The effects of lung volume reduction treatment on diffusing capacity and gas exchange

Dijk, Marlies van; Klooster, Karin; Hacken, Nick H. T. ten; Sciurba, Frank C.; Kerstjens, Huib A. M.; Slebos, Dirk‐Jan

doi:10.1183/16000617.0171-2019

Cited by 7 publications

(6 citation statements)

References 62 publications

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“…The RV/TLC ratio is associated with mortality [4], which indicates its relevance. In COPD, gas exchange is mainly hindered by diffusion capacity and ventilation/perfusion mismatch [5]. biomarkers as a proxy for measuring PFT.…”

Section: Introductionmentioning

confidence: 99%

Measuring pulmonary function in COPD using quantitative chest computed tomography analysis

et al. 2021

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COPD is diagnosed and evaluated by pulmonary function testing (PFT). Chest computed tomography (CT) primarily serves a descriptive role for diagnosis and severity evaluation. CT densitometry-based emphysema quantification and lobar fissure integrity assessment are most commonly used, mainly for lung volume reduction purposes and scientific efforts.A shift towards a more quantitative role for CT to assess pulmonary function is a logical next step, since more, currently underutilised, information is present in CT images. For instance, lung volumes such as residual volume and total lung capacity can be extracted from CT; these are strongly correlated to lung volumes measured by PFT.This review assesses the current evidence for use of quantitative CT as a proxy for PFT in COPD and discusses challenges in the movement towards CT as a more quantitative modality in COPD diagnosis and evaluation. To better understand the relevance of the traditional PFT measurements and the role CT might play in the replacement of these parameters, COPD pathology and traditional PFT measurements are discussed.

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Section: Introductionmentioning

confidence: 99%

Measuring pulmonary function in COPD using quantitative chest computed tomography analysis

et al. 2021

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“…Therefore, a possible cause of the observed decreased (F)VC in our patient group is that PPV reduced the expansion of the lungs, which decreases the IRV. DLCO (gas exchange) is less affected by total air inhalation, 23 which may explain the non-significant relation.…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence–based Quantification of Pleural Plaque Volume and Association With Lung Function in Asbestos-exposed Patients

Groot Lipman,

Boellaard,

de Gooijer

et al. 2023

Journal of Thoracic Imaging

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Purpose: Pleural plaques (PPs) are morphologic manifestations of long-term asbestos exposure. The relationship between PP and lung function is not well understood, whereas the time-consuming nature of PP delineation to obtain volume impedes research. To automate the laborious task of delineation, we aimed to develop automatic artificial intelligence (AI)–driven segmentation of PP. Moreover, we aimed to explore the relationship between pleural plaque volume (PPV) and pulmonary function tests. Materials and Methods: Radiologists manually delineated PPs retrospectively in computed tomography (CT) images of patients with occupational exposure to asbestos (May 2014 to November 2019). We trained an AI model with a no-new-UNet architecture. The Dice Similarity Coefficient quantified the overlap between AI and radiologists. The Spearman correlation coefficient (r) was used for the correlation between PPV and pulmonary function test metrics. When recorded, these were vital capacity (VC), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO). Results: We trained the AI system on 422 CT scans in 5 folds, each time with a different fold (n = 84 to 85) as a test set. On these independent test sets combined, the correlation between the predicted volumes and the ground truth was r = 0.90, and the median overlap was 0.71 Dice Similarity Coefficient. We found weak to moderate correlations with PPV for VC (n = 80, r = −0.40) and FVC (n = 82, r = −0.38), but no correlation for DLCO (n = 84, r = −0.09). When the cohort was split on the median PPV, we observed statistically significantly lower VC (P = 0.001) and FVC (P = 0.04) values for the higher PPV patients, but not for DLCO (P = 0.19). Conclusion: We successfully developed an AI algorithm to automatically segment PP in CT images to enable fast volume extraction. Moreover, we have observed that PPV is associated with loss in VC and FVC.

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“…29 30 Moreover, a review by van Dijk et al showed that lung volume reduction results in a small increase in DL CO . 31…”

Section: Treatment Options For Emphysemamentioning

confidence: 99%

“…29,30 Moreover, a review by van Dijk et al showed that lung volume reduction results in a small increase in DL CO . 31 Darwiche et al and Trudzinski et al performed a retrospective analysis of patients who were treated with endobronchial valves with FEV 1 20% of the predicted value. 32,33 In the study by Darwiche et al, 50% of the 20 patients had homogeneous emphysema and the mean DL CO was 21.5%.…”

Section: Low DL Co and Low Fevmentioning

confidence: 99%

Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update

Koster

Dijk

Slebos

2022

Semin Respir Crit Care Med

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In carefully selected patients with severe chronic obstructive pulmonary disease, characterized by emphysema and hyperinflation, lung volume reduction is an option to reduce lung hyperinflation, improve lung function, quality of life, and exercise capacity. Currently, there are several bronchoscopic and surgical treatment options to achieve lung volume reduction. It is important to carefully phenotype these patients, to select the optimal treatment option, with consideration of possible adverse events or contraindications, and it is highly recommended to discuss these treatment strategies in a multidisciplinary team. The treatment with one-way endobronchial valves has been investigated most extensively and more data are available regarding the treatment of more “marginal cases,” or subsequent lung volume reduction surgery. Other bronchoscopic lung volume reduction options include treatment with coils, thermal vapor ablation, and sclerosant agents. In this review, we aim to summarize the current clinical evidence on the bronchoscopic lung volume reduction therapies and important aspects regarding optimal patient selection.

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The effects of lung volume reduction treatment on diffusing capacity and gas exchange

Cited by 7 publications

References 62 publications

Measuring pulmonary function in COPD using quantitative chest computed tomography analysis

Measuring pulmonary function in COPD using quantitative chest computed tomography analysis

Artificial Intelligence–based Quantification of Pleural Plaque Volume and Association With Lung Function in Asbestos-exposed Patients

Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update

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