Preoperative chest computed tomography evaluation for predicting intraoperative lung resection strongly depends on interpreters experience

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Stephane Collaud - , University Hospital Essen (Author)
  • Yazan Alnajdawi - , University Hospital Essen (Author)
  • Theresa Stork - , University Hospital Essen (Author)
  • Till Plönes - , University Hospital Essen (Author)
  • Dirk Stefani - , University Hospital Essen (Author)
  • Keita Tokuishi - , University Hospital Essen (Author)
  • Daniel Valdivia - , University Hospital Essen (Author)
  • Mohamed Zaatar - , University Hospital Essen (Author)
  • Balazs Hegedüs - , University Hospital Essen (Author)
  • Lale Umutlu - , University of Duisburg-Essen (Author)
  • Hubertus Hautzel - , University of Duisburg-Essen (Author)
  • Clemens Aigner - , University Hospital Essen (Author)

Abstract

Objectives: Preoperative planning of lung resection extent is decisive for preoperative functional work-up and selection for multimodal treatment. It is mainly based on preoperative chest CT. We aimed at evaluating chest CT adequacy to predict the extent of lung resection and hypothesized a relation with CT interpreters’ level of experience. Materials and Methods: A pseudonymized CT library was built from patients who had curative intent lung resection for centrally located NSCLC. CT library was interpreted by 20 thoracic surgery residents or attendings. Interpreters were blinded to intraoperative findings and scored one point when lung resection was adequately planned. Points were summed up in a score from 0 to 20. Interpreters’ experience was evaluated through nine variables: age, position (resident vs. attending), years of experience in evaluating chest CTs, number of anatomic resections and sleeve resections attended as first assistant or performed as surgeon in presence of a teaching assistant or as main surgeon/teaching assistant. Variables characterizing interpreters’ experience were divided into equal sized groups. Independent sample T-test and one-way ANOVA/Tukey post hoc tests were used to compare scores between groups. Results: CT library included 20 patients. Lung resections were lobectomy (n = 7, 35 %), sleeve lobectomy (n = 10, 50 %), sleeve bilobectomy (n = 2, 10 %), pneumonectomy (n = 1, 5%). Twenty interpreters scored a median of 10 (4–14). Attending surgeons had significantly higher mean scores (11.2 ± 1.3) compared to residents (7.7 ± 2.3, p = 0.001). All scores were significantly different between groups related to interpreters’ levels of experience, except for interpreters´age. Conclusion: Preoperative CT evaluation for predicting intraoperative lung resection for centrally located NSCLC strongly depends on interpreters’ experience.

Details

Original languageEnglish
Pages (from-to)23-28
Number of pages6
JournalLung cancer
Volume154
Publication statusPublished - Apr 2021
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 33611223

Keywords

Sustainable Development Goals

Keywords

  • CT, Lung cancer, Sleeve resection, Surgery, Surgical planning