occlusive balloon within this target lobe during flexible endoscopy. Two senior thoracic radiologists studied the fissures on thoracic high-resolution CT. RESULTS: Collateral ventilation was successfully measured in 37 target lobes in 25 patients. The fissures surrounding the 37 target lobes were evaluated on CT. For the detection of collateral ventilation, the presence of a fissural defect on CT has a sensitivity, specificity, positive predictive value, and negative predictive value of 95%, 44%, 69%, and 88%, respectively. There was a statistically significant difference in the area of the defect between patients with collateral ventilation and those without collateral ventilation (p = 0.04). CONCLUSION: Analysis of pulmonary fissures using CT is useful before endoscopic volume reduction because results are well correlated to endoscopic measurements of collateral ventilation. Further study with clinical outcomes is mandatory to determine if and when one test or the other or both should be used in patient selection.
Authors: Sang Min Lee; Joon Beom Seo; Hye Jeon Hwang; Namkug Kim; Sang Young Oh; Jae Seung Lee; Sei Won Lee; Yeon-Mok Oh; Tae Hoon Kim Journal: Eur Radiol Date: 2016-11-23 Impact factor: 5.315
Authors: Christopher Kloth; Wolfgang Maximilian Thaiss; Jan Fritz; Konstantin Nikolaou; Meinrad Beer; Jürgen Hetzel; Sorin Dumitru Ioanoviciu; Marius Horger Journal: J Thorac Dis Date: 2019-01 Impact factor: 2.895
Authors: Karin Klooster; T David Koster; Christoph Ruwwe-Glösenkamp; Dorothea Theilig; Felix Doellinger; Jacopo Saccomanno; Huib A M Kerstjens; Dirk-Jan Slebos; Ralf-Harto Hübner Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-06-09
Authors: Tai Sun Park; Yoonki Hong; Jae Seung Lee; Sang Young Oh; Sang Min Lee; Namkug Kim; Joon Beom Seo; Yeon-Mok Oh; Sang-Do Lee; Sei Won Lee Journal: Int J Chron Obstruct Pulmon Dis Date: 2015-07-29