Journal Article

Limited Benefit of Additional Chartis ® Assessments for Collateral Ventilation Evaluation in Patients with Software Quantified Intact Target Lobe Fissure - Results from a Retrospective Analysis of the German Lung Emphysema Registry

Neumann, Konrad, Sgarbossa, Thomas, Gesierich, Wolfgang, Saccomanno, Jacopo, Andreas, Stefan, Witzenrath, Martin, Eisenmann, Stephan, Schmidt, Bernd, Stanzel, Franz, Hübner, Ralf Harto

2025

Overview

Endoscopic lung volume reduction (ELVR) with valves is a treatment option for selected patients with emphysema. Collateral Ventilation (CV) is measured directly with the Chartis bronchoscopic assessment system (PulmonX Inc. Redwood City, CA, USA) and indirectly via fissure completeness score (FCS) on computed-tomography (CT). It remains unclear, whether the additional Chartis assessment improves treatment outcome when the target lobe shows intact fissure (FCS ≥95%). This retrospective analysis used data from the German Lungenemphysemregister e.V. a prospective multicenter trial on lung volume reduction therapy. Patients with an intact fissure (FCS ≥95%) of the target lobe undergoing ELVR were included. Treatment outcomes were compared between patients who had a Chartis measurement prior to ELVR and those who did not. A total of 262 patients were analyzed: 175 with Chartis and 87 without. Baseline parameters were comparable between groups. At 3-month follow-up significant improvements in lung function parameters (FEV1, RV, DLCO, pCO2), exercise capacity (6-MWT) and quality of life parameters (SGRQ, mMRC and CAT) were seen in both groups. Treatment efficacy at 3-month follow-up was comparable in patients regardless of previous Chartis measurements. Furthermore, there was no difference in treatment outcome, when comparing improvements for the right and left lung separately. Responder rates were similar between the groups, with a comparable MCID in both. Complication rates were also largely comparable, except for a higher pneumothorax rate in the no-Chartis group (7% vs 22%). This analysis did not find evidence that a Chartis assessment provided additional benefit to the treatment response after ELVR at 3-month follow-up in patients with an intact fissure of the target lobe with an FCS ≥95%. These findings may be clinically relevant as they suggest that additional invasive Chartis measurement might be dispensable in this subgroup.

• Publisher: Dove Medical Press Limited,Dove Press
• Subject: Aged / Bronchoscopy - adverse effects / collateral ventilation / COPD / Emphysema, Pulmonary / endoscopic lung volume reduction with valves / Exercise Tolerance / Female / Germany / Humans / Lung - diagnostic imaging / Lung - physiopathology / Lung - surgery / Lung emphysema / Male / Middle Aged / Original Research / Pneumonectomy - adverse effects / Pneumonectomy - instrumentation / Pneumonectomy - methods / Predictive Value of Tests / Pulmonary Emphysema - diagnosis / Pulmonary Emphysema - diagnostic imaging / Pulmonary Emphysema - physiopathology / Pulmonary Emphysema - surgery / Pulmonary Ventilation / Quality of Life / Recovery of Function / Registries / Retrospective Studies / Software / Time Factors / Tomography, X-Ray Computed / Treatment Outcome / Valves