scholarly journals Skin marking with computed tomography at functional residual capacity to predict lung nodule site

2019 ◽  
Vol 30 (1) ◽  
pp. 36-38
Author(s):  
Ryo Miyoshi ◽  
Akihiko Yamashina ◽  
Shigeto Nishikawa ◽  
Shigeyuki Tamari ◽  
Misa Noguchi ◽  
...  

Abstract Various marking techniques for lung nodules may be complex and can cause serious complications. In this study, we aimed to describe and evaluate the feasibility of CTFRC marking, a novel preoperative skin marking technique guided by computed tomography (CT) at functional residual capacity (FRC). This simple and non-invasive marking technique only requires a preoperative CT scan without any anaesthesia. We retrospectively reviewed CTFRC markings performed for 109 lung nodules in 108 patients. The mean nodule size was 11.4 ± 5.0 mm. The mean distance from the nodule to the lung marking point was 3.8 ± 7.3 mm. We found no procedure-associated complications. CTFRC marking is a simple, safe and non-invasive method to predict the precise location of lung nodules during thoracoscopic surgery.

2020 ◽  
Vol 68 (06) ◽  
pp. 540-544 ◽  
Author(s):  
Ze-Dong Zhang ◽  
Hua-Long Wang ◽  
Xian-Yan Liu ◽  
Feng-Fei Xia ◽  
Yu-Fei Fu

Abstract Background Preoperative computed tomography (CT)-guided localization has been shown to significantly improve lung nodule video-assisted thoracoscopic surgery (VATS)-based wedge resection technical success rates. However, at present, there was insufficient research regarding the optimal approaches to localization of these nodules prior to resection. We aimed to compare the relative clinical efficacy of preoperative CT-guided methylene blue and coil-based lung nodule localization. Methods In total, 91 patients with lung nodules were subjected to either CT-guided methylene blue (n = 34) or coil (n = 57) localization and VATS resection from January 2014 to December 2018. We compared baseline data, localization-associated complication rates, as well as the technical success of localization and resection between these two groups of patients. Results In total, 42 lung nodules in 34 patients underwent methylene blue localization, with associated localization and wedge resection technical success rates of 97.6 and 97.6%, respectively. A total of 71 lung nodules in 57 patients underwent coil localization, with associated localization and wedge resection technical success rates of 94.4 and 97.2%, respectively. There were no significant differences in technical success rates of localization or wedge resection between these groups (p = 0.416 and 1.000, respectively). The coil group sustained a longer duration between localization and VATS relative to the methylene blue group (13.2 vs. 2.5 hours, p = 0.003). Conclusion Both methylene blue and coil localization can be safely and effectively implemented for conducting the diagnostic wedge resection of lung nodules. The coil-based approach is compatible with a longer period of time between localization and VATS procedures.


Mathematics ◽  
2021 ◽  
Vol 9 (13) ◽  
pp. 1457
Author(s):  
Muazzam Maqsood ◽  
Sadaf Yasmin ◽  
Irfan Mehmood ◽  
Maryam Bukhari ◽  
Mucheol Kim

A typical growth of cells inside tissue is normally known as a nodular entity. Lung nodule segmentation from computed tomography (CT) images becomes crucial for early lung cancer diagnosis. An issue that pertains to the segmentation of lung nodules is homogenous modular variants. The resemblance among nodules as well as among neighboring regions is very challenging to deal with. Here, we propose an end-to-end U-Net-based segmentation framework named DA-Net for efficient lung nodule segmentation. This method extracts rich features by integrating compactly and densely linked rich convolutional blocks merged with Atrous convolutions blocks to broaden the view of filters without dropping loss and coverage data. We first extract the lung’s ROI images from the whole CT scan slices using standard image processing operations and k-means clustering. This reduces the search space of the model to only lungs where the nodules are present instead of the whole CT scan slice. The evaluation of the suggested model was performed through utilizing the LIDC-IDRI dataset. According to the results, we found that DA-Net showed good performance, achieving an 81% Dice score value and 71.6% IOU score.


2020 ◽  
Vol 30 (4) ◽  
pp. 546-551
Author(s):  
Kazuhiro Ito ◽  
Junichi Shimada ◽  
Masanori Shimomura ◽  
Kunihiko Terauchi ◽  
Motohiro Nishimura ◽  
...  

Abstract OBJECTIVES This study aimed to evaluate the safety and reliability of percutaneous computed tomography (CT)-guided lipiodol marking for undetectable pulmonary lesions before video-assisted thoracic surgery (VATS). METHODS We retrospectively analysed the cases of CT-guided lipiodol marking followed by VATS in 9 institutes from May 2006 to March 2018. Lipiodol (0.2–0.5 ml) was percutaneously injected closely adjacent to undetectable pulmonary lesions with computed-tomography guidance. Lipiodol spots were identified using C-arm-shaped fluoroscopy during VATS. We grasped the lipiodol spots, including the target lesions, with ring-shaped forceps and resected them. RESULTS Of 1182 lesions, 1181 (99.9%) were successfully marked. In 1 case, the injected lipiodol diffused, and no spot was created. Of the 1181 lesions, 1179 (99.8%) were successfully resected with intraoperative fluoroscopy. Two lipiodol spots were not detected because of the lipiodol distribution during the division of pleural adhesions. The mean lesion size was 9.1 mm (range 1–48 mm). The mean distance from the pleural surface was 10.2 mm (range 0–43 mm). Lipiodol marking-induced pneumothorax occurred in 495 (57.1%) of 867 cases. Of these, chest drainage was required in 59 patients (6.8%). The other complications were 19 (2.2%) cases of bloody sputum, 3 (0.35%) cases of intravascular air, 1 (0.12%) case of pneumonia and 1 (0.12%) case of cerebral infarction. There were no lipiodol marking-induced deaths or sequelae. CONCLUSIONS Preoperative CT-guided lipiodol marking followed by VATS resection was shown to be a safe and reliable procedure with a high success rate and acceptably low severe complication rate.


Author(s):  
Ammar Chaudhry ◽  
Ammar Chaudhry ◽  
William H. Moore

Purpose: The radiographic diagnosis of lung nodules is associated with low sensitivity and specificity. Computer-aided detection (CAD) system has been shown to have higher accuracy in the detection of lung nodules. The purpose of this study is to assess the effect on sensitivity and specificity when a CAD system is used to review chest radiographs in real-time setting. Methods: Sixty-three patients, including 24 controls, who had chest radiographs and CT within three months were included in this study. Three radiologists were presented chest radiographs without CAD and were asked to mark all lung nodules. Then the radiologists were allowed to see the CAD region-of-interest (ROI) marks and were asked to agree or disagree with the marks. All marks were correlated with CT studies. Results: The mean sensitivity of the three radiologists without CAD was 16.1%, which showed a statistically significant improvement to 22.5% with CAD. The mean specificity of the three radiologists was 52.5% without CAD and decreased to 48.1% with CAD. There was no significant change in the positive predictive value or negative predictive value. Conclusion: The addition of a CAD system to chest radiography interpretation statistically improves the detection of lung nodules without affecting its specificity. Thus suggesting CAD would improve overall detection of lung nodules.


Author(s):  
Shabana Rasheed Ziyad ◽  
Venkatachalam Radha ◽  
Thavavel Vayyapuri

Background: Lung cancer has become a major cause of cancer-related deaths. Detection of potentially malignant lung nodules is essential for the early diagnosis and clinical management of lung cancer. In clinical practice, the interpretation of Computed Tomography (CT) images is challenging for radiologists due to a large number of cases. There is a high rate of false positives in the manual findings. Computer aided detection system (CAD) and computer aided diagnosis systems (CADx) enhance the radiologists in accurately delineating the lung nodules. Objectives: The objective is to analyze CAD and CADx systems for lung nodule detection. It is necessary to review the various techniques followed in CAD and CADx systems proposed and implemented by various research persons. This study aims at analyzing the recent application of various concepts in computer science to each stage of CAD and CADx. Methods: This review paper is special in its own kind because it analyses the various techniques proposed by different eminent researchers in noise removal, contrast enhancement, thorax removal, lung segmentation, bone suppression, segmentation of trachea, classification of nodule and nonnodule and final classification of benign and malignant nodules. Results: A comparison of the performance of different techniques implemented by various researchers for the classification of nodule and non-nodule has been tabulated in the paper. Conclusion: The findings of this review paper will definitely prove to be useful to the research community working on automation of lung nodule detection.


2016 ◽  
Vol 44 (6) ◽  
pp. 1314-1322 ◽  
Author(s):  
Daniel Hernández-Vaquero ◽  
Alfonso Noriega-Fernandez ◽  
Ivan Perez-Coto ◽  
Manuel A. Sandoval García ◽  
Andres A. Sierra-Pereira ◽  
...  

Objective To demonstrate that postoperative computed tomography (CT) is not needed if navigation is used to determine the rotational position of the femoral component during total knee replacement (TKR). Methods Preoperative CT, navigational, and postoperative CT data of 70 TKR procedures were analysed. The correlation between the rotational angulation of the femur measured by CT and that measured by perioperative navigation was examined. The correlation between the femoral component rotation determined by navigation and that determined by CT was also assessed. Results The mean femoral rotation determined by navigation was 2.64° ± 4.34°, while that shown by CT was 6.43° ± 1.65°. Postoperative rotation of the femoral component shown by CT was 3.09° ± 2.71°, which was closely correlated with the angle obtained through the intraoperative transepicondylar axis by navigation (Pearson’s R = 0.930). Conclusions Navigation can be used to collect the preoperative, intraoperative, and postoperative data and final position of the TKR. The rotation of the femoral component can be determined using navigation without the need for CT.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Azra Akhtar ◽  
Noreen Akhtar ◽  
Sajid Mushtaq ◽  
Usman Hassan ◽  
Ali Raza Khan

Background: Computed tomography (CT) imaging has improved the chances of detecting small indeterminate (<1 cm) lung nodules. The determination of the underlying malignant or benign nature of a lung nodule poses a great diagnostic challenge and depends on a number of factors, including the radiographic appearance of nodule, the presence of non-pulmonary metastases, characteristics of growth and histological criteria. Methods: The medical records of 89 patients admitted to our specialist cancer centre between 2008 and 2013 were reviewed. Patients of all age groups and tumour category were included in the study. Clinical data of these patients were collected and the following parameters were analysed: Radiographic diagnosis, location, size, laterality and number of nodules and histological impression. The radiological findings were then correlated with histopathological findings. The nodules were sub-classified into groups on the basis of size (A = 0–0.5 cm; B = 0.5–0.9 cm; C = 1.0–1.5 cm and D = >1.5 cm). Results: CT scan reports of 89 patients with lung nodules were reviewed. On radiology, 73/89 (82%) were reported to be malignant nodule. Histopathological review of the biopsies of these 89 nodules confirmed malignancy in 50/89 (56.2%) patients. CT scan was found to be highly sensitive (94%, 95% confidence interval [CI]: 83.43–98.68%) but with a very low specificity (33.3%, 95% CI: 19.10–50.22%). CT scan was found to have a higher negative predictive value (81.2%, 95% CI: 54.34–95.73%) and a lower positive predictive value 64.4% (95% CI: 52.31–75.25%) when correlated with histopathological findings. Pathology of these nodules included metastatic sarcoma (27/89; 30.3%) and carcinoma (18/89; 20.2%). The frequency of the biopsy-proven malignant nodules on the right side was 26/45 (57.8%) and on the left side was 24/44 (54.5%) (P = 0.832). Malignant nodules were more frequent in lower lobes (28/43, 65.1%) than in upper lobes (14/32, 43.8%). These two sites combined accounted for 84% of all malignant nodules. There was a significant correlation between nodule size and likelihood of underlying malignancy. The overall prevalence of malignancy in the larger nodules (C and D) was much higher (23/30 and 76.7%) compared to the smaller sized (A and B) nodules (27/58 and 46.8%), P < 0.05.Conclusion: CT scan is a useful tool in the initial clinical assessment of indeterminate lung nodules with high sensitivity (94%) and a high negative predictive value (81.2%).Key words: Computed tomography, fibrosis, indeterminate lung nodule, infection, lung nodule, malignancy, metastases


2019 ◽  
Vol 68 (06) ◽  
pp. 545-548 ◽  
Author(s):  
Feng-Fei Xia ◽  
Yi-Bing Shi ◽  
Tao Wang ◽  
Yu-Fei Fu

Background The objective of this study was to evaluate the feasibility, safety, and clinical effectiveness of preoperative computed tomography (CT)-guided transfissural coil localization (TFCL) of subfissural lung nodules. Methods Five patients with lung nodules who underwent CT-guided TFCL before video-assisted thoracoscopic surgery between November 2015 and December 2018 were included. Technical success rates of TFCL and wedge resection were assessed, as well complications and pathological results. Results The technical success rate of TFCL was 100%. Two patients experienced parenchymal hemorrhage around the needle path, and two patients experienced asymptomatic pneumothorax after TFCL. The technical success rate of the wedge resection of lung nodules was also 100%. The pathological diagnoses of the five nodules were minimally invasive adenocarcinoma (n = 3), adenocarcinoma in situ (n = 1), and inflammatory nodule (n = 1). Conclusion CT-guided TFCL is a safe and effective method for the preoperative localization of subfissural lung nodules.


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