TY - JOUR
T1 - Preoperative assessment of parietal pleural invasion/adhesion of subpleural lung cancer
T2 - advantage of software-assisted analysis of 4-dimensional dynamic-ventilation computed tomography
AU - for the ACTIve Study Group investigators
AU - Yamashiro, Tsuneo
AU - Moriya, Hiroshi
AU - Tsubakimoto, Maho
AU - Nagatani, Yukihiro
AU - Kimoto, Tatsuya
AU - Murayama, Sadayuki
AU - Sakuma, Kotaro
AU - Sakai, Fumikazu
AU - Iwasawa, Tae
AU - Nitta, Norihisa
AU - Murata, Kiyoshi
AU - Yanagawa, Masahiro
AU - Honda, Osamu
AU - Tomiyama, Noriyuki
AU - Koyama, Mitsuhiro
AU - Nishimoto, Yuko
AU - Noma, Satoshi
AU - Ohno, Yoshiharu
AU - Aoki, Takatoshi
AU - Yamashiro, Tsuneo
AU - Xu, Yanyan
N1 - Funding Information:
The authors greatly thank Dr. Shinsuke Tsukagoshi, Ms. Misae Kobayashi, and Mr. Shun Muramatsu for their technical support. The ACTIve Study Group currently consists of the following institutions: Ohara General Hospital, Fukushima-City, Fukushima, Japan; (Kotaro Sakuma, MD, Hiroshi Moriya, MD, PhD) Saitama International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan; (Fumikazu Sakai, MD, PhD) Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan; (Tae Iwasawa, MD, PhD) Shiga University of Medical Science, Otsu, Shiga, Japan; (Yukihiro Nagatani, MD, Norihisa Nitta, MD, Kiyoshi Murata, MD) Osaka University, Suita, Osaka, Japan; (Masahiro Yanagawa, MD, PhD, Osamu Honda, MD, PhD, Noriyuki Tomiyama, MD, PhD) Osaka Medical College, Takatsuki, Osaka, Japan; (Mitsuhiro Koyama, MD, PhD) Tenri Hospital, Tenri, Nara, Japan; (Yuko Nishimoto, MD, Satoshi Noma, MD, PhD) Kobe University, Kobe, Hyogo, Japan; (Yoshiharu Ohno, MD, PhD) University of Occupational and Environmental Health, Kita-kyushu, Fukuoka, Japan; (Takatoshi Aoki, MD, PhD) University of the Ryukyus, Nishihara, Okinawa, Japan; (Tsuneo Yamashiro, MD, Maho Tsubakimoto, MD, Yanyan Xu, MD, Sadayuki Murayama, MD, PhD)
Funding Information:
Acknowledgements The authors greatly thank Dr. Shinsuke Tsukagoshi, Ms. Misae Kobayashi, and Mr. Shun Muramatsu for their technical support. The ACTIve Study Group currently consists of the following institutions: Ohara General Hospital, Fukushima-City, Fukushima, Japan; (Kotaro Sakuma, MD, Hiroshi Moriya, MD, PhD) Saitama International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan; (Fumikazu Sakai, MD, PhD) Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan; (Tae Iwasawa, MD, PhD) Shiga University of Medical Science, Otsu, Shiga, Japan; (Yukihiro Nagatani, MD, Norihisa Nitta, MD, Kiyoshi Murata, MD) Osaka University, Suita, Osaka, Japan; (Masahiro Yanagawa, MD, PhD, Osamu Honda, MD, PhD, Noriyuki Tomiyama, MD, PhD) Osaka Medical College, Takatsuki, Osaka, Japan; (Mitsuhiro Koyama, MD, PhD) Tenri Hospital, Tenri, Nara, Japan; (Yuko Nishimoto, MD, Satoshi Noma, MD, PhD) Kobe University, Kobe, Hyogo, Japan; (Yoshiharu Ohno, MD, PhD) University of Occupational and Environmental Health, Kita-kyushu, Fukuoka, Japan; (Takatoshi Aoki, MD, PhD) University of the Ryukyus, Nishihara, Okinawa, Japan; (Tsuneo Yamashiro, MD, Maho Tsubakimoto, MD, Yanyan Xu, MD, Sadayuki Murayama, MD, PhD) Funding information The authors state that this work has not received any funding. However, this work has been partially supported by a research grant that Dr. Yamashiro received from the Japan Society for the Promotion of Science (Kakenhi-16K19837).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objective: To evaluate the accuracy of four-dimensional (4D) dynamic-ventilation computed tomography (CT) scanning coupled with our novel image analysis software to diagnose parietal pleural invasion/adhesion of peripheral (subpleural) lung cancer. Methods: Eighteen patients with subpleural lung cancer underwent both 4D dynamic-ventilation CT during free breathing and conventional (static) chest CT during preoperative assessment. The absence of parietal pleural invasion/adhesion was surgically confirmed in 13 patients, while the presence of parietal pleural invasion/adhesion was confirmed in 5 patients. Two chest radiologists, who were blinded to patient status, cooperatively evaluated the presence of pleural invasion/adhesion using two different imaging modalities: (i) conventional high-resolution CT images, reconstructed in the axial, coronal, and sagittal directions, and (ii) 4D dynamic-ventilation CT images combined with a color map created by image analysis software to visualize movement differences between the lung surface and chest wall. Parameters of diagnostic accuracy were assessed, including a receiver operating characteristic analysis. Results: Software-assisted 4D dynamic-ventilation CT images achieved perfect diagnostic accuracy for pleural invasion/adhesion (sensitivity, 100%; specificity, 100%; area under the curve [AUC], 1.000) compared to conventional chest CT (sensitivity, 60%; specificity, 77%; AUC, 0.846). Conclusion: Software-assisted 4D dynamic-ventilation CT can be considered as a novel imaging approach for accurate preoperative analysis of pleural invasion/adhesion of peripheral lung cancer. Key Points: • 4D dynamic-ventilation CT can correctly assess parietal pleural invasion/adhesion of peripheral lung cancer. • A unique color map clearly demonstrates parietal pleural invasion/adhesion. • Our technique can be expanded to diagnose “benign” pleural adhesions for safer thoracoscopic surgery.
AB - Objective: To evaluate the accuracy of four-dimensional (4D) dynamic-ventilation computed tomography (CT) scanning coupled with our novel image analysis software to diagnose parietal pleural invasion/adhesion of peripheral (subpleural) lung cancer. Methods: Eighteen patients with subpleural lung cancer underwent both 4D dynamic-ventilation CT during free breathing and conventional (static) chest CT during preoperative assessment. The absence of parietal pleural invasion/adhesion was surgically confirmed in 13 patients, while the presence of parietal pleural invasion/adhesion was confirmed in 5 patients. Two chest radiologists, who were blinded to patient status, cooperatively evaluated the presence of pleural invasion/adhesion using two different imaging modalities: (i) conventional high-resolution CT images, reconstructed in the axial, coronal, and sagittal directions, and (ii) 4D dynamic-ventilation CT images combined with a color map created by image analysis software to visualize movement differences between the lung surface and chest wall. Parameters of diagnostic accuracy were assessed, including a receiver operating characteristic analysis. Results: Software-assisted 4D dynamic-ventilation CT images achieved perfect diagnostic accuracy for pleural invasion/adhesion (sensitivity, 100%; specificity, 100%; area under the curve [AUC], 1.000) compared to conventional chest CT (sensitivity, 60%; specificity, 77%; AUC, 0.846). Conclusion: Software-assisted 4D dynamic-ventilation CT can be considered as a novel imaging approach for accurate preoperative analysis of pleural invasion/adhesion of peripheral lung cancer. Key Points: • 4D dynamic-ventilation CT can correctly assess parietal pleural invasion/adhesion of peripheral lung cancer. • A unique color map clearly demonstrates parietal pleural invasion/adhesion. • Our technique can be expanded to diagnose “benign” pleural adhesions for safer thoracoscopic surgery.
UR - http://www.scopus.com/inward/record.url?scp=85064070885&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85064070885&partnerID=8YFLogxK
U2 - 10.1007/s00330-019-06131-w
DO - 10.1007/s00330-019-06131-w
M3 - Article
C2 - 30915563
AN - SCOPUS:85064070885
VL - 29
SP - 5247
EP - 5252
JO - European Radiology
JF - European Radiology
SN - 0938-7994
IS - 10
ER -