Masayuki Hashimoto1, Yukihiro Nagatani2, Yasuhiko Oshio3, Norihisa Nitta4, Tsuneo Yamashiro5, Shinsuke Tsukagoshi6, Noritoshi Ushio7, Masayuki Mayumi8, Tatsuya Kimoto9, Tomoyuki Igarashi10, Makoto Yoshigoe11, Kyohei Iwai12, Koki Tanaka13, Shigetaka Sato14, Akinaga Sonoda15, Hideji Otani16, Kiyoshi Murata17, Jun Hanaoka18. 1. Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: mhashi@belle.shiga-med.ac.jp. 2. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: yatsushi@belle.shiga-med.ac.jp. 3. Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: yasuhiko@belle.shiga-med.ac.jp. 4. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: r34nitta@belle.shiga-med.ac.jp. 5. Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, 903-0215, Japan. Electronic address: clatsune@yahoo.co.jp. 6. CT System Division, Toshiba Medical Systems, Otawara, Tochigi, 324-8550, Japan. Electronic address: shinsuke.tsukagoshi@toshiba.co.jp. 7. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: ushio@belle.shiga-med.ac.jp. 8. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: mmayumi@belle.shiga-med.ac.jp. 9. Center for Medical Research and Development, Toshiba Medical Systems, Otawara, Tochigi, 324-8550, Japan. Electronic address: tatsuya.kimoto@glb.toshiba.co.jp. 10. Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: igarashi@belle.shiga-med.ac.jp. 11. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: shigagoe@belle.shiga-med.ac.jp. 12. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: 6a5e6a11@belle.shiga-med.ac.jp. 13. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: 8r2p@belle.shiga-med.ac.jp. 14. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: kanimiso@belle.shiga-med.ac.jp. 15. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: akinaga@belle.shiga-med.ac.jp. 16. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: otani@belle.shiga-med.ac.jp. 17. Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: murata@belle.shiga-med.ac.jp. 18. Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. Electronic address: hanaoka@belle.shiga-med.ac.jp.
Abstract
PURPOSE: To assess the feasibility of Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) for distinguishing pleural aspects with localized pleural adhesion (LPA) from those without. METHODS: Twenty-seven patients underwent 4D-ULDCT during a single respiration with a 16cm-coverage of the body axis. The presence and severity of LPA was confirmed by their intraoperative thoracoscopic findings. A point on the pleura and a corresponding point on the outer edge of the costal bone were placed in identical axial planes at end-inspiration. The distance of the two points (PCD), traced by automatic tracking functions respectively, was calculated at each respiratory phase. The maximal and average change amounts in PCD (PCDMCA and PCDACA) were compared among 110 measurement points (MPs) without LPA, 16MPs with mild LPA and 10MPs with severe LPA in upper lung field cranial to the bronchial bifurcation (ULF), and 150MPs without LPA, 17MPs with mild LPA and 9MPs with severe LPA in lower lung field caudal to the bronchial bifurcation (LLF) using the Mann-Whitney U test. RESULTS: In the LLF, PCDACA as well as PCDMCA demonstrated a significant difference among non-LPA, mild LPA and severe LPA (18.1±9.2, 12.3±6.2 and 5.0±3.3mm) (p<0.05). Also in the ULF, PCDACA showed a significant difference among three conditions (9.2±5.5, 5.7±2.8 and 2.2±0.4mm, respectively) (p<0.05), whereas PCDMCA for mild LPA was similar to that for non-LPA (12.3±5.9 and 17.5±11.0mm). CONCLUSIONS: Four D-ULDCT could be a useful non-invasive preoperative assessment modality for the detection of the presence or severity of LPA.
PURPOSE: To assess the feasibility of Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) for distinguishing pleural aspects with localized pleural adhesion (LPA) from those without. METHODS: Twenty-seven patients underwent 4D-ULDCT during a single respiration with a 16cm-coverage of the body axis. The presence and severity of LPA was confirmed by their intraoperative thoracoscopic findings. A point on the pleura and a corresponding point on the outer edge of the costal bone were placed in identical axial planes at end-inspiration. The distance of the two points (PCD), traced by automatic tracking functions respectively, was calculated at each respiratory phase. The maximal and average change amounts in PCD (PCDMCA and PCDACA) were compared among 110 measurement points (MPs) without LPA, 16MPs with mild LPA and 10MPs with severe LPA in upper lung field cranial to the bronchial bifurcation (ULF), and 150MPs without LPA, 17MPs with mild LPA and 9MPs with severe LPA in lower lung field caudal to the bronchial bifurcation (LLF) using the Mann-Whitney U test. RESULTS: In the LLF, PCDACA as well as PCDMCA demonstrated a significant difference among non-LPA, mild LPA and severe LPA (18.1±9.2, 12.3±6.2 and 5.0±3.3mm) (p<0.05). Also in the ULF, PCDACA showed a significant difference among three conditions (9.2±5.5, 5.7±2.8 and 2.2±0.4mm, respectively) (p<0.05), whereas PCDMCA for mild LPA was similar to that for non-LPA (12.3±5.9 and 17.5±11.0mm). CONCLUSIONS: Four D-ULDCT could be a useful non-invasive preoperative assessment modality for the detection of the presence or severity of LPA.