scholarly journals Preoperative non-invasive visual localization of synchronous multiple lung cancers using three-dimensional computed tomography lung reconstruction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guofei Zhang ◽  
Duo Xu ◽  
Zipu Yu ◽  
Lian Wang ◽  
Haihua Gu ◽  
...  

Abstract Background Synchronous multiple primary lung cancers are becoming more common with increasing use of computed tomography for screening. Intraoperative localization and resection of ill-defined pulmonary ground-glass opacities during thoracoscopic resection is challenging. This study aimed to determine the clinical feasibility of non-invasive visual localization of these nodules by three-dimensional computed tomography lung reconstruction before sublobar resection. Methods Forty-four patients with synchronous multiple primary lung cancers underwent thoracoscopic pulmonary resection at our institution between June 2017 and August 2019. Preadmission computed tomography images were downloaded and reconstructed into a three-dimensional model. Small nodules (< 15 mm) were localized non-invasively by three-dimensional computed tomography lung reconstruction before surgery. Patient demographics, nodule characteristics, procedural details, pathological data, and outcomes were obtained from the medical records. Results One hundred and twenty-one pulmonary nodules from the 44 patients were scheduled for video-assisted thoracic surgery; 54 (44.6%) were pure ground-glass opacities and 57 (47.1%) were mixed ground-glass opacities. One hundred and seventeen nodules were localized preoperatively. The mean nodule diameter was 7.67 ± 3.87 mm. The mean distance from the nodule to the pleura was 14.84 ± 14.43 mm. All nodules were removed successfully by wedge resection (27 patients), lobectomy (26 patients), or segmentectomy (25 patients). Most lesions (85.1%) were malignant. Paraffin pathology revealed 12 cases of atypical adenomatous hyperplasia (9.92%), 13 of adenocarcinoma in situ (10.74%), 16 of minimally invasive adenocarcinoma (13.22%), and 73 of invasive adenocarcinoma (60.33%). Conclusions Three-dimensional computed tomography lung reconstruction is a feasible and alternative method of visual localization for small lung nodules before sublobar resection in some suitable patients.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weichun Wu ◽  
Yimin Wu ◽  
Gang Shen ◽  
Guofei Zhang

Abstract Background As the positions and sizes of nodules in synchronous multiple primary lung cancer (SMPLC) patients differ, the development of surgical strategies to maximize long-term survival and preserved postoperative pulmonary function in SMPLC patients for whom surgical resection is an alternative strategy presents challenges. Case presentation We provide a case managed through video-assisted thoracoscopic surgery (VATS) resection using three-dimensional computed tomography lung reconstruction (3D-CTLR) to reconstruct lobes containing pulmonary nodules to preoperatively simulate and intraoperatively guide the extent and method of resection. Conclusion The successful attempt demonstrates a technically simplified, feasible alternative to preoperative plans utilizing less invasive VATS to manage SMPLC.


Author(s):  
H.W. Deckman ◽  
B.F. Flannery ◽  
J.H. Dunsmuir ◽  
K.D' Amico

We have developed a new X-ray microscope which produces complete three dimensional images of samples. The microscope operates by performing X-ray tomography with unprecedented resolution. Tomography is a non-invasive imaging technique that creates maps of the internal structure of samples from measurement of the attenuation of penetrating radiation. As conventionally practiced in medical Computed Tomography (CT), radiologists produce maps of bone and tissue structure in several planar sections that reveal features with 1mm resolution and 1% contrast. Microtomography extends the capability of CT in several ways. First, the resolution which approaches one micron, is one thousand times higher than that of the medical CT. Second, our approach acquires and analyses the data in a panoramic imaging format that directly produces three-dimensional maps in a series of contiguous stacked planes. Typical maps available today consist of three hundred planar sections each containing 512x512 pixels. Finally, and perhaps of most import scientifically, microtomography using a synchrotron X-ray source, allows us to generate maps of individual element.


Author(s):  
L Epprecht ◽  
L Qingsong ◽  
N Stenz ◽  
S Hashimi ◽  
T Linder

Abstract Objective Ventilation of the middle ear and mastoid air cells is believed to play an important role in the pathogenesis of chronic ear disease. Traditionally, ventilation is assessed by computed tomography. However, this exposes patients to cumulative radiation injury. In cases with a perforation in the tympanic membrane, tympanometry potentially presents a non-invasive alternative to measure the ventilated middle-ear and mastoid air cell volume. This study hypothesised that total tympanometry volume correlates with ventilated middle-ear and mastoid air cell volume. Method Total tympanometry volume was compared with ventilated middle-ear and mastoid air cell volume on computed tomography scans in 20 tympanic membrane perforations. Results There was a high correlation between tympanometry and computed tomography volumes (r = 0.78; p < 0.001). A tympanometry volume more than 2 ml predicted good ventilation on computed tomography. Conclusion These results may help reduce the need for pre-operative computed tomography in uncomplicated cases with tympanic membrane perforations.


2018 ◽  
Vol 27 (1) ◽  
pp. 45-48
Author(s):  
Shinsuke Uchida ◽  
Koji Tsuta ◽  
Masahiko Kusumoto ◽  
Kouya Shiraishi ◽  
Takashi Kohno ◽  
...  

Pulmonary collision tumors have been described as a special entity of synchronous multiple lung cancer. There have been no reports detailing the chronological changes in primary collision lung cancers on chest computed tomography. We report a case of ground-glass lung nodules gradually colliding with each other. The collision tumors of the lung were composed of minimally invasive adenocarcinoma and adenocarcinoma in situ with epidermal growth factor mutations. Immunohistochemically, the Ki-67 labeling indices were different in the 2 components. Ki-67 staining was useful to distinguish the 2 components. The 2 dominant ground-glass tumors grew slowly with radiologic and pathologic heterogeneity.


2016 ◽  
Vol 8 (7) ◽  
pp. 1561-1570 ◽  
Author(s):  
Youngkyu Moon ◽  
Sook Whan Sung ◽  
Kyo Young Lee ◽  
Sung Bo Sim ◽  
Jae Kil Park

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