Sang Min Lee MD, Presenter: Nothing to Disclose

Joon Beom Seo MD, PhD, Abstract Co-Author: Speaker, Siemens AG

Eun Jin Chae MD, PhD, Abstract Co-Author: Nothing to Disclose

Hyun Joo Lee, Abstract Co-Author: Nothing to Disclose

Namkug Kim PhD, Abstract Co-Author: Nothing to Disclose

Yong Hee Kim MD, Abstract Co-Author: Nothing to Disclose

Hye Jeon Hwang MD, Abstract Co-Author: Nothing to Disclose

Sang Young Oh MD, Abstract Co-Author: Nothing to Disclose

Eun Young Kim, Abstract Co-Author: Nothing to Disclose

To evaluate the changes of blood volume and lung volume after lobectomy and mismatch between the changes of blood volume and lung volume in patients with lung cancer using dual-energy perfusion CT.

Twenty-five patients (M:F = 17:8; mean age, 60.5 years) were prospectively enrolled and they underwent dual-energy perfusion CT before surgery and 6 months after lobectomy. Lobectomy in 23 and bilobectomy in two were performed. CT was scanned at 40 seconds after contrast injection using dual-source CT (Definition, Siemens) with dual-energy technique. On dual-energy CT data, each lobe was segmented using in-house software. Blood volume of each lobe was calculated by multiplying lobe volume and iodine value per voxel at both pre/post-operative CT data. The ratio of increased blood volume (BVΔ) and lung volume (LVΔ) of remained ipsilateral lobes (ips-lobe) and contralateral lobes (con-lobe) after surgery was measured. To evaluate the mismatch in increase of blood and lung volume, BVΔ/LVΔ was measured. We categorized patients into two groups (A, left side lobectomy, n=13; B, right side lobectomy, n=12).  

BVΔ and LVΔ of ips-lobe increased more than those of con-lobe (paired T-test, p=0.01, p<0.01). Between two groups, BVΔ and LVΔ of ips-lobe and con-lobe were statistically equal (unpaired T-test, p>0.05). There were parallel increase in BVΔ and LVΔ in both ips-lobe and con-lobe as a whole (BVΔ/LVΔ, paired-t, p>0.05). However, the BVΔ/LVΔ of right lobes was larger than BVΔ/LVΔ of left lobes (paired T-test, p=0.01). On right lobe, blood volume increased more than lung volume. In contrast, lung volume increased more than blood volume on left lobe.  

After lobectomy, blood and lung volumes of ipsilateral lobes increase more than those of contralateral lobes. The redistribution of blood volume is more dominant in right lobes, and the redistribution of lung volume is more dominant in left lobes.  

Compensatory increase in blood and lung volume after surgery can be assessed with DECT. It might be useful in predicting postoperative lung function in patient with limited lung function.  

Lee, S, Seo, J, Chae, E, Lee, H, Kim, N, Kim, Y, Hwang, H, Oh, S, Kim, E, Evaluation of the Changes of Blood Volume and Lung Volume after Lobectomy: Assessment with Dual-Energy Perfusion CT.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034596.html