[Radiological Aspects of Surgery to Reduce Lung Volume]

Abstract

In cases where conservative treatment for COPD with emphysema has been unsuccessful and a lung transplant is not a viable option, reducing the lung volume may be the most appropriate therapeutic course of action. Lung volume reduction surgery (LVRS) employs a range of techniques, including apical shaving, targeted resection of a target zone and complete flap resection. In addition to these LVRS techniques, minimally invasive, bronchoscopically guided therapy with one-way valves, endobronchial coils or water vapour ablation is also a possibility. All surgical and bronchoscopic procedures have one thing in common: they all require critical patient selection and meaningful radiological diagnostics for treatment planning. This encompasses the acquisition of a data set for computed tomography of the lung, the software-supported quantification of the proportion of empyema in the lung tissue, and the assessment of fissure integrity. Nuclear medicine examinations have been shown to provide valuable additional information, particularly in cases of complex constellations of findings. The interdisciplinary emphysema conference is then convened to determine the most appropriate treatment procedure for each patient, taking into account all preliminary diagnostic findings.