Respirology (Carlton, Vic.) · 2026
Prediction of Total Lung Capacity and Residual Volume Eligibilities for Endobronchial Valve Treatment Using Measurements by the Helium Dilution Technique, CT-Based Lung Volume Analysis, and Spirometry.
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Kinose Daisuke, Nakano Yasutaka, Mineshita Masamichi
Аннотация
BACKGROUND AND OBJECTIVE: Endobronchial valve (EBV) placement reduces hyperinflation in patients with severe COPD. Eligibility criteria of EBV include total lung capacity (TLCpleth) ≥ 100% and residual volume (RVpleth) ≥ 175% by body plethysmography. In this study, we evaluated the performance of alternative modalities for predicting EBV criteria in clinical settings where body plethysmography is unavailable.
METHODS: This is a single centre observational study. We recruited 41 patients with COPD at St. Marianna University Hospital. The participants underwent spirometry for VC, FVC, and FEV1, body plethysmography for TLCpleth and RVpleth, and the helium dilution technique for TLCHe and RVHe as well as CT scanning at full inspiration and expiration to calculate air volume (AV) and total lung volume (TLV), which includes both air and tissue volumes. We also estimated TLVpleth and RVpleth by using previously proposed formulas from the University of Groningen (TLCGroningen and RVGroningen) and from the University of Pittsburgh (RVPittsburgh).
RESULTS: The alternative measurements, that is, TLCHe, AVinspiratory CT, TLVinspiratory CT, TLCGroningen, RVHe, AVinspiratory CT - VC, AVexpiratory CT, TLVinspiratory CT - VC, TLVexpiratory CT, RVGroningen, and RVPittsburgh, correlated well with TLCpleth and RVpleth. Receiver operating characteristic analysis to predict TLCpleth ≥ 100%, RVpleth ≥ 175%, or RVpleth ≥ 150% by these alternatives yielded high area under the curve (AUC) values around 0.924-0.937. We also determined the threshold values for sensitivity = 100% (Rule-out threshold) and specificity = 100% (Rule-in threshold) to predict TLCpleth ≥ 100%, RVpleth ≥ 175%, or RVpleth ≥ 150%.
CONCLUSION: Our findings indicate that, when body plethysmography is not feasible, these measurements may help identify patients likely or unlikely to meet plethysmography-defined EBV eligibility criteria.
METHODS: This is a single centre observational study. We recruited 41 patients with COPD at St. Marianna University Hospital. The participants underwent spirometry for VC, FVC, and FEV1, body plethysmography for TLCpleth and RVpleth, and the helium dilution technique for TLCHe and RVHe as well as CT scanning at full inspiration and expiration to calculate air volume (AV) and total lung volume (TLV), which includes both air and tissue volumes. We also estimated TLVpleth and RVpleth by using previously proposed formulas from the University of Groningen (TLCGroningen and RVGroningen) and from the University of Pittsburgh (RVPittsburgh).
RESULTS: The alternative measurements, that is, TLCHe, AVinspiratory CT, TLVinspiratory CT, TLCGroningen, RVHe, AVinspiratory CT - VC, AVexpiratory CT, TLVinspiratory CT - VC, TLVexpiratory CT, RVGroningen, and RVPittsburgh, correlated well with TLCpleth and RVpleth. Receiver operating characteristic analysis to predict TLCpleth ≥ 100%, RVpleth ≥ 175%, or RVpleth ≥ 150% by these alternatives yielded high area under the curve (AUC) values around 0.924-0.937. We also determined the threshold values for sensitivity = 100% (Rule-out threshold) and specificity = 100% (Rule-in threshold) to predict TLCpleth ≥ 100%, RVpleth ≥ 175%, or RVpleth ≥ 150%.
CONCLUSION: Our findings indicate that, when body plethysmography is not feasible, these measurements may help identify patients likely or unlikely to meet plethysmography-defined EBV eligibility criteria.