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Choosing which lung lobe to treat with valves in severe emphysema

Compares two ways of choosing the lung lobe for valve placement in emphysema.

Plain-language title generated from the registry record
Registry title: Ventilation-Perfusion Discrepancy Index Versus Conventional Anatomic-Physiologic Assessment for Target Lung Lobe Selection in Endobronchial Valve Placement: A Multicenter, Randomised Controlled Trial

Key facts

Where
Beijing, ChinaSee the site

Where in China

  • China-Japan Friendship HospitalBeijing, ChinaNo longer taking part

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Trial details

Who runs it
China-Japan Friendship Hospital
Trial code
NCT07403617
Record updated
11 February 2026
Original description
The goal of this clinical trial is to learn if a Ventilation-Perfusion Discrepancy Index (VQDI)-guided strategy for selecting the target lung lobe can improve outcomes compared to the standard strategy in patients with severe emphysema undergoing bronchoscopic lung volume reduction with endobronchial valves (EBVs).Read full original descriptionShow less

Ventilation-Perfusion Discrepancy Index Versus Conventional Anatomic-Physiologic Assessment for Target Lung Lobe Selection in Endobronchial Valve Placement: A Multicenter, Randomised Controlled Trial

The goal of this clinical trial is to learn if a Ventilation-Perfusion Discrepancy Index (VQDI)-guided strategy for selecting the target lung lobe can improve outcomes compared to the standard strategy in patients with severe emphysema undergoing bronchoscopic lung volume reduction with endobronchial valves (EBVs).

The main question it aims to answer is:

· Does selecting the target lobe based on the lowest VQDI (indicating the worst functional mismatch) lead to a higher rate of successful treatment response at 6 months compared to selecting the lobe based on the worst destruction on CT scan?

If there is a comparison group: Researchers will compare the VQDI-guided selection group to the conventional CT/Chartis-guided selection group to see which strategy results in more patients achieving significant improvement in both lung function and reduction in the size of the treated lobe.

Participants will:

* Undergo standard clinical assessments (lung function tests, CT scan, exercise test) and an additional V/Q SPECT/CT scan to calculate the VQDI. * Have their collateral ventilation status checked using the Chartis system during bronchoscopy. * Be randomly assigned to one of the two target lobe selection strategies. * Receive EBV placement in the selected lobe. * Attend follow-up visits at 1, 3, 6, and 12 months after the procedure for check-ups, repeated lung function tests, questionnaires, and CT scans to assess their response to treatment.

Inclusion: Clinical and radiological evidence of emphysema; Nonsmoking for 4 months prior to screening interview; BMI less than 35 kg/m2; Stable on current medication regimen; Forced expiratory volume in one second (FEV1) between 15% and 45% of predicted value; Residual Volume less than 175% predicted (determined by body plethysmography); Little or no collateral ventilation (CV-) as determined using the Chartis System.

Exclusion: Had a prior lung transplant, lung volume reduction surgery, bullectomy or lobectomy; Had a heart attack or congestive heart failure within the last 6 months; Have heart arrhythmia; Had two or more hospitalizations over the last year for a COPD exacerbation; Had two or more hospitalizations over the last year for pneumonia; Is alpha-1 antitrypsin deficient.

ClinicalTrials.gov NCT07403617