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Identification of target zones for lung volume reduction surgery using three-dimensional computed tomography
Claudio Caviezel1, Tamara Froehlich1, Didier Schneiter1
1Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
ERJ Open Research
|September 23, 2020
Summary
New 3D CT software aids lung volume reduction surgery (LVRS) planning by identifying emphysema zones. Patients showed significant improvements in lung function and reduced hyperinflation after surgery guided by this technology.
Area of Science:
- Pulmonary Medicine
- Radiology
- Surgical Planning
Background:
- Lung volume reduction surgery (LVRS) effectiveness depends on accurate target zone identification.
- Three-dimensional computed tomography (3D CT) rendering and densitometry are emerging tools for assessing emphysema severity and distribution.
- Personalized surgical planning for LVRS requires advanced imaging techniques.
Purpose of the Study:
- To demonstrate a novel software for emphysema imaging.
- To evaluate the pre- and post-operative results of LVRS planned using this new 3D CT software.
- To assess the software's utility in identifying target zones for LVRS.
Main Methods:
- A real-time 3D image analysis software was utilized in six patients (5 heterogeneous, 1 homogeneous emphysema) undergoing LVRS.
- Pre- and 3-month post-operative CT scans focused on low attenuation areas (<950 HU) and their distribution.
- Surgical planning was based on 3D images, and functional outcomes were assessed via pulmonary function tests.
Main Results:
- All patients experienced a median 70% increase in forced expiratory volume in 1 second (FEV1).
- Hyperinflation, measured by residual volume/total lung capacity ratio, decreased by a median of 30%.
- In heterogeneous emphysema cases, low attenuation areas decreased by 23% on the right and 17% on the left post-operatively.
Conclusions:
- 3D CT-rendered images facilitate personalized lung remodeling planning for LVRS.
- The user-friendly software aids surgeons and pulmonologists in patient selection and target area visualization for LVRS.
- This technology enhances the precision and potential effectiveness of LVRS procedures.
