Clinical Utility of Quantitative CT Analysis for Fissure Completeness in Bronchoscopic Lung Volume Reduction: Comparison between CT and Chartis™
- Author:
Sei Won LEE
1
;
So Youn SHIN
;
Tai Sun PARK
;
Yoon Young CHOI
;
Jong Chun PARK
;
Jina PARK
;
Sang Young OH
;
Namkug KIM
;
Se Hee LEE
;
Jae Seung LEE
;
Joon Beom SEO
;
Yeon Mok OH
;
Sang Do LEE
;
Sang Min LEE
Author Information
- Publication Type:Original Article
- Keywords: Chronic obstructive pulmonary disease; Emphysema; Tomography; X-ray computed
- MeSH: Cone-Beam Computed Tomography; Emphysema; Humans; Lung; Pneumonectomy; Pulmonary Disease, Chronic Obstructive; Ventilation
- From:Korean Journal of Radiology 2019;20(7):1216-1225
- CountryRepublic of Korea
- Language:English
- Abstract: 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™.
