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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

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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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Acknowledgments

The authors thank Siemens Healthcare for technical support. The scientific guarantor of this publication is Prof. Marius Horger. The authors of this manuscript declare relationships with the following companies: One of the authors (HD) is employee of Siemens Healthcare.

The authors state that this work has not received any funding. One of the authors (WT) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany

    C. Kloth, W. M. Thaiss, U. Grosse, K. Nikolaou & M. Horger

  2. Department of Internal Medicine II, Eberhard Karls University, Otfried-Müller-Str. 10, 72076, Tübingen, Germany

    J. Hetzel

  3. Siemens AG Healthcare, Imaging & Therapy Systems Computed Tomography & Radiation Oncology, HC IM CR R&D PA CA DC, Siemensstr. 1, 91301, Forchheim, Germany

    H. Ditt

Authors
  1. C. Kloth
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  2. W. M. Thaiss
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  3. J. Hetzel
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  4. H. Ditt
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  5. U. Grosse
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  6. K. Nikolaou
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  7. M. Horger
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Corresponding author

Correspondence to C. Kloth.

Additional information

J. Hetzel and M. Horger both senior co-authors contributed equally

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Kloth, C., Thaiss, W.M., Hetzel, J. et al. 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. Eur Radiol 26, 2176–2183 (2016). https://doi.org/10.1007/s00330-015-4033-4

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  • DOI: https://doi.org/10.1007/s00330-015-4033-4

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