University of Worcester Worcester Research and Publications

A New Functional Method to Choose the Target Lobe for Lung Volume Reduction in Emphysema - Comparison with the Conventional Densitometric Method

Hetzel, J., Boeckeler, M., Horger, M., Ehab, A., Kloth, C., Wagner, R., Freitag, L., Slebos, D., Lewis, Richard and Haentschel, M. (2017) A New Functional Method to Choose the Target Lobe for Lung Volume Reduction in Emphysema - Comparison with the Conventional Densitometric Method. International Journal of Chronic Obstructive Pulmonary Disease, 12. pp. 2621-2628. ISSN 1176-9106 Online: 1178-2005

article.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (1MB) | Preview


Lung volume reduction (LVR) improves breathing mechanics by reducing hyperinflation. Lobar selection usually focuses on choosing the most destroyed emphysematous lobes as seen on an inspiratory CT scan. However, it has never been shown to what extent these densitometric CT parameters predict the least deflation of an individual lobe during expiration. The addition of expiratory CT analysis allows measurement of the extent of lobar air trapping and could therefore provide additional functional information for choice of potential treatment targets.To determine lobar vital capacity/lobar total capacity (LVC/LTC) as a functional parameter for lobar air trapping using on an inspiratory and expiratory CT scan. To compare lobar selection by LVC/LTC with the established morphological CT density parameters.36 patients referred for endoscopic LVR were studied. LVC/LTC, defined as delta volume over maximum volume of a lobe, was calculated using inspiratory and expiratory CT scans. The CT morphological parameters of mean lung density (MLD), low attenuation volume (LAV), and 15th percentile of Hounsfield units (15%P) were determined on an inspiratory CT scan for each lobe. We compared and correlated LVC/LTC with MLD, LAV, and 15%P.There was a weak correlation between the functional parameter LVC/LTC and all inspiratory densitometric parameters. Target lobe selection using lowest lobar deflation (lowest LVC/LTC) correlated with target lobe selection based on lowest MLD in 18 patients (50.0%), with the highest LAV in 13 patients (36.1%), and with the lowest 15%P in 12 patients (33.3%).CT-based measurement of deflation (LVC/LTC) as a functional parameter correlates weakly with all densitometric CT parameters on a lobar level. Therefore, morphological criteria based on inspiratory CT densitometry partially reflect the deflation of particular lung lobes, and may be of limited value as a sole predictor for target lobe selection in LVR.

Item Type: Article
Additional Information:

The full-text can be accessed via the Official URL.

Uncontrolled Discrete Keywords: Emphysema, Lung volume reduction, chronic obstructive pulmonary disease, high-resolution computed tomography
Subjects: Q Science > Q Science (General)
Divisions: College of Health, Life and Environmental Sciences > School of Science and the Environment
Related URLs:
SWORD Depositor: Prof. Pub Router
Depositing User: Karol Kosinski
Date Deposited: 02 Nov 2017 10:23
Last Modified: 17 Jun 2020 17:20

Actions (login required)

View Item View Item
Worcester Research and Publications is powered by EPrints 3 which is developed by the School of Electronics and Computer Science at the University of Southampton. More information and software credits.