Dataset Information

Computed tomography volumetric analysis for predicting postoperative lung function for segmentectomy.

ABSTRACT:

Objectives

We compared the computed tomographic (CT) volumetric analysis and anatomical segment counting (ASC) for predicting postoperative forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLCO) in patients who had segmentectomy for early-stage lung cancer.

Methods

A total of 175 patients who had segmentectomy for lung cancer and had postoperative pulmonary function test were included. CT volumetric analysis was performed by software, which could measure total lung and target segment volume from CT images. ASC and CT volumetric analysis were used to determine predicted postoperative (PPO) values and the concordance and difference of these values were assessed. The relationship between PPO values and actual postoperative values was also investigated.

Results

The PPO-FEV1 and PPO-DLCO showed high concordance between 2 methods (concordance correlation coefficient = 0.96 for PPO-FEV1 and 0.95 for PPO-DLCO). There was no significant difference between PPO values as determined by 2 methods (P = 0.53 for PPO-FEV1, P = 0.25 for PPO-DLCO) and actual postoperative values [P = 0.77 (ASC versus actual) and P = 0.20 (CT versus actual) for FEV1; P = 0.41 (ASC versus actual) and P = 0.80 (CT versus actual) for DLCO]. We subdivided the patients according to poor pulmonary function test, the number of resected segments and the location of the resected lobe. All subgroup analyses revealed no significant difference between PPO values and actual postoperative values.

Conclusions

Both CT volumetric analysis and ASC showed high predictability for actual postoperative FEV1 and DLCO in segmentectomy.

SUBMITTER: Bae SY

PROVIDER: S-EPMC9338704 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Computed tomography volumetric analysis for predicting postoperative lung function for segmentectomy.

Bae Seon Yong SY Lee Haeju H Na Kwon Joong KJ Na Bubse B Park Samina S Park In Kyu IK Kang Chang Hyun CH Kim Young Tae YT

Interactive cardiovascular and thoracic surgery 20220701 2

<h4>Objectives</h4>We compared the computed tomographic (CT) volumetric analysis and anatomical segment counting (ASC) for predicting postoperative forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLCO) in patients who had segmentectomy for early-stage lung cancer.<h4>Methods</h4>A total of 175 patients who had segmentectomy for lung cancer and had postoperative pulmonary function test were included. CT volumetric analysis was performed by software, which could ...[more]

PMID: 35876799

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Project description:BackgroundThe effect of different surgical methods on postoperative lung function in patients with lung cancer is still inconclusive. The main objective of this study was to compare the effects of video-assisted thoracic surgery (VATS) lobectomy and segmentectomy on postoperative pulmonary function and compensatory changes in patients undergoing lung cancer surgery.MethodsA total of 120 patients (82 VATS lobectomy, 38 VATS segmentectomy) were assessed for demographic characteristics, baseline pulmonary function, tumor volume, T stage, and histological grade. Postoperative pulmonary function and compensatory changes [percentage of the well-aerated lung (WAL) total (or unilateral) lung volume (LV) (WAL%) and non-operated lung (NOL)] were measured at multiple time points up to 2 years. Logistic regression analysis identified factors associated with WAL% decline after 1 year.ResultsBoth VATS lobectomy and segmentectomy led to a decrease in pulmonary function, with no significant difference in the extent of decline between the two groups (all P>0.05). Lobectomy triggered a more pronounced compensatory response, characterized by increased ipsilateral NOL volume over time. Segmentectomy induced minimal compensatory changes and had a minimal impact on pulmonary function. Factors associated with decreased pulmonary ventilation after 1 year differed between the lobectomy and segmentectomy groups. In the lobectomy group, a higher preoperative WAL% of ipsilateral NOL [odds ratio (OR) =1.073; 95% confidence interval (CI): 1.017-1.133; P=0.01] was associated with a higher risk of decline in pulmonary function, whereas in the segmentectomy group, the only influencing factor was the preoperative contralateral mean lung density (MLD) (OR =0.932; 95% CI: 0.884-0.984; P=0.01).ConclusionsBoth lobectomy and segmentectomy after lung cancer surgery result in a decrease in WAL%, with lobectomy demonstrating a stronger pulmonary compensatory capacity. The application of quantitative computed tomography (CT) has shown significant value in predicting postoperative pulmonary function preservation and compensatory changes, providing strong support for personalized surgical decision-making.

Project description:BackgroundIdiopathic pulmonary fibrosis (IPF) is a fatal lung disease involving progressive degeneration of lung capacity. Current diagnosis of IPF heavily relies on visual evaluation of fibrotic features in high-resolution computed tomography (HRCT) images of the lungs. Although the characteristics of this disease have been studied at the molecular and cellular levels, little is known about the mechanical characteristics of IPF lungs inferred from HRCT images. To this end, we performed a pilot study to investigate the radiographic and volumetric characteristics of lungs in subjects with IPF.MethodsWe collected HRCT images of healthy (N = 13) and IPF (N = 9) lungs acquired at breath-holds after full inspiration (expanded state) and full expiration (contracted state). We performed statistical analyses on Hounsfield unit (HU) histograms, lobar volumes (V: lobe volume normalized by the lung volume), and lobar flows (Q: the difference in lobe volume divided by the difference in lung volume between the expanded and contracted states).ResultsParameters characterizing the HU histograms (i.e., mean, median, skewness, and kurtosis) significantly differed between healthy and IPF subjects, for all lobes in both expanded and contracted states. The distribution of V across lobes differed significantly between the groups in both states. The distribution of Q also differed significantly between the groups: Q values of the lower lobes for the IPF group were 33% (right) and 22% (left) smaller than those for the healthy group, consistent with the observation that radiographic scores were highest in the lower lung section in IPF. Notably, the root-mean-squared difference (RMSD) of Q, a measure of distance from the mean value of the healthy group, clearly distinguished the IPF subjects (RMSD of Q > 1.59) from the healthy group (RMSD of Q < 0.67).ConclusionThis study shows that lung volume and flow distribution change heterogeneously across the lung lobes of IPF subjects, with reduced capacity in the lower lobes. These volumetric changes may improve our understanding of the pathophysiology in IPF lungs.

Dataset Information

Computed tomography volumetric analysis for predicting postoperative lung function for segmentectomy.

Objectives

Methods

Results

Conclusions

Publications

Computed tomography volumetric analysis for predicting postoperative lung function for segmentectomy.

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