Identification of pulmonary nodule location in three dimensional images and its clinical significance_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Xiang ¹ , ZHU Yining ¹ , WU Weibing ¹ , ZHU Quan ¹ , YUAN Mei ² , CHEN Liang ¹ ,  WANG Jun ¹

1. Department of Thoracic Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210000, P.R.China;
2. Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210000, P.R.China;

Corresponding author：

WANG Jun, Email: drwangjun@njmu.edu.cn

Keywords：

Lung nodule; three dimensional reconstruction; depth ration; sublobectomy

DOI：

10.7507/1007-4848.202010006

Video：

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Objective To analyze the difference of location identification of pulmonary nodules in two dimensional (2D) and three dimensional (3D) images, and to discuss the identification methods and clinical significance of pulmonary nodules location in 3D space.Methods The clinical data of 105 patients undergoing sublobectomy in the Department of Thoracic Surgery, the First Affiliated Hospital with Nanjing Medical University from December 2018 to December 2019 were analyzed retrospectively. There were 28 males and 77 females, with an average age of 57.21±13.19 years. The nodule location was determined by traditional 2D method and 3D depth ratio method respectively, and the differences were compared.Results A total of 30 nodules had different position identification between the two methods, among which 25 nodules in the inner or middle zone of 2D image were located in the peripheral region of 3D image. The overall differences between the two methods were statistically significant (P<0.05). The diagnostic consistency rates of two methods were 66.67% in the right upper lung, 83.33% in the right middle lung, 73.68% in the right lower lung, 75.76% in the left upper lung, and 64.71% in the left lower lung. In each lung lobe, the difference between the two methods in the right upper lung (P=0.014) and the left upper lung (P=0.019) was statistically significant, while in the right middle lung (P=1.000), right lower lung (P=0.460) and left lower lung (P=0.162) were not statistically significant.Conclusion The 3D position definition of lung nodules based on depth ratio is more accurate than the traditional 2D definition, which is helpful for preoperative planning of sublobectomy.

Citation： LI Xiang, ZHU Yining, WU Weibing, ZHU Quan, YUAN Mei, CHEN Liang, WANG Jun. Identification of pulmonary nodule location in three dimensional images and its clinical significance. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(3): 305-310. doi: 10.7507/1007-4848.202010006 Copy

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11.	Tsutani Y, Miyata Y, Nakayama H, et al. Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage ⅠA lung adenocarcinoma: Propensity score-matched analysis in a multicenter study. J Thorac Cardiovasc Surg, 2013, 146(2): 358-364.
12.	Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: A meta-analysis. Ann Surg, 2018, 268(2): 254-259.
13.	Okada M, Koike T, Higashiyama M, et al. Radical sublobar resection for small-sized non-small cell lung cancer: A multicenter study. J Thorac Cardiovasc Surg, 2006, 132(4): 769-775.
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1. Liu A, Wang Z, Yang Y, et al. Preoperative diagnosis of malignant pulmonary nodules in lung cancer screening with a radiomics nomogram. Cancer Commun (Lond), 2020, 40(1): 16-24.
2. Fan J, Wang L, Jiang GN, et al. Sublobectomy versus lobectomy for stage Ⅰ non-small-cell lung cancer, a meta-analysis of published studies. Ann Surg Oncol, 2012, 19(2): 661-668.
3. Wo Y, Yang HX, Zhang YL, et al. Development and external validation of a nomogram for predicting survival in patients with Stage ⅠA non-small cell lung cancer ≤2 cm undergoing sublobectomy. Front Oncol, 2019, 9: 1385.
4. 滑炎卿, 郑向鹏, 张国桢. 胸部断层影像解剖学研究进展. 上海医学影像, 2001, 10(4): 301-305.
5. 朱燚宁, 李志华, 何志成, 等. 胸腔镜下肺亚段切除术的临床对比研究. 自然科学版, 2020, 40(6): 870-874.
6. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
7. Cheng X, Onaitis MW, D'amico TA, et al. Minimally invasive thoracic surgery 3. 0: Lessons learned from the history of lung cancer surgery. Ann Surg, 2018, 267(1): 37-38.
8. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615-622.
9. Ueda K, Hayashi M, Tanaka N, et al. Long-term pulmonary function after major lung resection. Gen Thorac Cardiovasc Surg, 2014, 62(1): 24-30.
10. Griffin JP, Eastridge CE, Tolley EA, et al. Wedge resection for non-small cell lung cancer in patients with pulmonary insufficiency: prospective ten-year survival. J Thorac Oncol, 2006, 1(9): 960-964.
11. Tsutani Y, Miyata Y, Nakayama H, et al. Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage ⅠA lung adenocarcinoma: Propensity score-matched analysis in a multicenter study. J Thorac Cardiovasc Surg, 2013, 146(2): 358-364.
12. Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: A meta-analysis. Ann Surg, 2018, 268(2): 254-259.
13. Okada M, Koike T, Higashiyama M, et al. Radical sublobar resection for small-sized non-small cell lung cancer: A multicenter study. J Thorac Cardiovasc Surg, 2006, 132(4): 769-775.
14. NCCN clinical practice guidelines in oncology: Non-small cell lung cancer (version 1.2020). https://www.nccn.org/.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Identification of pulmonary nodule location in three dimensional images and its clinical significance

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