title: Parietal pleural invasion/adhesion of subpleural lung cancer: Quantitative 4-dimensional CT analysis using dynamic-ventilatory scanning.
abstract: OBJECTIVE
  Using 4-dimensional dynamic-ventilatory scanning by a 320-row computed tomography (CT) scanner, we performed a quantitative assessment of parietal pleural invasion and adhesion by peripheral (subpleural) lung cancers.
  
  
  METHODS
  Sixteen patients with subpleural lung cancer underwent dynamic-ventilation CT during free breathing. Neither parietal pleural invasion nor adhesion was subsequently confirmed by surgery in 10 patients, whereas the other 6 patients were judged to have parietal pleural invasion or adhesion. Using research software, we tracked the movements of the cancer and of an adjacent structure such as the rib or aorta, and converted the data to 3-dimensional loci. The following quantitative indices were compared by the Mann-Whitney test: cross-correlation coefficient between time curves for the distances moved from the inspiratory frame by the cancer and the adjacent structure, the ratio of the total movement distances (cancer/adjacent structure), and the cosine similarities between the inspiratory and expiratory vectors (from the cancer to the adjacent structure) and between vectors of the cancer and of the adjacent structure (from inspiratory to expiratory frames).
  
  
  RESULTS
  Generally, the movements of the loci of the lung cancer and the adjacent structure were similar in patients with parietal pleural invasion/adhesion, while they were independent in patients without. There were significant differences in all the parameters between the two patient groups (cross-correlation coefficient and the movement distance ratio, P<0.01; cosine similarities, P<0.05).
  
  
  CONCLUSIONS
  These observations suggest that quantitative indices by dynamic-ventilation CT can be utilized as a novel imaging approach for the preoperative assessment of parietal pleural invasion/adhesion.
authors.affiliation: Department of Radiology, Ohara General Hospital, 6-11 Omachi, Fukushima City, Fukushima 960-8611, Japan; Department of Radiology and Nuclear Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295, Japan. Electronic address: ksakuma@ohara-hp.or.jp.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Sakuma
authors.affiliation: Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. Electronic address: clatsune@yahoo.co.jp.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Yamashiro
authors.affiliation: Department of Radiology, Ohara General Hospital, 6-11 Omachi, Fukushima City, Fukushima 960-8611, Japan. Electronic address: hrshmoriya@gmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriya
authors.affiliation: Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. Electronic address: sadayuki@med.u-ryukyu.ac.jp.
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
authors.affiliation: Department of Radiology and Nuclear Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295, Japan. Electronic address: h-ito@fmu.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging; D010994:Pleura / Q000000981:diagnostic imaging* / Q000473:pathology*; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D015203:Reproducibility of Results; D012119:Respiration; D012189:Retrospective Studies
keywords: Computed tomography; Four-dimensional scanning; Lung cancer; Pleural adhesion; Ventilation