Assessing the use of 4DCT-ventilation in pre-operative surgical lung cancer evaluation.

Publication/Presentation Date

1-1-2017

Abstract

PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection. Nuclear medicine imaging is currently considered the standard of care when evaluating the amount of ventilation that would be lost due to surgery. A novel lung function imaging modality has been developed in radiation oncology that uses 4-Dimensional computed tomography data to calculate ventilation maps (4DCT-ventilation). Compared to nuclear medicine, 4DCT-ventilation is cheaper, does not require a radioactive contrast agent, provides a faster imaging procedure, and has improved spatial resolution. In this work we perform a retrospective study to assess the use of 4DCT-ventilation as a pre-operative surgical lung function evaluation tool. Specifically, the purpose of our study was to compare %PPO PFT values calculated with 4DCT-ventilation and %PPO PFT values calculated with nuclear medicine ventilation-perfusion imaging.

METHODS: The study included 16 lung cancer patients that had undergone 4DCT imaging, nuclear medicine imaging, and had Forced Expiratory Volume in 1 second (FEV

RESULTS: Overall the 4DCT-ventilation derived %PPO FEV

CONCLUSIONS: 4DCT-ventilation is an innovative technology developed in radiation oncology that has great potential to translate to the surgical domain. The high correlation results when comparing 4DCT-ventilation to the current standard of care provide a strong rationale for a prospective clinical trial assessing 4DCT-ventilation in the clinical setting. 4DCT-ventilation can reduce the cost and imaging time for patients while providing improved spatial accuracy and quantitative results for surgeons.

Volume

44

Issue

1

First Page

200

Last Page

208

ISSN

2473-4209

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

28102961

Department(s)

Administration and Leadership

Document Type

Article

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