title: Radiographic evaluation of the potential lung volume reduction surgery candidate.
abstract: Delineating the extent and distribution of emphysema is an essential component of the evaluation of candidates for lung volume reduction surgery (LVRS). Imaging also may identify contraindications to LVRS, including bronchiectasis and pleural scarring. The chest X-ray is of limited utility in LVRS evaluation. Chest computed tomography (CT) scanning is an essential component of the evaluation, demonstrating the presence of emphysema and its amount and distribution. Clinical experience has shown that a substantial minority of chest CT scans will also demonstrate pulmonary nodules, some of which represent lung cancers. Published series, including the National Emphysema Treatment Trial, consistently demonstrate that patients with upper lobe predominant or heterogeneous emphysema are most likely to benefit from LVRS. Heterogeneity and distribution can also be assessed by radionuclide ventilation perfusion scanning, but this modality adds little additional information to CT scanning.
authors.affiliation: Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: George R
authors.initials: GR
authors.lastname: Washko
authors.forename: Eric
authors.initials: E
authors.lastname: Hoffman
authors.forename: John J
authors.initials: JJ
authors.lastname: Reilly
mesh_terms: D006801:Humans; D018579:Patient Selection; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000601:surgery*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed / Q000379:methods*