Low-dose computed tomography screening, follow-up, and management of lung nodules – An expert consensus statement from Taiwan

Hsu, Han-Shui; Chiang, Xu-Heng; Hsu, Hsao‐Hsun; Chen, Jin‐Shing; Hsu, Chung-Ping

doi:10.4103/fjs.fjs_114_22

Cited by 1 publication

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“…For stage II-IIIA lung cancer, surgical resection is often combined with perioperative medical treatment. For small peripheral lung cancers less than 2 cm, sublobar resection offers considerable advantages, particularly for patients with compromised cardiopulmonary function, making it a more suitable option [ 1 , 2 , 3 , 4 ]. However, compared to lobectomy, sublobar resection may be associated with higher rates of tumor recurrence in centrally located lung cancer, with inadequate resection margin distance being a major contributing factor [ 5 , 6 , 7 ].…”

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confidence: 99%

Quantification of Resection Margin following Sublobar Resection in Lung Cancer Patients through Pre- and Post-Operative CT Image Comparison: Utilizing a CT-Based 3D Reconstruction Algorithm

Lin,

Chen,

Wang

et al. 2024

Cancers

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Sublobar resection has emerged as a standard treatment option for early-stage peripheral non-small cell lung cancer. Achieving an adequate resection margin is crucial to prevent local tumor recurrence. However, gross measurement of the resection margin may lack accuracy due to the elasticity of lung tissue and interobserver variability. Therefore, this study aimed to develop an objective measurement method, the CT-based 3D reconstruction algorithm, to quantify the resection margin following sublobar resection in lung cancer patients through pre- and post-operative CT image comparison. An automated subvascular matching technique was first developed to ensure accuracy and reproducibility in the matching process. Following the extraction of matched feature points, another key technique involves calculating the displacement field within the image. This is particularly important for mapping discontinuous deformation fields around the surgical resection area. A transformation based on thin-plate spline is used for medical image registration. Upon completing the final step of image registration, the distance at the resection margin was measured. After developing the CT-based 3D reconstruction algorithm, we included 12 cases for resection margin distance measurement, comprising 4 right middle lobectomies, 6 segmentectomies, and 2 wedge resections. The outcomes obtained with our method revealed that the target registration error for all cases was less than 2.5 mm. Our method demonstrated the feasibility of measuring the resection margin following sublobar resection in lung cancer patients through pre- and post-operative CT image comparison. Further validation with a multicenter, large cohort, and analysis of clinical outcome correlation is necessary in future studies.

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