Postoperative computed tomography of insufflated lung specimens obtained by video-assisted thoracic surgery: detection and margin assessment of pulmonary nodules

• Published in: Radiologia brasileira
• Main Authors: Antunes, Milene da Silva, Hochhegger, Bruno, Alves, Giordano Rafael Tronco, Gazzoni, Fernando Ferreira, Forte, Gabriele Carra, Andrade, Rubens Gabriel Feijó, Felicetti, José Carlos
• Format: Journal Article
• Language: Portuguese
• Published: Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2022
• Subjects: RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING; Lung neoplasms/diagnostic imaging; Tomografia computadorizada; Thoracic surgery, video-assisted; Cirurgia torácica videoassistida; Neoplasias pulmonares/diagnóstico por imagem; Tomography, X-ray computed
• ISSN: 1678-7099
• DOI: 10.1590/0100-3984.2021.0046

Abstract Objective: To investigate the utility of computed tomography (CT) scans to detect and assess the margin status of pulmonary nodules that were insufflated after being resected by video-assisted thoracic surgery. Materials and Methods: This was a novel multicenter study conducted at two national referral centers for thoracic diseases. Patients suspected of having lung cancer underwent video-assisted thoracic surgery for the resection of pulmonary nodules, which were submitted to postoperative CT. Measurements from the CT scans were compared with the results of the histopathological analysis. Results: A total of 37 pulmonary nodules from 37 patients were evaluated. The mean age of the patients was 65 years (range, 36-84 years), and 27 (73%) were female. A CT analysis of insufflated specimens identified all 37 nodules, and 33 of those nodules were found to have tumor-free margins. The histopathological analysis revealed lung cancer in 30 of the nodules, all with tumor-free margins, and benign lesions in the seven remaining nodules. Conclusion: Postoperative CT of insufflated suspicious lung lesions provides real-time detection of pulmonary nodules and satisfactory assessment of tumor margins. This initial study shows that CT of insufflated lung lesions can be a valuable tool at centers where intraoperative histopathological analysis is unavailable.