Three-dimensional computed tomographic volumetry precisely predicts the postoperative pulmonary function

Surgery Today volume 47, pages1303–1311(2017)Cite this article

Abstract

Purpose

It is important to accurately predict the patient’s postoperative pulmonary function. The aim of this study was to compare the accuracy of predictions of the postoperative residual pulmonary function obtained with three-dimensional computed tomographic (3D-CT) volumetry with that of predictions obtained with the conventional segment-counting method.

Methods

Fifty-three patients scheduled to undergo lung cancer resection, pulmonary function tests, and computed tomography were enrolled in this study. The postoperative residual pulmonary function was predicted based on the segment-counting and 3D-CT volumetry methods. The predicted postoperative values were compared with the results of postoperative pulmonary function tests.

Results

Regarding the linear correlation coefficients between the predicted postoperative values and the measured values, those obtained using the 3D-CT volumetry method tended to be higher than those acquired using the segment-counting method. In addition, the variations between the predicted and measured values were smaller with the 3D-CT volumetry method than with the segment-counting method. These results were more obvious in COPD patients than in non-COPD patients.

Conclusions

Our findings suggested that the 3D-CT volumetry was able to predict the residual pulmonary function more accurately than the segment-counting method, especially in patients with COPD. This method might lead to the selection of appropriate candidates for surgery among patients with a marginal pulmonary function.

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References

  1. 1.

    Kearney DJ, Lee TH, Reilly JJ, DeCamp MM, Sugarbaker DJ. Assessment of operative risk in patients undergoing lung resection. importance of predicted pulmonary function. Chest 1994;105:753–59.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Brunelli A, Al Refai M, Monteverde M, Sabbatini A, Xiumé F, Fianchini A. Predictors of early morbidity after major lung resection in patients with and without airflow limitation. Ann Thorac Surg. 2002;74:999–1003.

    Article  PubMed  Google Scholar 

  3. 3.

    Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: american college of chest physicians evidence-based clinical practice guidelines. Chest 2013;143:e166S–e90S.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Ali MK, Mountain CF, Ewer MS, Johnston D, Haynie TP. Predicting loss of pulmonary function after pulmonary resection for bronchogenic carcinoma. Chest 1980;77:337–42.

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Gass GD, Olsen GN. Preoperative pulmonary function testing to predict postoperative morbidity and mortality. Chest. 1986;89:127–35.

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Wu MT, Chang JM, Chiang AA, Lu JY, Hsu HK, Hsu WH, et al. Use of quantitative CT to predict postoperative lung function in patients with lung cancer. Radiology. 1994;191:257–62.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Ueda K, Tanaka T, Li TS, Tanaka N, Hamano K. Quantitative computed tomography for the prediction of pulmonary function after lung cancer surgery: a simple method using simulation software. Eur J Cardio-Thoracic Surg Off J Eur Assoc Cardio-Thoracic Surg 2009;35:414–8.

    Article  Google Scholar 

  8. 8.

    Yoshimoto K, Nomori H, Mori T, Kobayashi H, Ohba Y, Shibata H, et al. Prediction of pulmonary function after lung lobectomy by subsegments counting, computed tomography, single photon emission computed tomography and computed tomography: a comparative study. Eur J Cardio-Thoracic Surg Off J Eur Assoc Cardio-Thoracic Surg. 2009;35:408–13.

    Article  Google Scholar 

  9. 9.

    Ueda K, Kaneda Y, Sudo M, Mitsutaka J, Li TS, Suga K, et al. Quantitative computed tomography versus spirometry in predicting air leak duration after major lung resection for cancer. Ann Thorac Surg. 2005;80:1853–8.

    Article  PubMed  Google Scholar 

  10. 10.

    Ueda K, Kaneda Y, Sudoh M, Mitsutaka J, Tanaka N, Suga K, et al. Role of quantitative CT in predicting hypoxemia and complications after lung lobectomy for cancer, with special reference to area of emphysema. Chest. 2005;128:3500–6.

    Article  PubMed  Google Scholar 

  11. 11.

    Sekine Y, Behnia M, Fujisawa T. Impact of COPD on pulmonary complications and on long-term survival of patients undergoing surgery for NSCLC. Lung Cancer 2002;37:95–101.

    Article  PubMed  Google Scholar 

  12. 12.

    Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.

    Article  PubMed  Google Scholar 

  13. 13.

    Wu M-T, Pan H-B, Chiang AA, Hsu H-K, Chang H-C, Peng N-J, et al. Prediction of postoperative lung function in patients with lung cancer. Am J Roentgenol. 2002;178:667–72.

    Article  Google Scholar 

  14. 14.

    Park KJ, Bergin CJ, Clausen JL. Quantitation of emphysema with three-dimensional CT densitometry: comparison with two-dimensional analysis, visual emphysema scores, and pulmonary function test results. Radiology 1999;211:541–47.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Kinsella M, Müller NL, Abboud RT, Morrison NJ, DyBuncio A. Quantitation of emphysema by computed tomography using a “density mask” program and correlation with pulmonary function tests. Chest 1990;97:315–21.

    CAS  Article  PubMed  Google Scholar 

  16. 16.

    Knudson RJ, Standen JR, Kaltenborn WT, Knudson DE, Rehm K, Habib MP, et al. Expiratory computed tomography for assessment of suspected pulmonary emphysema. Chest. 1991;99:1357–66.

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Müller NL, Staples CA, Miller RR, Abboud RT. “Density mask”. an objective method to quantitate emphysema using computed tomography. Chest 1988;94:782–87.

    Article  PubMed  Google Scholar 

  18. 18.

    Iwano S, Kitano M, Matsuo K, Kawakami K, Koike W, Kishimoto M, et al. Pulmonary lobar volumetry using novel volumetric computer-aided diagnosis and computed tomography. Interact Cardiovasc Thorac Surg. 2013;17:59–65.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Madani A, Keyzer C, Gevenois P-A. Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema. Eur Respiratory J 2001;18:720–30.

    CAS  Article  Google Scholar 

  20. 20.

    Sciurba FC, Rogers RM, Keenan RJ, Slivka WA, Gorcsan J 3rd, Ferson PF, et al. Improvement in pulmonary function and elastic recoil after lung-reduction surgery for diffuse emphysema. N Engl J Med. 1996;334:1095–9.

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Geddes D, Davies M, Koyama H, Hansell D, Pastorino U, Pepper J, et al. Effect of lung-volume-reduction surgery in patients with severe emphysema. N Engl J Med. 2000;343:239–45.

    CAS  Article  PubMed  Google Scholar 

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Affiliations

  1. Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Keisuke Kobayashi, Yusuke Saeki, Shinsuke Kitazawa, Naohiro Kobayashi, Shinji Kikuchi, Yukinobu Goto, Mitsuaki Sakai & Yukio Sato

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  1. Keisuke Kobayashi
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  2. Yusuke Saeki
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  3. Shinsuke Kitazawa
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  4. Naohiro Kobayashi
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  7. Mitsuaki Sakai
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  8. Yukio Sato
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Correspondence to Yukio Sato.

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Conflict of interest statement: Keisuke Kobayashi and the other co-authors have no conflicts of interest.

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Kobayashi, K., Saeki, Y., Kitazawa, S. et al. Three-dimensional computed tomographic volumetry precisely predicts the postoperative pulmonary function. Surg Today 47, 1303–1311 (2017). https://doi.org/10.1007/s00595-017-1505-y

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Keywords

  • Three-dimensional computed tomographic volumetry
  • Segment-counting method
  • Residual pulmonary function
  • Chronic obstructive pulmonary disease