Densitometry for assessment of effect of Lung Volume Reduction Surgery for emphysema

¹ Dept of Pulmonology and
² Thoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
³ Dept of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
⁴ Divisions of Pulmonology and
⁵ Dept of Radiology, University Hospital Zurich, Zurich, Switzerland
⁶ Thoracic Surgery

^* To whom correspondence should be addressed. E-mail: j.stolk.long{at}lumc.nl.

	Abstract

To explore if change in the extent of emphysema correlated with change in lung function, the effect of resection of emphysematous tissue was studied by CT densitometry. In addition, we studied how surgery-induced change in emphysema related to lung density in control subjects.

We investigated 30 patients (14 females, mean (SD) age: 59 (10)) with severe emphysema before and 3 months after LVRS, 48 patients with moderate emphysema, and 76 control subjects. Lung density (15^th percentile point) of both lungs and heterogeneity of lung density between 12 isovolumetric partitions in each lung were calculated from chest CT images.

Fifteenth percentile point and its heterogeneity could distinguish controls from subjects with moderate emphysema with a sensitivity and specificity of more than 95%. LVRS increased lung density by 5.0±10.9 g·L^-1 (p=0.01, n=30). Improvement in DLCO and in residual volume correlated with increase in lung density (r=0.56, p=0.009, n=20, r= -0.54, p=0.003, n=28 respectively). Change in FEV₁ did not correlate with change in lung density (r=0.24, p=0.19).

We conclude that lung density 15^th percentile point is a valuable surrogate marker for detection of both extent of and reduction in emphysema.

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