Document Detail

Selection of patients for lung volume reduction surgery using a power law analysis of the computed tomographic scan.
MedLine Citation:
PMID:  12775863     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A study was undertaken to test the hypothesis that patients respond better to lung volume reduction surgery (LVRS) if their emphysema is confluent and predominantly located in the upper lobes. METHODS: A density mask analysis was used to identify voxels inflated beyond 10.2 ml gas/g tissue (-910 HU) on preoperative and postoperative CT scans from patients receiving LVRS. These hyperinflated regions were considered to represent emphysematous lesions. A power law analysis was used to determine the relationship between the number (K) and size (A) of the emphysematous lesions in the whole lung and two anatomical regions using the power law equation Y=KA(-D). RESULTS: The analysis showed a positive correlation between the change in the power law exponent (D) and the change in exercise (Watts) after surgery (r=0.47, p=0.03). There was also a negative correlation between the power law exponent D in the upper region of the lung preoperatively and the change in exercise following surgery (r=-0.60, p<0.05). CONCLUSIONS: These results confirm that patients with large upper lobe lesions respond better to LVRS than patients with small uniformly distributed disease. Power law analysis of lung CT scans provides a quantitative method for determining the extent and location of emphysema within the lungs of patients with COPD.
H O Coxson; K P Whittall; Y Nakano; R M Rogers; F C Sciurba; R J Keenan; J C Hogg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  58     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-30     Completed Date:  2003-07-07     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  510-4     Citation Subset:  IM    
University of British Columbia, McDonald Research Laboratories, St Paul's Hospital, Vancouver, BC, Canada V6Z 1Y6.
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MeSH Terms
Exercise Tolerance
Middle Aged
Patient Selection*
Pneumonectomy / methods*
Postoperative Care / methods
Preoperative Care / methods
Pulmonary Emphysema / radiography,  surgery*
Respiratory Function Tests
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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