Relation of interlobar collaterals to radiological heterogeneity in severe emphysema

Higuchi, Terumi; Reed, Anna; Oto, Takahiro; Holsworth, Lynda; Ellis, Samantha; Bailey, Michael; Williams, Trevor; Snell, Gregory I

doi:10.1136/thx.2005.051219

Cited by 68 publications

(70 citation statements)

References 33 publications

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“…In any case, the relevant frequency of peri-interventional pneumothorax following EBV implantation necessitates post-interventional monitoring, a hospital stay of at least 48 hours [23] and radiological follow-up. Patients developing complete atelectasis following EBV therapy exhibit significantly better trends in terms of physical activity and spirometrically measurable lung function [24,25]. In addition, the appearance of complete atelectasis appears to be the main criterion for improved survival following ELVR with EBV [25].…”

Section: Occlusive Endobronchial Valves (Ebv)mentioning

confidence: 99%

“…In addition, the appearance of complete atelectasis appears to be the main criterion for improved survival following ELVR with EBV [25]. Hopkinson et al ascertained 6-year survival rates following EBV implantation of 100 % and 43 % for subgroups with and without complete atelectasis, respectively [25]. However, there are currently no large randomized controlled studies concerning long-term survival following EBV implantation.…”

Section: Occlusive Endobronchial Valves (Ebv)mentioning

confidence: 99%

“…Patients developing complete atelectasis following EBV therapy exhibit significantly better trends in terms of physical activity and spirometrically measurable lung function [24,25]. In addition, the appearance of complete atelectasis appears to be the main criterion for improved survival following ELVR with EBV [25]. Hopkinson et al ascertained 6-year survival rates following EBV implantation of 100 % and 43 % for subgroups with and without complete atelectasis, respectively [25].…”

Section: Occlusive Endobronchial Valves (Ebv)mentioning

confidence: 99%

“…However, not all patients with IF have CV. Frequently, CV is incorrectly used synonymously with IF [25,63]. The highly publicized 2010 "VENT" study was the first randomized controlled study on occlusive valves.…”

mentioning

confidence: 99%

“…While accessory collateral ventilation has an insignificant effect on the respiratory physiology of healthy lungs, different mechanisms promote the formation of collateral ventilation in lungs damaged through emphysema [59]. Higuchi et al accordingly demonstrated that up to 66 % of all patients with high-grade pulmonary emphysema exhibit functionally effective CV [25]. The pathophysiological mechanism of increased appearance of CV in emphysema patients is not yet understood.…”

mentioning

confidence: 99%

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

Doellinger

Huebner

Kuhnigk

et al. 2015

Fortschr Röntgenstr

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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 scientifc evidence. Citation Format: ??Doellinger F, Huebner RH, Kuhnigk JM et?al. Lung Volume Reduction in Pulmonary Emphysema from the Radiologist?s Perspective. Fortschr R?ntgenstr 2015; 187: 662???675

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