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Understanding the mechanism of bronchial thermoplasty using airway volume assessed by computed tomography

David Langton, Peter B. Noble, Frank Thien, Graham M. Donovan
ERJ Open Research 2019 5: 00272-2019; DOI: 10.1183/23120541.00272-2019
David Langton
1Dept of Thoracic Medicine, Frankston Hospital, Peninsula Health, Frankston, Australia
2Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
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Peter B. Noble
3School of Human Sciences, The University of Western Australia, Crawley, Australia
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Frank Thien
2Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
4Dept of Respiratory Medicine, Eastern Health, Box Hill, Australia
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Graham M. Donovan
5Dept of Mathematics, University of Auckland, Auckland, New Zealand
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  • For correspondence: g.donovan@auckland.ac.nz
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    FIGURE 1

    Comparison of volume of bronchial thermoplasty (BT)-treated airways in a, c, d and f) each patient as assessed by computed tomography (CT) (eight patients) and model predictions (20 simulations). CT measurements at a, d and g) functional residual capacity (FRC) and c, f and h) total lung capacity (TLC) are compared with b and e) model predictions. Model predictions are for fatal asthma at a low level of airway smooth muscle activation [5]. The response threshold is defined as an increase in airway volume that exceeds half of the interquartile range of the intervisit variability, as assessed on the untreated right side (∼8.5% at FRC and ∼17% at TLC). p-values reflect paired t-tests. The untreated right lung was not modelled. Subject characteristics were as follows. Males: seven out of 18 patients; mean±sd age 57.6±14.2 years; BMI: 32.1±7.2 kg·m−2; cigarettes: 10 never-smokers, eight ever-smokers; Asthma Control Questionnaire (ACQ) score (baseline): 3.5±0.9; oral steroids: 15/18 mg·day−1, mean 14.3±15.8 mg·day−1; forced expiratory volume in 1 s: 44.9±13.7% pred; ACQ score after one lung treated: 2.4±1.2. The protocol was prospectively reviewed and approved by the Peninsula Health Human Research Ethics Committee. LLL: left lower lobe; LUL: left upper lobe; RUL: right upper lobe; RLL: right lower lobe; RML: right middle lobe.

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Understanding the mechanism of bronchial thermoplasty using airway volume assessed by computed tomography
David Langton, Peter B. Noble, Frank Thien, Graham M. Donovan
ERJ Open Research Oct 2019, 5 (4) 00272-2019; DOI: 10.1183/23120541.00272-2019

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Understanding the mechanism of bronchial thermoplasty using airway volume assessed by computed tomography
David Langton, Peter B. Noble, Frank Thien, Graham M. Donovan
ERJ Open Research Oct 2019, 5 (4) 00272-2019; DOI: 10.1183/23120541.00272-2019
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