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Published on: April 5, 2024
Conventional Multi-Planar Reconstruction Imaging Is Insufficient to Determine the Indication for Segmentectomy
Toshiyuki Nagata1, Kazuhiro Ueda1, Souichi Suzuki1
1Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan.
Purpose:
The diagnostic potential of conventional multi-planar reconstruction (MPR) images, which consist of horizontal, frontal, and sagittal section, in approximating the anatomical distance between tumors and intersegmental planes remains unclear. The aim of the present study was to clarify the validity of decision-making for segmentectomy based on MPR imaging and identify a specific tumor location that is likely to result in the overestimation of the anatomical margin on MPR images.
Methods:
The study population included 33 patients who were considered eligible for segmentectomy based on the observation of MPR images, and verified using a commercially available image-analysis software whether the decision-making based on MPR images was indeed correct or not.
Results:
MPR image-based assessment resulted in the overestimation of the anatomical margin in as many as 8 (24%) of the 33 patients. Overestimation predominantly occurred in cases involving patients with tumors at certain segments (right S1, right S2, right S3, left S3, and left S4) that had a complex and oblique intersegmental plane.
Conclusion:
Conventional MPR image-based assessment frequently resulted in the overestimation of the anatomical margin. We recommend using software-based assessment preoperatively in patients with tumors in the risky segments, particularly in cases involving indistinct tumors.
