Lung Volume Reduction in Pulmonary Emphysema from the Radiologist's Perspective

Doellinger, F; Huebner, R H; Kuhnigk, J M; Pöllinger, Alexander (2015). Lung Volume Reduction in Pulmonary Emphysema from the Radiologist's Perspective. RöFo. Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 187(8), pp. 662-675. Thieme 10.1055/s-0034-1399540

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Pulmonary emphysema causes decrease in lung function due to irreversible dilatation of intrapulmonary air spaces, which is linked to high morbidity and mortality. Lung volume reduction (LVR) is an invasive therapeutical option for pulmonary emphysema in order to improve ventilation mechanics. LVR can be carried out by lung resection surgery or different minimally invasive endoscopical procedures. All LVR-options require mandatory preinterventional evaluation to detect hyperinflated dysfunctional lung areas as target structures for treatment. Quantitative computed tomography can determine the volume percentage of emphysematous lung and its topographical distribution based on the lung's radiodensity. Modern techniques allow for lobebased quantification that facilitates treatment planning. Clinical tests still play the most important role in post-interventional therapy monitoring, but CT is crucial in the detection of postoperative complications and foreshadows the method's high potential in sophisticated experimental studies. Within the last ten years, LVR with endobronchial valves has become an extensively researched minimally-invasive treatment option. However, this therapy is considerably complicated by the frequent occurrence of functional interlobar shunts. The presence of "collateral ventilation" has to be ruled out prior to valve implantations, as the presence of these extraanatomical connections between different lobes may jeopardize the success of therapy. Recent experimental studies evaluated the automatic detection of incomplete lobar fissures from CT scans, because they are considered to be a predictor for the existence of shunts. To date, these methods are yet to show acceptable results. KEY POINTS Today, surgical and various minimal invasive methods of lung volume reduction are in use. Radiological and nuclear medical examinations are helpful in the evaluation of an appropriate lung area. Imaging can detect periinterventional complications. Reduction of lung volume has not yet been conclusively proven to be effective and is a therapeutical option with little scientific evidence.

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:

Aisha Stefania Mzinga

Date Deposited:

17 Mar 2016 10:37

Last Modified:

30 Mar 2016 13:51

Publisher DOI:

10.1055/s-0034-1399540

PubMed ID:

26062174

BORIS DOI:

10.7892/boris.77174

URI:

https://boris.unibe.ch/id/eprint/77174

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