Bronchoscopic lung volume reduction treatment in severe COPD: from improving patient selection to management of complications

Chronic Obstructive Pulmonary Disease (COPD) is a common disease, often characterized by shortness of breath and coughing and this can lead to a poor quality of life. In patients with severe COPD, there can be hyperinflation and an increased residual volume. In some patients with severe increased residual volume, bronchoscopic lung volume reduction treatment using one-way valves can be an option. It has been proven that valve treatment can lead to improvements in shortness of breath, exercise capacity and quality of life. For treatment, it is important that there is sufficient emphysema in the treatment lobe and no collateral ventilation between the treated lobe and the adjacent lobe.
Currently, the CT scan of the lungs is the most important tool to determine whether a patient is potentially suitable for the treatment with one-way valves. With quantitative CT scan analysis, various parameters can be assessed automatically (e.g. severity of emphysema and fissure completeness).
In this thesis, we investigate whether the use of quantitative CT scan analysis can be optimized in patients who are evaluated for treatment with valves and to improve the selection of the right patients and the optimal treatment lobe. Additionally, we discuss several methods to improve the measurement of collateral ventilation (Chartis measurement) and to discuss the main complications after valve treatment.