Emphysematous lungs do not affect visibility of virtual-assisted lung mapping

Area of Science:

• Thoracic Surgery
• Medical Imaging
• Pulmonary Medicine

Background:

• Virtual-assisted lung mapping (VALM) is a novel technique for intraoperative navigation.
• Conventional preoperative lung marking strategies have limitations in safety and reliability.
• VALM may offer improved navigation compared to traditional methods.

Purpose of the Study:

• To evaluate the relationship between emphysematous lungs and intraoperative visibility of VALM markings.
• To identify factors influencing the visibility of VALM markings during lung resection surgery.

Main Methods:

• Retrospective analysis of 21 patients undergoing VALM and lung resection.
• Assessment of intraoperative marking visibility and degree of pulmonary emphysema (percentage of low attenuation area).
• Statistical analysis (Spearman rank correlation, stepwise multivariate regression) to determine associations between marking grade and various patient/procedural factors.

Main Results:

• No correlation was found between the Brinkman index (smoking history) and the percentage of low attenuation area (emphysema severity).
• Marking visibility was significantly correlated with the marking operator's skill and the patient's Brinkman index.
• No significant association was found between marking visibility and patient age, sex, pulmonary lobe mapped, or degree of pulmonary emphysema.

Conclusions:

• The intraoperative visibility of VALM markings is influenced by the expertise of the marking operator and the patient's smoking history.
• Emphysematous lung changes do not significantly impact the intraoperative visibility of VALM markings.
• VALM demonstrates potential for safe and reliable intraoperative navigation, with operator experience being a key factor.