Selecting Patients for Lobar Lung Volume Reduction Therapy: What Quantitative Computed Tomography Parameters Matter?

Theilig, Dorothea Cornelia; Huebner, Ralf-Harto; Neumann, Konrad; Pöllinger, Alexander; Doellinger, Felix (2019). Selecting Patients for Lobar Lung Volume Reduction Therapy: What Quantitative Computed Tomography Parameters Matter? RöFo. Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 191(1), pp. 40-47. Thieme 10.1055/a-0638-0058

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PURPOSE  Evaluation of emphysema distribution with quantitative computed tomography (qCT) prior to endoscopic lung volume reduction (ELVR) is recommended. The aim of this study was to determine which of the commonly assessed qCT parameters prior to endoscopic lung volume reduction (ELVR) best predicts outcome of treatment. MATERIALS AND METHODS  50 patients who underwent technically successful ELVR at our institution were retrospectively analyzed. We performed quantitative analysis of the CT scans obtained prior to ELVR and carried out Mann-Whitney U-tests and a logistic regression analysis to identify the qCT parameters that predict successful outcome of ELVR in terms of improved forced expiratory volume in 1 second (FEV1). RESULTS  In the Mann-Whitney U-test, the interlobar emphysema heterogeneity index (p = 0.008) and the pulmonary emphysema score (p = 0.022) showed a statistically significant difference between responders and non-responders. In multiple logistic regression analysis only the interlobar emphysema heterogeneity index (p = 0.008) showed a statistically significant impact on the outcome of ELVR, while targeted lobe volume, total lung volume, targeted lobe emphysema score and total lung emphysema score did not. CONCLUSION  Of all commonly assessed quantitative CT parameters, only the heterogeneity index definitely allows prediction of ELVR outcome in patients with advanced chronic obstructive pulmonary disease (COPD). KEY POINTS   · Quantitative CT is recommended prior to ELVR.. · The relevance of the obtained parameters from quantitative CT remains controversial.. · This study confirms that only the emphysema heterogeneity index has a definite impact.. CITATION FORMAT · Theilig DC, Huebner R, Neumann K et al. Selecting Patients for Lobar Lung Volume Reduction Therapy: What Quantitative Computed Tomography Parameters Matter?. Fortschr Röntgenstr 2018; DOI: 10.1055/a-0638-0058.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Pöllinger, Alexander

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1438-9029

Publisher:

Thieme

Language:

English

Submitter:

Isabelle Ursula Saurer

Date Deposited:

15 Nov 2018 13:45

Last Modified:

15 Dec 2018 01:32

Publisher DOI:

10.1055/a-0638-0058

PubMed ID:

30308688

BORIS DOI:

10.7892/boris.121257

URI:

https://boris.unibe.ch/id/eprint/121257

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