Evaluating the Benefit and Role of Using V/Q Lung Scan with Quantitative SPECT/CT in patients with COPD undergoing Bronchoscopic Lung Volume Reduction Therapy (2024)

Abstract

P1321

Introduction: To establish the role of nuclear medicine with SPECT/CT in the treatment of Chronic Obstructive Pulmonary Disease (COPD) with Bronchoscopic Lung Volume Reduction (BLVR). BLVR is a new, minimally invasive treatment for emphysema and hyperinflation associated with COPD and allows other lobes to expand with greater efficiency while blocking the most diseased lobes. Due to the difficulty of qualifying for and obtaining a lung transplant in severe COPD, BLVR offers a viable alternative for a greater population of patients. However, there has not yet been adequate emphasis on patient selection for this procedure. Radiology can play a significant role in this process with ventilation/perfusion (V/Q) lung scans with SPECT/CT, which has shown to have high specificity and less complications in patients. This study will investigate the effectiveness of V/Q with SPECT/CT in selecting patients who would benefit from BLVR, and advise which lobe to block to offer the best outcome for patients’ ineligible for surgical intervention or waiting for lung transplantation and improve BLVR therapy.

Methods: This retrospective study consisted of 77 consecutive patients who were treated with BLVR therapy and had a quantitative SPECT/CT study prior to the procedure between November 1, 2018 and March 1, 2022. The patients ranged from 56-85 years with a mean of 70 years old. 45 (58%) were male and 32 (42%) were female. The SPECT/CT would quantify the ventilation and perfusion for each lobe and the lowest V/Q ratios were used to determine where to perform the BLVR. After the BLVR procedure, SPECT/CT was used again to compare the V/Q ratios to determine where the perfusion shifted. The 6-minute-walk test and pulmonary function tests (PFT) were also compared pre- and post-BLVR to evaluate the efficacy of the procedure using paired-t test.