Preoperative assessment of pleural adhesion by Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) with Adaptive Iterative Dose Reduction using Three-Dimensional Processing (AIDR-3D)

Publication date: Available online 21 November 2017
Source:European Journal of Radiology
Author(s): Masayuki Hashimoto, Yukihiro Nagatani, Yasuhiko Oshio, Norihisa Nitta, Tsuneo Yamashiro, Shinsuke Tsukagoshi, Noritoshi Ushio, Masayuki Mayumi, Tatsuya Kimoto, Tomoyuki Igarashi, Makoto Yoshigoe, Kyohei Iwai, Koki Tanaka, Shigetaka Sato, Akinaga Sonoda, Hideji Otani, Kiyoshi Murata, Jun Hanaoka
PurposeTo 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.MethodsTwenty-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.RESULTSIn 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).ConclusionsFour D-ULDCT could be a useful non-invasive preoperative assessment modality for the detection of the presence or severity of LPA.



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