Partitioning the lung field based on the depth ratio in three-dimensional space

Area of Science:

• Thoracic surgery
• Pulmonary imaging
• Surgical planning

Background:

• Assessing lung nodule location is crucial for pulmonary segmentectomy.
• The depth ratio method offers a novel approach to lung parenchyma partitioning.

Purpose of the Study:

• To evaluate the feasibility of the depth ratio method for partitioning lung parenchyma.
• To determine the depth distribution of lung nodules in pulmonary segmentectomy.

Main Methods:

• Patients were grouped into chest, lobar, and symmetrical 3 sectors based on measurement units.
• A radial line from the bronchial cross-section center to the pleura was trisected to define regions.
• Depth ratios and regional distributions were verified using 2D and 3D computed tomography (CT) images.

Main Results:

• The symmetrical 3 sectors group showed significantly less mediastinal disturbance (4.8%) compared to chest (69.4%) and lobar (26.3%) groups.
• Intra-group consistency for depth ratio region partition was 100%.
• Inter-group partition consistency varied (Kappa values 0.511-0.923).

Conclusions:

• The depth ratio method, especially in symmetrical 3 sectors, accurately partitions lung parenchyma in 3D space.
• This method minimizes mediastinal structure interference during pulmonary segmentectomy.
• The depth ratio method is feasible for sublobar resection of outer 2/3 pulmonary nodules.