Clinical value of CT-based preoperative software assisted lung lobe volumetry for predicting postoperative pulmonary function after lung surgery

摘要

This study was aimed to evaluate a morphology-based approach for prediction of postoperative forced expiratoryvolume in one second (FEV1) after lung resection from preoperative CT scans. Fifteen Patients with surgically treated(lobectomy or pneumonectomy) bronchogenic carcinoma were enrolled in the study. A preoperative chest CT andpulmonary function tests before and after surgery were performed. CT scans were analyzed by prototype software:automated segmentation and volumetry of lung lobes was performed with minimal user interaction. Determinedvolumes of different lung lobes were used to predict postoperative FEV1 as percentage of the preoperative values.Predicted FEV1 values were compared to the observed postoperative values as standard of reference. Patients underwentlobectomy in twelve cases (6 upper lobes; 1 middle lobe; 5 lower lobes; 6 right side; 6 left side) and pneumonectomy inthree cases. Automated calculation of predicted postoperative lung function was successful in all cases. Predicted FEV1ranged from 54% to 95% (mean 75% ± 11%) of the preoperative values. Two cases with obviously erroneous LFT wereexcluded from analysis. Mean error of predicted FEV1 was -20 ± 160 ml, indicating absence of systematic error; meanabsolute error was 7.4 ± 3.3% respective 137 ± 77 ml/s. The 200 ml reproducibility criterion for FEV1 was met in 11 of13 cases (85%). In conclusion, software-assisted prediction of postoperative lung function yielded a clinicallyacceptable agreement with the observed postoperative values. This method might add useful information for evaluationof functional operability of patients with lung cancer.