title: Computerized estimation of the lung volume removed during lung volume reduction surgery.
abstract: OBJECTIVE
  This study was designed to develop an automated method for estimating lung volume removed during lung volume reduction surgery (LVRS) using computed tomography (CT).
  
  
  METHODS
  The CT examinations of six patients who underwent bilateral LVRS were analyzed in this study. The resected lung tissue (right and left) was weighed during pathologic examination. An automated computer scheme was developed to estimate the lung volume removed using the CT voxel values and lung specimen weight. The computed fraction of lung volume removed was evaluated across a range of simulated surgical planes (ie, other than parallel to the CT image plane) and CT reconstruction kernels, and it was compared with the surgeons' postsurgical estimates.
  
  
  RESULTS
  The computed fraction of the lung volume removed during LVRS was linearly correlated with the resected lung tissue weight (Pearson correlation = 0.697, P = .012). The computed fraction of lung volume removed ranged from 12.9% to 51.7% of the total lung volume. The surgeons' postsurgical estimates of lung volume removed ranged from 30% to 33%. The percent difference between the surgeons' estimates and the computed lung volume removed as a percentage of the surgeons' estimates ranged from -72.3% to 57.0% with mean absolute difference of 29.7% (+/-20.7).
  
  
  CONCLUSIONS
  The preliminary findings of this study suggest that the proposed quantitative model should provide an objective measure of lung volume removed during LVRS that may be used to investigate the relationship between lung volume removed and outcome.
authors.affiliation: Department of Surgery, University of Pittsburgh, Imaging Research Division, 300 Halket Street, Suite 4200, Pittsburgh, PA 15213, USA.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gilbert
authors.forename: Bin
authors.initials: B
authors.lastname: Zheng
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Leader
authors.forename: James D
authors.initials: JD
authors.lastname: Luketich
authors.forename: Carl R
authors.initials: CR
authors.lastname: Fuhrman
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Landreneau
authors.forename: David
authors.initials: D
authors.lastname: Gur
authors.forename: Frank C
authors.initials: FC
authors.lastname: Sciurba
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001185:Artificial Intelligence; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D012107:Research Design; D036542:Tomography, Spiral Computed; D014109:Total Lung Capacity; D016896:Treatment Outcome
chemical_list: D002248:Carbon Monoxide