An Integrative Approach of the Fissure Completeness Score and Chartis Assessment in Endobronchial Valve Treatment for Emphysema
| Autor: | Felix Doellinger, Ralf-Harto Hübner, Dirk-Jan Slebos, Dorothea Theilig, Huib A. M. Kerstjens, Jacopo Saccomanno, Christoph Ruwwe-Glösenkamp, Karin Klooster, T. David Koster |
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| Rok vydání: | 2020 |
| Předmět: |
Lung volume reduction
COPD medicine.medical_specialty Fissure business.industry Endobronchial valve General Medicine medicine.disease Collateral ventilation 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030228 respiratory system Multicenter study medicine Right major fissure lipids (amino acids peptides and proteins) In patient 030212 general & internal medicine Radiology business |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease. 15:1325-1334 |
| ISSN: | 1178-2005 |
| DOI: | 10.2147/copd.s242210 |
| Popis: | Purpose Lung volume reduction using one-way endobronchial valves is a bronchoscopic treatment for patients with severe emphysema without collateral ventilation between the treatment target lobe and the ipsilateral lobe(s). CT-scan fissure analysis is often used as a surrogate to predict the absence of collateral ventilation. We aimed to evaluate the predictive value of the fissure completeness score (FCS) compared to the functional Chartis measurement of collateral ventilation and to provide cut-off values of the FCS in patient selection. Patients and methods Multicenter study in patients eligible for treatment with one-way valves. The FCS was calculated by quantitative CT analysis (Thirona, the Netherlands) and compared to status of interlobar collateral ventilation measured with Chartis system (PulmonX, USA). Thresholds were calculated for the predictive values of the presence of collateral ventilation. Results An FCS >95% of the left major fissure had a positive predictive value (PPV) of 91%, with 1 in 11 fissures demonstrating collateral ventilation with Chartis measurement, whereas an FCS of ≤80% had a negative predictive value (NPV) of 100% for the presence of collateral ventilation. For the right major fissure, the NPV was 100% for an FCS ≤90%, but 69.7% for the right upper lobe fissure. Conclusion Quantitative CT analysis is recommended in all patients evaluated for endobronchial valves. Patients with incomplete fissures (left major fissure: FCS 95%. |
| Databáze: | OpenAIRE |
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