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KMID : 0880420190200071216
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Korean Journal of Radiology
2019 Volume.20 No. 7 p.1216 ~ p.1225
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Clinical Utility of Quantitative CT Analysis for Fissure Completeness in Bronchoscopic Lung Volume Reduction: Comparison between CT and Chartis™
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Lee Sei-Won
Shin So-Youn
Park Tai-Sun
Choi Yoon-Young
Park Jong-Chun
Park Jin-A
Oh Sang-Young
Kim Nam-Kug
Lee Se-Hee
Lee Jae-Seung
Seo Joon-Beom
Oh Yeon-Mok
Lee Sang-Do
Lee Sang-Min
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Abstract
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Objective: The absence of collateral ventilation (CV) is crucial for effective bronchoscopic lung volume reduction (BLVR) with an endobronchial valve. Here, we assessed whether CT can predict the Chartis™ results.
Materials and Methods: This study included 69 patients (mean age: 70.9 ± 6.6 years; 66 [95.7%] males) who had undergone CT to assess BLVR eligibility. The Chartis™ system (Pulmonox Inc.) was used to check CV. Experienced thoracic radiologists independently determined the completeness of fissures on volumetric CT images.
Results: The comparison between the visual and quantitative analyses revealed that 5% defect criterion showed good agreement. The Chartis™ assessment was performed for 129 lobes; 11 (19.6%) of 56 lobes with complete fissures on CT showed positive CV, while this rate was significantly higher (40 of 49 lobes, i.e., 81.6%) for lobes with incomplete fissures. The size of the fissure defect did not affect the rate of CV. Of the patients who underwent BLVR, 22 of 24 patients (91.7%) with complete fissures and three of four patients with incomplete fissures (75%) achieved target lobe volume reduction (TLVR).
Conclusion: The quantitative analysis of fissure shows that incomplete fissures increased the probability of CV on Chartis™, while the defect size did not affect the overall rates. TLVR could be achieved even in some patients with relatively large fissure defect, if they showed negative CV on Chartis™.
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KEYWORD
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Chronic obstructive pulmonary disease, Emphysema, Tomography, X-ray computed
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