Efficacy of bronchoscopic thermal vapor ablation in patients with heterogeneous emphysema and lobar quantification by three-dimensional ventilation/perfusion single-photon emission computed tomography/computed tomography: a prospective pilot study from China

[1] In addition, with the heterogeneity existing within the treatment lobe, complete lobar treatment from implants may result in excessive reduction of the less diseased segments. [...]a more targeted approach of the most severe emphysematous parts of the lobe is warranted. Spirometry, 6-min walk distance (6MWD), modified Medical Research Council dyspnea scale (mMRC), and COPD assessment test (CAT) were examined during each FU. Improvement in residual volume (RV) (–0.91 [–1.60 to –0.61] L vs. 0.33 [–0.75 to 0.63] L, U = 9.000, P = 0.015) and RV% predicted (–43.50 [–81.34 to –30.23]% vs. 10.15 [–31.30 to 25.15]%, U = 9.000, P = 0.015) showed significant difference at 6 months when comparing the BTVA and control groups, but not at 3 and 12 months. The significant results at 6 and 12 months suggest that staged ongoing treatment results in additional improvements over time. Since emphysema is an inexorable progressive disease and heterogeneity often exists within the treatment lobe, indicating that the lobe has segments that are almost healthy, a targeted strategy that preserves lung tissue is highly desirable.