Functional imaging: a new method to figure out COPD
18 september 2014
University of Antwerpen - Campus Drie Eiken - Building Q - Promotiezaal - Universiteitsplein 1 - 2610 Wilrijk
Organisatie / co-organisatie:
Faculty of Medicine and Health Sciences
Lieve De Backer
Prof P. Jorens and Prof B. Sabbe
PhD defense Lieve De Backer - Faculty of Medicine and Health Sciences
Functional Imaging: a new method to figure out COPD.
COPD is a lung disease characterized by irreversible airway obstruction (mostly due to cigarette smoking). Considering the irreversible decrease in lung function, measured bij FEV1, it is difficult to evaluate treatment and find the right patients for the right treatment using routine pulmonary function measures (FEV1).
We used a new method: Functional Respiratory Imaging (FRI). This is an imaging technique that can add functionality to HRCT images, using segmentation and Computational Fluid Dynamics. This way, it is possible to measure local volumes of airways, lobes and lungs; and to calculate also local Resistances. It turns out to be a technique that can highlight changes in the airways after treatment.
We found redistribution of mass flow to better functioning parts of the lungs after longterm NIV treatment, which gives an indication for the selection of patients for this treatment: patients with localized emphysema seem to benefit most. FRI also showed a bronchodilating effect of salbutamol, ipratropium bromide and formoterol/budesonide, mainly in the distal airways. FRI is a very sensitive method, even minor changes in airway volume and resistance become clear.
Physiotherapy techniques are an important part of treatment in COPD, although there is not much evidence. FRI shows movement of mucus after IPV treatment, and gives us a method to evaluate physiotherapy treatment.
Because multidisciplinary treatment in chronic disease is the best treatment, we also used FRI images for the education of COPD patients. This intervention improved symptom scores, especially in patients with an open personality. This too is an important finding, since it is an easy intervention that can make a great difference for the patient.
We can conclude that FRI is a new method to phenotype COPD patients, to select them for treatment, to evaluate treatment and to educate patients about their disease and improve symptom scores.