Functional Respiratory Imaging as a Tool to Personalize Respiratory Treatment in Patients With Unilateral Diaphragmatic Paralysis

Abstract

A completely different treatment approach was chosen for 2 patients with unilateral diaphragmatic paralysis and complaints of dyspnea despite similar anatomic and physiologic abnormalities. These decisions were supported by results obtained by functional respiratory imaging (FRI). FRI generated functional information on lobar ventilation and local drug deposition. In the first patient, some lobes were poorly ventilated, and drug deposition simulation showed that some regions were undertreated. This patient underwent diaphragmatic plication to restore ventilation. In the second patient, all lobes were still ventilated. A conservative approach with regular follow-ups was chosen to wait for spontaneous recovery of the diaphragmatic function. Both patients improved subjectively and objectively. These cases demonstrate how novel medical imaging techniques such as FRI can be used to personalize respiratory treatment in patients with unilateral diaphragmatic paralysis.

Dry powder inhalation: past, present and future

“…CT scans at functional residual capacity and total lung capacity are also used as boundary conditions for computational fluid dynamics (CFD) simulation to predict flow behavior and drug deposition [144]. It is anticipated that this functional respiratory imaging may become a tool for personalized respiratory treatment [145].…”

“…New 3D printing techniques facilitate rapid DPI prototyping and making casts of (upper) parts the respiratory tract based on high-resolution CT scans [178]. Coimaging may enable to draw better conclusions about respiratory tract deposition in individual patients with diseased lungs and eventually facilitate personalized treatment with highly expensive drugs [143][144][145]. But most important of all may be reducing the cost of inhaled therapy considering the pressure on health budgets and the rapidly growing demand for inhaled therapies in developing and newly industrialized countries.…”

Longitudinal assessment of bleomycin-induced lung fibrosis by Micro-CT correlates with histological evaluation in mice

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Multichannel analysis of normal and continuous adventitious respiratory sounds for the assessment of pulmonary function in respiratory diseases

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