Association between Image Characteristics on Chest CT and Severe Pleural Adhesion during Lung Cancer Surgery

Abstract

The aim of this study was to investigate the association between image characteristics on preoperative chest CT and severe pleural adhesion during surgery in lung cancer patients. We included consecutive 124 patients who underwent lung cancer surgeries. Preoperative chest CT was retrospectively reviewed to assess pleural thickening or calcification, pulmonary calcified nodules, active pulmonary inflammation, extent of emphysema, interstitial pneumonitis, and bronchiectasis in the operated thorax. The extent of pleural thickening or calcification was visually estimated and categorized into two groups: localized and diffuse. We measured total size of pulmonary calcified nodules. The extent of emphysema, interstitial pneumonitis, and bronchiectasis was also evaluated with a visual scoring system. The occurrence of severe pleural adhesion during lung cancer surgery was retrospectively investigated from the electrical medical records. We performed logistic regression analysis to determine the association of image characteristic on chest CT with severe pleural adhesion. Localized pleural thickening was found in 8 patients (6.5%), localized pleural calcification in 8 (6.5%), pulmonary calcified nodules in 28 (22.6%), and active pulmonary inflammation in 22 (17.7%). There was no patient with diffuse pleural thickening or calcification in this study. Trivial, mild, and moderate emphysema was found in 31 (25.0%), 21 (16.9%), and 12 (9.7%) patients, respectively. Severe pleural adhesion was found in 31 (25.0%) patients. The association of localized pleural thickening or calcification on CT with severe pleural adhesion was not found (P = 0.405 and 0.107, respectively). Size of pulmonary calcified nodules and extent of emphysema were significant variables in a univariate analysis (P = 0.045 and 0.005, respectively). In a multivariate analysis, moderate emphysema was significantly associated with severe pleural adhesion (odds ratio of 11.202, P = 0.001). In conclusion, severe pleural adhesion might be found during lung cancer surgery, provided that preoperative chest CT shows substantial pulmonary calcified nodules or emphysema.

[Retracted] The Effect of CT‐Guided Artificial Pneumothorax plus Thoracoscopy and Central Venous Catheterization on the Drainage Effect of Pediatric Empyema and Pulmonary Function

“…It was found that the two groups of pediatric patients were significantly different in terms of operation time, intraoperative blood loss, postoperative length of hospital stay, postoperative drainage volume, and exposure to the operative field ( P < 0.05). Our results agreed with Chen et al [ 17 ], confirming that the central venous catheterization did shorten the length of hospital stay. The probable reason is that it is easier to perform central venous catheterization and a syringe can be connected to the catheter to aid the suction in case of inadequate drainage.…”

Evaluation of lung tumor motion in a large sample: Target‐related and clinical factors influencing tumor motion based on four‐dimensional CT

“…For patients who had undergone pulmonary surgery, the tumor motion was significantly smaller in the CC and 3D directions than for patients without pulmonary surgery ( p = 0.024 and 0.015, respectively), which may be associated with pulmonary inflammation, tissue adhesion, 33 and lung volume reduction after pulmonary surgery. The tumor motion for these patients is more unpredictable and is poorly associated with the tumor location and clinical factors.…”

Predictors of conversion to thoracotomy during video-assisted thoracoscopic surgery lobectomy in lung cancer: additional predictive value of FDG-PET/CT in a tuberculosis endemic region

“…The CT findings of pleural calcification and parenchymal calcified nodule were also evaluated as image characteristics for predicting pleural adhesion and subsequent conversion. Pleural calcification was defined as any calcification at the pleural area on the axial images of unenhanced CT. Any size of parenchymal nodule containing calcification o n t h e u n e n h a n c e d C T i m a g e s w a s r e g a r d e d a s parenchymal calcified nodule, regardless of the shape of calcification (16,17). Calcification was defined as the attenuation above 200 HU and measured in mediastinal window setting (window with, 400 HU; window center, 30 HU).…”