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Bronchoscopy: Interventional Pulmonary Procedures


Tuesday, October 28, 2008

1:00 PM - 2:15 PM

VIBRATION RESPONSE IMAGING (VRI): A NEW METHOD FOR EVALUATION OF INTERVENTIONAL BRONCHOSCOPY

Heinrich D. Becker, MD*, Mathias Slavik, MD, Momn M. Wahidi, MD, Herve Dutau, MD, Ali Musani, MD, Merav Gat, MSc and Teruomi Miyazawa, MD

Thoraxklinik at Heidelberg University, Heidelberg, Germany

PURPOSE: Interventional bronchoscopy gained increasing importance for treatment of central airway stenosis. However, tools for assessing outcome (dyspnea score [DS], PFT, X-ray/CT [RAD]) are frequently unreliable or cannot be applied in an emergency situation. This is why we explored the VRI before and after interventions.

METHODS: The 40 sensors of the VRI register vibrations by breathing maneuvers on the chest wall. A processor transforms the signals to dynamic grey scale images which can be observed real time on a monitor. In a prospective study we evaluated the VRI before and after interventions (stenting, lasering, APC, Mechanical dilation etc.) for localization and success.

RESULTS: We enrolled 108 subjects, 25 normals and 83 patients of whom 51 (45%f,59+/–13y) under went 64 procedures (53% stents, 36% resection/dilation, 11% removal of mucus plugs). Localization of the stenosis by VRI was successful in 95%. Analyzing results of outcome was successful in 90% and superior to DS (73%), PFT (61%) and RAD (32%)and as good as the three combined.

CONCLUSION: VRI is a useful tool for assessment of bronchoscopic interventions in central airway stenosis. It is non-invasive, radiation free, redaily available, cheap and can be repeatedly applied. In an ongoing international multi-center study the results are currently confirmed in a larger population.

CLINICAL IMPLICATIONS: VRI has the potential to add to or even replace more invasive and costly methods for assessment of interventions.

DISCLOSURE: Heinrich Becker, None.






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