title: Lung volume reduction of pulmonary emphysema: the radiologist task.
abstract: OBJECTIVE
  Several lung volume reduction (LVR) techniques have been increasingly evaluated in patients with advanced pulmonary emphysema, especially in the last decade. Radiologist plays a pivotal role in the characterization of parenchymal damage and, thus, assessment of eligibility criteria. This review aims to discuss the most common LVR techniques, namely LVR surgery, endobronchial valves, and coils LVR, with emphasis on the role of computed tomography (CT).
  
  
  RESULTS
  Several trials have recently highlighted the importance of regional quantification of emphysema by computerized CT-based segmentation of hyperlucent parenchyma, which is strongly recommended for candidates to any LVR treatment. In particular, emphysema distribution pattern and fissures integrity are evaluated to tailor the choice of the most appropriate LVR technique. Furthermore, a number of CT measures have been tested for the personalization of treatment, according to imaging detected heterogeneity of parenchymal disease.
  
  
  CONCLUSIONS
  CT characterization of heterogeneous parenchymal abnormalities provides criteria for selection of the preferable treatment in each patient and improves outcome of LVR as reflected by better quality of life, higher exercise tolerance, and lower mortality.
authors.affiliation: Division of Radiology, Department of Surgical Sciences, University of Parma, Parma, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Milanese
authors.forename: Mario
authors.initials: M
authors.lastname: Silva
authors.forename: Nicola
authors.initials: N
authors.lastname: Sverzellati
mesh_terms: D006801:Humans; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D011788:Quality of Life; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome