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European Radiology

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01-07-2016 | Chest

Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests

Authors: C. Kloth, W. M. Thaiss, J. Hetzel, H. Ditt, U. Grosse, K. Nikolaou, M. Horger

Published in: European Radiology | Issue 7/2016

Abstract

Objectives

To assess the impact of endobronchial coiling on the segment bronchus cross-sectional area and volumes in patients with lung emphysema using quantitative chest-CT measurements.

Materials and methods

Thirty patients (female = 15; median age = 65.36 years) received chest-CT before and after endobronchial coiling for lung volume reduction (LVR) between January 2010 and December 2014. Thin-slice (0.6 mm) non-enhanced image data sets were acquired both at end-inspiration and end-expiration using helical technique and 120 kV/100–150 mAs. Clinical response was defined as an increase in the walking distance (Six-minute walk test; 6MWT) after LVR-therapy. Additionally, pulmonary function test (PFT) measurements were used for clinical correlation.

Results

In the treated segmental bronchia, the cross-sectional lumen area showed significant reduction (p < 0.05) in inspiration and tendency towards enlargement in expiration (p > 0.05). In the ipsilateral lobes, the lumina showed no significant changes. In the contralateral lung, we found tendency towards increased cross-sectional area in inspiration (p = 0.06). Volumes of the treated segments correlated with the treated segmental bronchial lumina in expiration (r = 0.80, p < 0.001). Clinical correlation with changes in 6MWT/PFT showed a significant decrease of the inspiratory volume of the treated lobe in responders only.

Conclusion

Endobronchial coiling causes significant decrease in the cross-sectional area of treated segment bronchi in inspiration and a slight increase in expiration accompanied by a volume reduction.

Key Points

• Endobronchial coiling has indirect impact on cross-sectional area of treated segment bronchi

• Volume changes of treated lobes correlate with changes in bronchial cross-sectional area

• Coil-induced effects reflect their stabilizing and stiffening impact on lung parenchyma

• Endobronchial coiling reduces bronchial collapsing compensating the loss of elasticity

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Title: Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests
Authors: C. Kloth
W. M. Thaiss
J. Hetzel
H. Ditt
U. Grosse
K. Nikolaou
M. Horger
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4033-4

At a glance: The STEP trials

Springer Medicine

Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests

Abstract

Objectives

Materials and methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Key Points

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