Preoperative assessment of pleural adhesion by Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) with Adaptive Iterative Dose Reduction using Three-Dimensional processing (AIDR-3D)

Hashimoto, Masayuki; Nagatani, Yukihiro; Oshio, Yasuhiko; Nitta, Norihisa; Yamashiro, Tsuneo; Tsukagoshi, Shinsuke; Ushio, Noritoshi; Mayumi, Masayuki; Kimoto, Tsunenobu; Igarashi, Tomoyuki; Yoshigoe, Makoto; Iwai, Kyohei; Tanaka, Koki; Sato, Shigeo; Sonoda, Akinaga; Otani, Hideji; Murata, Kiyoshi; Hanaoka, Jun

doi:10.1016/j.ejrad.2017.11.011

Cited by 18 publications

(24 citation statements)

References 29 publications

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“…In COPD and/or emphysematous patients, comparatively good values for sensitivity, specificity, and AUC were obtained for the lateral and dorsal regions. These results indicated that PCD ACA can be a useful indicator for differentiating LPA for pulmonary apical dorsal and lateral regions for COPD and/or emphysematous patients, which was partially compatible with the overall difference in PCD ACA between pleural aspects with mild LPA and those without LPA demonstrated in previous research (13). For smokers, MLD was demonstrated to increase in association with airflow limitation severity for total expiration in the non-dependent lateral decubitus position ( 21); severe airflow limitation and alveolar wall destruction may lead to somewhat complementary thoracic motion, which would appear to compensate for insufficient ventilation in the dependent lateral position and result in larger sliding of the pleural aspect for the lateral and dorsal regions in the non-dependent lateral decubitus position.…”

Section: Discussionsupporting

confidence: 90%

“…based on the value at end-inspiration (13). For patients with LPA, only aspects in which LPA was confirmed were used for the measurement of PCD ACA .…”

Section: Quantitative Measurement Of Pleuro-chest Wall Distancementioning

confidence: 99%

“…In combination with iterative reconstruction, ultralow-dose computed tomography (ULDCT) (<0.3 mSv) has demonstrated comparable detection performance of lung nodules (7)(8)(9)(10) and equivalent quantification in larger sub-solid nodules to low-dose CT (1-1.7 mSv) (11). In the ultra-low-dose setting, on fourdimensional (4D) CT during a single respiratory cycle (2.4 mSv), some previous studies have demonstrated the feasibility of the quantitative assessment of direct invasion of lung tumors into adjacent structures and LPA (12,13).…”

Section: Introductionmentioning

confidence: 99%

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Usability of the lateral decubitus position on four-dimensional ultra-low-dose computed tomography for the detection of localized pleural adhesion in the pulmonary apical region

et al. 2020

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Background Localized pleural adhesion (LPA) evaluation in the apical region is difficult even with four-dimensional ultra-low-dose computed tomography (4D-ULDCT) in the supine position due to smaller pleural movements. Purpose To assess usability of 4D-ULDCT in the lateral decubitus (LD) position for LPA detection in the apical region. Material and Methods Forty-seven patients underwent 4D-ULDCT of a single respiration cycle with 16-cm coverage of body axis in supine and LD positions with the affected lung uppermost. Intraoperative thoracoscopic findings confirmed LPA presence. A pleural point and a corresponding point on costal outer edge were placed in identical axial planes at end-inspiration. Pleuro-chest wall distance between two points (PCD) was calculated at each respiratory phase. In the affected lung, average change in amount of PCD (PCDACA) was compared between patients with and without LPA in total and two sub-groups (non-COPD and COPD, non-emphysematous and emphysematous patients) in supine and non-dependent (ND) LD positions. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal thresholds in PCDACA for differentiating patients with LPA from those without. Results In COPD/emphysematous patients and total population, PCDACA with LPA was smaller than in those without in the supine and NDLD positions for overall, lateral, and dorsal regions. For the lateral region in COPD patients, area under ROC curve (AUC) increased from supine (0.64) to NDLD position (0.81). For the dorsal region in emphysematous patients, AUC increased from supine (0.76) to NDLD position (0.96). Conclusion 4D-ULDCT in LD position may be useful for LPA detection in apical regions for COPD and/or emphysematous patients.

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Section: Discussionsupporting

confidence: 90%

“…based on the value at end-inspiration (13). For patients with LPA, only aspects in which LPA was confirmed were used for the measurement of PCD ACA .…”

Section: Quantitative Measurement Of Pleuro-chest Wall Distancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usability of the lateral decubitus position on four-dimensional ultra-low-dose computed tomography for the detection of localized pleural adhesion in the pulmonary apical region

et al. 2020

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“…Written informed consent was obtained from all the enrolled patients. This retrospective study was planned as a supplementary analysis after our previous research, which aimed at evaluating the potential of dynamic-ventilation CT for the preoperative detection of pleural adhesion 12. All scan data were anonymized and stored in a research computer.…”

Section: Methodsmentioning

confidence: 99%

“…By applying an iterative reconstruction algorithm, it has been demonstrated that ultra-low-dose (ULD) CT (0.16–0.29 mSv) has similar diagnostic capability to low-dose CT (0.92–1.74 mSv) in the field of lung cancer (nodule) screening 6–10. These ULD settings have gradually been applied to four-dimensional (4D) dynamic-ventilation CT, which enables the observation of a longer respiratory cycle with acceptable radiation exposure (~2.4 mSv) for the evaluation of direct invasion by lung tumors into adjacent structures and localized pleural adhesion 11,12…”

Section: Introductionmentioning

confidence: 99%

Continuous quantitative measurement of the main bronchial dimensions and lung density in the lateral position by four-dimensional dynamic-ventilation CT in smokers and COPD patients

Nagatani

Hashimoto

Nitta

et al. 2018

COPD

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PurposeThe purpose of this study was to measure changes in lung density and airway dimension in smokers in the lateral position using four-dimensional dynamic-ventilation computed tomography (CT) during free breathing and to evaluate their correlations with spirometric values.Materials and methodsPreoperative pleural adhesion assessments included dynamic-ventilation CT of 42 smokers (including 22 patients with COPD) in the lateral position, with the unoperated lung beneath (dependent lung). The scanned lungs’ mean lung density (MLD) and the bilateral main bronchi’s luminal areas (Ai) were measured automatically (13–18 continuous image frames, 0.35 seconds/frame). Calculations included cross-correlation coefficients (CCCs) between the MLD and Ai time curves, and correlations between the quantitative measurements and spirometric values were evaluated by using Spearman’s rank coefficient.ResultsThe ΔMLD1.05 (from the peak inspiration frame to the third expiratory frame, 1.05 seconds later) in the nondependent lung negatively correlated with FEV1/FVC (r=−0.417, P<0.01), suggesting that large expiratory movement of the nondependent lung would compensate limited expiratory movement of the dependent lung due to COPD. The ΔAi1.05 negatively correlated with the FEV1/FVC predicted in both the lungs (r=−0.465 and −0.311, P<0.05), suggesting that early expiratory collapses of the main bronchi indicate severe airflow limitation. The CCC correlated with FEV1/FVC in the dependent lung (r=−0.474, P<0.01), suggesting that reduced synchrony between the proximal airway and lung occurs in patients with severe airflow limitation.ConclusionIn COPD patients, in the lateral position, the following abnormal dynamic-ventilation CT findings are associated with airflow limitation: enhanced complementary ventilation in the nondependent lung, early expiratory airway collapses, and reduced synchrony between airway and lung movements in the dependent lung.

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Preoperative assessment of pleural adhesions in patients with lung cancer based on quantitative motion analysis with dynamic chest radiography: A retrospective study

Tanaka

Matsumoto

Takayama

et al. 2023

J Applied Clin Med Phys

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Preoperative assessment of pleural adhesion is crucial for appropriate surgical planning. This study aimed to quantitatively evaluate the usefulness of motion analysis using dynamic chest radiography (DCR) for assessing pleural adhesions. Methods: Sequential chest radiographs of 146 lung cancer patients with or without pleural adhesions (n = 25/121) were obtained using a DCR system during respiration (registration number: 1729). The local motion vector was measured, and the percentage of poor motion area to the maximum expiration lung area (%lung area with poor motion) was calculated. Subsequently, percentage values ≥49.0% were considered to indicate pleural adhesions. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the prediction performance. The percentage of lung area with poor motion was compared between patients with and without pleural adhesions (p < 0.05). Results: DCR-based motion analysis correctly predicted pleural adhesions in 21 out of 25 patients, with 47 false-positive results (sensitivity, 84.0%; specificity, 61.2%; PPV, 30.9%; NPV, 94.9%). The lung with pleural adhesions showed a significantly greater %lung area with poor motion than the opposite lung in the same patient,similar to the cancerous lung in patients without pleural adhesions. Conclusion: On DCR-based motion analysis, pleural adhesions could be indicated by an increase in the percentage of lung area with poor motion. Although the proposed method cannot identify the exact location of pleural adhesions, information regarding the presence or absence of pleural adhesions provided by DCR would help surgeons prepare for challenging surgeries and obtain informed consent from patients. K E Y W O R D S digital radiography, lung cancer, motion analysis, pleural adhesions INTRODUCTIONVideo-assisted thoracoscopic surgery, a less invasive and well-established approach for the surgical resectionThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Preoperative assessment of pleural adhesion by Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) with Adaptive Iterative Dose Reduction using Three-Dimensional processing (AIDR-3D)

Cited by 18 publications

References 29 publications

Usability of the lateral decubitus position on four-dimensional ultra-low-dose computed tomography for the detection of localized pleural adhesion in the pulmonary apical region

Usability of the lateral decubitus position on four-dimensional ultra-low-dose computed tomography for the detection of localized pleural adhesion in the pulmonary apical region

Continuous quantitative measurement of the main bronchial dimensions and lung density in the lateral position by four-dimensional dynamic-ventilation CT in smokers and COPD patients

Preoperative assessment of pleural adhesions in patients with lung cancer based on quantitative motion analysis with dynamic chest radiography: A retrospective study

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