The U.S. Department of Veterans Affairs (VA) is tasked with meeting the screening and diagnostic needs of hundreds of thousands of Veterans struggling with respiratory illness as a consequence of deployment related exposures. To help VA meet that challenge, Philips—in collaboration with 4DMedical—is leveraging new and innovative healthcare technology. With over 5,000 imaging systems installed across the VA network and over 800+ PACS installations deployed in North America, Philips is a well-positioned Strategic Partner of VA.
Veterans Exposed to Airborne Toxins During Deployment
Over 3.5 million military personnel were exposed to burn pits and other toxic particulate matter while on deployment. Many more were affected by other hazards like jet fuel, chemical agents and radiation (VA.gov, 2015). The diversity of these exposures means Veterans may suffer from conditions not fully understood within existing healthcare frameworks.
The Challenge of Diagnosing Deployment Related Respiratory Disease
Veterans are often misdiagnosed with conditions such as asthma, bronchitis or pleuritis when they may in fact have a more serious condition such as deployment-related respiratory disease (DRRD), constrictive bronchiolitis (CB). Misdiagnosis can lead to inappropriate treatment and a cascade of other medical issues.
The diagnosis of constrictive bronchiolitis (CB) in previously deployed individuals, and evaluation of respiratory symptoms more broadly, present considerable challenges. These include using consistent histopathologic criteria gathered during a lung biopsy for the purposes of clinical assessments. Such procedures are often last resort due to health risk. In the absence of CB diagnosis, DRRD provides a broad descriptor encompassing a range of post-deployment respiratory findings.
Philips and 4DMedical—A New Standard of Lung Function Analysis
Philips has teamed with innovative collaborator 4DMedical to bring a revolutionary new capability to market—non-invasive, quantitative analysis of lung function. Together, Philips and 4DMedical are creating a new standard in lung function analyses for lung disorders, including unexplained dyspnea (shortness of breath), asthma, COPD, and Interstitial Lung Disease (ILD).
The collaboration between VA, Philips and 4DMedical is a testament to the power of collaboration to address the significant health challenges faced by Veterans due to military toxic exposures. This ongoing collaboration is a pivotal strategy to provide advanced care and support for those who have bravely served our country. For further information on Philips initiatives and government partnerships in Veteran healthcare, visit https://www.usa.philips.com/healthcare/government.
A study at Vanderbilt University Medical Center characterized post-deployment Veterans with small airways disease. These Veterans had undergone a surgical lung biopsy which confirmed the presence of constrictive bronchiolitis (CB). The Veterans, and healthy controls, were then scanned using 4DMedical X-ray Velocimetry Lung Ventilation Analysis Software (XV LVAS). This pilot study demonstrated that 4D’s XV LVAS software could differentiate between the lungs of a healthy control and those with CB, which was undetectable on computed tomography (CT) scans and with pulmonary function tests (PFTs).
Selected images from a healthy control subject (left) and a burn pit exposed Veteran (right) with biopsy-proven constrictive bronchiolitis, as processed by 4DMedical XV LVAS Software. (Images from Vanderbilt University.) The control subject demonstrates large regions of homogeneous green color representing average ventilation whereas the impacted Veteran has marked heterogeneity and significant regions of both red (low) and blue (high) ventilation. In addition to the visualizations shown here, extensive quantitative assessments identify the measurable and objective differences between Veterans with constrictive bronchiolitis and healthy controls.