Analytic Morphomics Are Related to Outcomes After Lung Volume Reduction Surgery

Area of Science:

• Thoracic surgery
• Radiology
• Pulmonary medicine

Background:

• Lung volume reduction surgery (LVRS) has high morbidity despite established selection criteria.
• Analytic morphomics offers a novel approach to assess patient characteristics from CT scans.

Purpose of the Study:

• To evaluate the association between analytic morphomics on chest CT scans and outcomes after LVRS.
• To identify imaging biomarkers for improved risk stratification in LVRS candidates.

Main Methods:

• Retrospective review of 85 LVRS patients (1998-2013).
• Assessment of dorsal muscle area, subcutaneous/visceral fat, and bone mineral density using analytic morphomics.
• Analysis of outcomes including survival, hospital stay, 30-day readmission, and pulmonary complications.

Main Results:

• Lower bone mineral density correlated with decreased survival, longer hospital stay, and readmissions.
• Higher lung density (scarring) was associated with pulmonary complications and longer hospital stay.
• Lower subcutaneous fat area:height linked to readmissions, potentially indicating reduced metabolic reserve.

Conclusions:

• Signs of frailty, such as lower bone mineral density, may increase the risk of adverse outcomes after LVRS.
• Analytic morphomics shows potential for improving risk stratification and patient selection for LVRS.
• Further multicenter trials are needed to confirm these findings.