An atlas of anatomical variants of subsegmental pulmonary arteries and recognition error analysis
Hao Xu1,2, Heng Zhao1,2, Jian Jin1,2
1Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
Background:
Surgery, including lobectomy and segmentectomy, is the major curative intervention for lung cancer. Surgical planning for pulmonary surgery is difficult due to the high variation rate of pulmonary arteries and needs a fine-grained atlas as a reference. We conducted a study to create a surgically oriented atlas and analyzed the error encountered during the production.
Method:
A total of 100 Chest CTs performed at Peking University People's Hospital from 2013.09 to 2020.10 were randomly selected for segmental artery labeling. Dicom files were collected for 3D reconstruction. Manual segmentation of each segmental artery was performed by 4 thoracic surgeons. Cross-validation by surgeons was performed to establish the golden standard based on their consensus. Initial recognition errors were recorded accordingly.
Result:
The most frequently seen variants for the right upper lobe is 2-branch RA1+2rec+3 and RA2asc; right middle lobe 2-branch RA4a and RA4b+5; right lower lobe 3-branch RA7, RA8 and RA9+10; left upper lobe 3-branch LA1+2a+3, LA1+2b, LA1+2c and 1-branch LA4+5; left lower lobe 2-branch LA8 and LA9+10. Top 5 segmental error occurs in RA4 (23%), LA8 (17%), RA9 (17%), RA8 (14%) and LA9 (11%). A rapid surgical planning tool form was created based on high frequency anatomic variants.
Conclusion:
Our research provided an atlas for lobectomy and segmentectomy at the subsegmental or more distal level. We demonstrated that the recognition accuracy of pulmonary arteries in a non-time-sensitive experimental scenario was still unfavorable. We also suggest that extra attention should be paid to certain surgeries during the surgical planning process.
More Related Videos
07:12Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
06:02Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
Related Concept Videos
Aneurysm I: Introduction
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic Aorta
Overview of Systemic Arteries
Systemic circulation is the part of the cardiovascular system that carries oxygenated blood away from the heart to the body's tissues and returns deoxygenated blood back to the...
