title: Diagnostic performance comparison of the Chartis System and high-resolution computerized tomography fissure analysis for planning endoscopic lung volume reduction.
abstract: OBJECTIVE
  Endobronchial valve (EBV) therapy is optimized in patients who demonstrate little or no collateral ventilation (CV). The accuracy of the Chartis System and visual assessment of high-resolution computerized tomography (HRCT) fissure completeness by a core radiology laboratory for classifying CV status was compared by evaluating the relationship of each method with target lobe volume reduction (TLVR) after EBV placement.
  
  
  METHODS
  Retrospective HRCT fissure analysis of a study population who underwent catheter-based measurement of CV followed by complete occlusion of the targeted lobe by EBV. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the HRCT fissure analysis and the catheter-based measurement of CV for predicting TLVR was determined.
  
  
  RESULTS
  Accuracy for correctly classifying TLVR with EBV was similar for Chartis System and HRCT fissure analysis (74 vs 77%). The sensitivity and specificity of the Chartis measurement were 86% and 61% and those of HRCT fissure analysis 75% and 79%. Patients with TLVR ≥ 350 mL had statistically significant improvement in respiratory function, exercise performance and quality of life measures.
  
  
  CONCLUSIONS
  When evaluating patients for likelihood of successful EBV therapy, the Chartis System CV assessment and HRCT fissure analysis appear to have comparable accuracy. Both techniques were found to be beneficial for EBV procedure planning.
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Gompelmann
authors.forename: Ralf
authors.initials: R
authors.lastname: Eberhardt
authors.forename: Dirk-Jan
authors.initials: DJ
authors.lastname: Slebos
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Brown
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Abtin
authors.forename: Hyun J
authors.initials: HJ
authors.lastname: Kim
authors.forename: Debby
authors.initials: D
authors.lastname: Holmes-Higgin
authors.forename: Sri
authors.initials: S
authors.lastname: Radhakrishnan
authors.forename: Felix J F
authors.initials: FJ
authors.lastname: Herth
authors.forename: Jonathan
authors.initials: J
authors.lastname: Goldin
mesh_terms: D000368:Aged; D058109:Airway Management / Q000379:methods; D001999:Bronchoscopy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000145:classification / Q000379:methods / Q000592:standards; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D012123:Pulmonary Ventilation / Q000502:physiology; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Endoscopic Lung Volume Reduction; bronchoscopy and interventional technique; collateral ventilation; emphysema; valve therapy