Evaluation of postoperative lung volume and perfusion changes by dual-energy computed tomography in patients with lung cancer |
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| Affiliation: | 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 Gil, Songpa-gu, Seoul 138-736, Republic of Korea;2. Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea;1. Department of Radiology, University of Washington School of Medicine, Box 357115, 1959 Northeast Pacific Street, Seattle, WA 98195, USA;2. Department of Radiology, Duke University Medical Center, Box 3808 Erwin Road, Durham, NC 27710, USA;1. Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India;2. Clinical Immunology and Rheumatology Services, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India;1. Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA;2. R&D Promotion Division, Healthcare Business Headquarters, KONICA MINOLTA, INC., 2970 Ishikawa-machi, Hachioji-shi, Tokyo, Japan;3. Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan;4. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan;5. Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan;6. Department of Health Care, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan;7. Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan;8. Japan Anti-Tuberculosis Association, 1-3-12 Kanda-Misakicho, Chiyoda-ku, Tokyo, Japan;1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;2. Department of Radiology, Informatics and Network, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;3. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan |
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| Abstract: | PurposeThe aim of our study was to retrospectively evaluate postoperative physiologic changes in lung cancer patients using dual-energy CT (DECT), and develop modified methods reflecting postoperative change for predicting pulmonary function.Methods and materials88 patients (M:F = 64:24; mean age, 63.5 years) with lung cancer who underwent DECT and pulmonary function tests before and after operation were included. Volume and iodine values for perfusion of each lobe were quantified. The predicted postoperative FEV1 using the current method was calculated by multiplying the preoperative FEV1 by the fractional contribution of perfusion of the remaining lung. The modified method reflecting postoperative volume change was compared to the current method.ResultsPostoperative lung volume showed compensatory increases in the contralateral and remaining ipsilateral lobes, with a significantly greater increase in the ipsilateral lobe than contralateral lobe (21.8% ± 46.2% vs. 10.0% ± 20.8%, P = 0.031). Perfusion analysis showed blood volume increases in both ipsilateral and contralateral lobes without statistical differences (blood volume ratio difference, 29.2% ± 26.7 vs. 24.6% ± 16.5, P = 0.368). The performance of the modified method considering postoperative lung volume change was comparable to that of the current method in the development and validation datasets (95% CI, −24.5% to 37.1% vs. −33.3% to 22.2% and −23.6% to 32.0% vs. −31.9% to 16.0%, respectively).ConclusionsPostoperative compensatory increases in lung volume and perfusion occur in different ways. Our modified method incorporating postoperative lung volume changes can be considered a comparable method for prediction of postoperative lung function. |
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| Keywords: | Lung cancer Surgery Physiologic change Dual-energy CT Quantitative imaging |
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