Role of quantitative perfusion scintigraphy evaluation in determination of the efficiency of the procedure before lung volume reduction coil (LVRC) treatment for severe emphysema

Background: LVRC is a new treatment method used in severe emphysema patients to increase lung volume and exercise capacity. We examined the contribution of quantitative perfusion scintigraphy in HRCT applied to determine pre-LVRC emphysema distribution. Methods: Study was carried out retrospectively on heavy COPD cases. Scores of emphysema regions of patients in HRCT were determined through densitometry analysis. Pre-procedure 00lung V/Q scintigraphies were taken. Lobes which were shown to have high emphysema score and perfusion reduction in V/Q scintigraphy were determined as regions of treatment. Results: 22 patients were treated with LVRC. In lobes with high emphysema damage score revealed by HRCT a decrease in perfusion was observed. Between pre- and post-operational measurements; a statistically significant difference was found in terms of FEV1, RV and TAK (p Conclusions: V/Q scintigraphy is a method reliable in demonstration of regional perfusion differences reflecting emphysema distribution and conducive for a quantitative analysis. In severe emphysema cases, performing a quantitative perfusion scintigraphy prior to LVRC treatment is a guiding application in determination of target lobe for the treatment, as well as contributive in efficiency of the procedure. References: 1. Shah PL, Zoumot Z,Singh S,Bicknell SR,Ross ET,Quiring J,Hopkinson NS,Kemp SV;RESET trial Study Group. Endobronchialcoilsfor the treatment of severeemphysemawith hyperinflation (RESET): a randomised controlled trial.Lancet Respir Med.2013 May;1(3):233-40.