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Erschienen in: General Thoracic and Cardiovascular Surgery 8/2023

05.02.2023 | Original Article

The preoperative assessment of thoracic wall adhesions using four-dimensional computed tomography

verfasst von: Jun Suzuki, Satoshi Shiono, Katsuyuki Suzuki, Hikaru Watanabe, Satoshi Takamori, Takayuki Sasage, Kaito Sato, Yusuke Matsui, Testsuro Uchida, Fumika Watarai

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 8/2023

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Abstract

Objective

Pleural adhesions are challenging during lung cancer surgery and may be associated with a long surgery time and excessive blood loss due to pleural adhesiolysis. We used preoperative four-dimensional computed tomography to quantitatively assess parietal pleural adhesions and determine its diagnostic accuracy.

Methods

A total of 216 patients with lung cancer underwent four-dimensional computed tomography during the study period. Pleural adhesions were subsequently confirmed by surgery in 85 of these patients, whereas 126 patients had no adhesions. The movements of the tumor or target vessels (α) was tracked. Receiver-operating characteristic curve analysis was used to identify the relationship between adhesions and (α).

Results

The movement of (α) was smaller in patients with adhesions than in those without adhesions. The greater the adhesion, the shorter the movement distance (p < 0.001). Receiver-operating characteristic curve analysis demonstrated an area under the curve for the moving (α) point at 0.71 (95% confidence interval: 0.62–0.80) in the upper lung field and at 0.75 (95% confidence interval: 0.64–0.85) in the lower field. To identify adhesions, a cut off of 11.3 mm (sensitivity = 43.6%, specificity = 93.2%) in the upper lung field and a cut off of 41.2 mm (sensitivity = 71.4%, specificity = 66.0%) in the lower lung field were established.

Conclusions

Four-dimensional computed tomography is a novel and helpful modality for predicting the presence of parietal pleural adhesions. To obtain robust evidence, further accumulation of cases and re-examination of the analysis methods are needed.
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Metadaten
Titel
The preoperative assessment of thoracic wall adhesions using four-dimensional computed tomography
verfasst von
Jun Suzuki
Satoshi Shiono
Katsuyuki Suzuki
Hikaru Watanabe
Satoshi Takamori
Takayuki Sasage
Kaito Sato
Yusuke Matsui
Testsuro Uchida
Fumika Watarai
Publikationsdatum
05.02.2023
Verlag
Springer Nature Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 8/2023
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-023-01912-z

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