Dual-energy CT (DECT) assessments could help guide surgical decisions pertaining to small malignant pulmonary nodules in the future.
The authors of a new study published in the American Journal of Roentgenology explained the benefits of DECT. In the paper, the authors suggested that DECT could enhance clinicians’ depictions of patients’ postoperative pulmonary function in comparison to pulmonary function tests (PFTs) and perfusion scintigraphy, which have limited utility.
“In patients with lung cancer, DECT has further potential to quantify postsurgical global and regional changes in lung volume and perfusion,” correspondfing author Young Jin Kim, MD, PhD, of the Research Institute of Radiological Science in the Republic of Korea and co-authors explained. “Such changes may vary depending on the type of surgery and location of the resected tumor.”
For the study, researchers assessed the cases of 81 patients who underwent lung cancer surgery between March 2019 and February 2020. Thoracic DECT exams and PFTs were completed preoperatively for each patient, and again six months postoperatively. Lobar volume and perfusion ratios were calculated, in addition to the completion of quality of life (QOL) surveys six months postoperatively.
When researchers compared these measures between patients who underwent limited resection (38) versus a lobectomy (43), they found that patients who had a lobectomy exhibited greater increases in lung volume and lung perfusion ratios.
Specifically, in patients with right lower lobe tumors, the most significant increases in lung volume ratio were in the right middle lobe for both lobectomy and limited resection patients. In comparison, the largest increase in lung perfusion ratio was in the left lower lobe in the lobectomy group and in right middle lobe in the resection group.
Of note, the largest volume and perfusion ratio increases were observed in ipsilateral nonresected lobes (vs contralateral lobes) regardless of operative approach and lobar location.
“A substantial portion of patients with lung cancer cannot tolerate lobectomy because of limited pulmonary reserve. Limited resection could become a standard treatment option if confirmed to result in better postoperative pulmonary function relative to lobectomy, with noninferior overall survival,” the authors wrote.
They went on to conclude that DECT-derived metrics could play a role in better understanding how patients might physiologically respond to surgery.
To view the study’s abstract, click here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.