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.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. christopher.kloth@med.uni-tuebingen.de.
authors.forename: C
authors.initials: C
authors.lastname: Kloth
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
authors.forename: W M
authors.initials: WM
authors.lastname: Thaiss
authors.affiliation: Department of Internal Medicine II, Eberhard Karls University, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hetzel
authors.affiliation: Siemens AG Healthcare, Imaging & Therapy Systems Computed Tomography & Radiation Oncology, HC IM CR R&D PA CA DC, Siemensstr. 1, 91301, Forchheim, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Ditt
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Grosse
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Horger
mesh_terms: D000368:Aged; D001980:Bronchi / Q000000981:diagnostic imaging* / Q000601:surgery; D001999:Bronchoscopy; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011013:Pneumonectomy; D011653:Pulmonary Diffusing Capacity; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D014797:Vital Capacity; D000070857:Walk Test
keywords: Chronic obstructive pulmonary disease (COPD); Computed tomography densitometry; Endobronchial coiling; High-resolution CT (HRCT); Lung volume reduction (LVR)