New 133Xe gas trapping index for quantifying severe emphysema before partial lung volume reduction

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Jeffrey J MathewsHarvey O Coxson

Abstract

Lung volume reduction (LVR) is an effective therapy for end-stage emphysema. Preliminary and postprocedure imaging is usually limited to CT for anatomic delineation of the location and severity of the most acutely affected lung zones. The purpose of this study was to investigate the potential of using a new quantitative gas trapping index (GTI) derived from a (133)Xe ventilation scan to assess the severity of emphysema. Using the equilibration and washout phases of a (133)Xe ventilation study, a GTI was compared with visual National Emphysema Treatment Trial (NETT) CT scoring, semiautomated CT densitometry, and (99m)Tc perfusion scintigraphy in 28 patients being evaluated for LVR. The GTI was calculated as the percentage of (133)Xe gas retention in a 3-min washout image compared with the peak equilibrium image for 6 lung zones. The GTI correlated best with the percentage of perfusion (-0.39, P<0.0001) and the CT density scoring with the percentage of severe emphysema (0.36, P<0.0001). There was less correlation with visual NETT CT scores (0.25, P<0.001). This GTI, based on widely available (133)Xe imaging, shows good correlation with other quantitative measures of emphysema that are anatomically based. Because this GTI provides...Continue Reading

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Citations

Mar 27, 2010·Annals of Nuclear Medicine·Kazuyoshi SugaNaofumi Matsunaga
Jan 10, 2012·Nuclear Medicine Communications·Kazuyoshi SugaNaofumi Matsunaga
Apr 8, 2011·American Journal of Respiratory and Critical Care Medicine·Cynthia GordonRonald G Crystal
Sep 6, 2011·Radiologic Clinics of North America·Frederick D Grant, S Ted Treves
Jun 27, 2017·Applied Radiation and Isotopes : Including Data, Instrumentation and Methods for Use in Agriculture, Industry and Medicine·F BorgnaA Andrighetto
Jul 18, 2012·Polish journal of radiology·Agnieszka Choromańska, Katarzyna J Macura

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