title: Role of post-mapping computed tomography in virtual-assisted lung mapping.
abstract: Background Virtual-assisted lung mapping is a novel bronchoscopic preoperative lung marking technique in which virtual bronchoscopy is used to predict the locations of multiple dye markings. Post-mapping computed tomography is performed to confirm the locations of the actual markings. This study aimed to examine the accuracy of marking locations predicted by virtual bronchoscopy and elucidate the role of post-mapping computed tomography. Methods Automated and manual virtual bronchoscopy was used to predict marking locations. After bronchoscopic dye marking under local anesthesia, computed tomography was performed to confirm the actual marking locations before surgery. Discrepancies between marking locations predicted by the different methods and the actual markings were examined on computed tomography images. Forty-three markings in 11 patients were analyzed. Results The average difference between the predicted and actual marking locations was 30 mm. There was no significant difference between the latest version of the automated virtual bronchoscopy system (30.7 ± 17.2 mm) and manual virtual bronchoscopy (29.8 ± 19.1 mm). The difference was significantly greater in the upper vs. lower lobes (37.1 ± 20.1 vs. 23.0 ± 6.8 mm, for automated virtual bronchoscopy; p < 0.01). Despite this discrepancy, all targeted lesions were successfully resected using 3-dimensional image guidance based on post-mapping computed tomography reflecting the actual marking locations. Conclusions Markings predicted by virtual bronchoscopy were dislocated from the actual markings by an average of 3 cm. However, surgery was accurately performed using post-mapping computed tomography guidance, demonstrating the indispensable role of post-mapping computed tomography in virtual-assisted lung mapping.
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagayama
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kuwano
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Jun-Ichi
authors.initials: JI
authors.lastname: Nitadori
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Anraku
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
mesh_terms: D000368:Aged; D001999:Bronchoscopy / Q000379:methods*; D004396:Coloring Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed
chemical_list: D004396:Coloring Agents
keywords: Anatomic landmarks; Bronchoscopy; Lung neoplasms; Surgery; computer-assisted