Open AccessReduced ventilation–perfusion (V/Q) mismatch following endobronchial valve insertion demonstrated by Gallium‐68 V/Q photon emission tomography/computed tomography
Author(s) -
Leong Paul,
Le Roux PierreYves,
Callahan Jason,
Siva Shankar,
Hofman Michael S,
Steinfort Daniel P
Publication year - 2017
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.253
Subject(s) - medicine , tomography , perfusion , nuclear medicine , positron emission tomography , computed tomography , spirometry , emission computed tomography , single photon emission computed tomography , ventilation (architecture) , radiology , asthma , mechanical engineering , engineering
Endobronchial valves ( EBVs ) are increasingly deployed in the management of severe emphysema. Initial studies focussed on volume reduction as the mechanism, with subsequent improvement in forced expiratory volume in 1 s ( FEV 1 ). More recent studies have emphasized importance of perfusion on predicting outcomes, though findings have been inconsistent. Gallium‐68 ventilation–perfusion (V/Q) photon emission tomography ( PET )/computed tomography ( CT ) is a novel imaging modality with advantages in spatial resolution, quantitation, and speed over conventional V/Q scintigraphy. We report a pilot case in which V/Q‐PET / CT demonstrated discordant findings compared with quantitative CT analysis, and directed left lower lobe EBV placement. The patient experienced a significant improvement in 6‐min walk distance ( 6MWD ) without change in spirometry. Post‐ EBV V/Q‐ PET / CT demonstrated a marked decrease in unmatched (detrimental) V/Q areas and improvement in overall V/Q matching on post‐ EBV V/Q‐ PET / CT . These preliminary novel findings suggest that EBVs improve V/Q matching and may explain the observed functional improvements.