Dual-phase computed tomography imaging for lung function assessment in patients with early-stage non-small cell lung cancer.

Background: Early-stage non-small cell lung cancer (NSCLC) requires accurate preoperative lung function assessment, but traditional tests have limitations in evaluating regional lung function. This study aimed to evaluate the efficacy of dual-phase computed tomography (CT) imaging for preoperative lung function assessment in patients with early-stage NSCLC.

Methods: Sixty patients (28 men and 32 women; mean age 55.47±10.30 years) with early-stage NSCLC were prospectively included in this study. The data utilized in this study were retrospectively analyzed from prospectively collected clinical data. Each patient underwent dual-phase (inspiratory and respiratory) CT using dual-energy computed tomography (DECT) before surgery. The DECT parameters, including volume, iodine content, and iodine concentration (iodine content per unit volume) for each lung and lobe in both phases, were collected by a dual-energy workstation and the eXamine software. Semi-automatic lobe segmentation was achieved through the DE Lung Isolation function in the eXamine. Pulmonary function tests (PFTs) before surgery were conducted as the reference standard to assess the accuracy of DECT in lung function evaluation. The correlation between DECT parameters and PFT metrics was analyzed using Spearman correlation.

Results: DECT can achieve stable and reliable semi-automatic lung lobe segmentation. The median iodine concentration in each lobe showed that the left lung had slightly lower values than the right, with the left upper lobe having lower concentrations than the left lower lobe. In the right lung, the middle lobe had the lowest concentration, while the lower lobe had the highest. The Spearman correlation analysis indicated that multiple parameters from DECT correlated with lung function indices measured by PFT (P<0.05). Dual-phase functional CT imaging can accurately measure lung function.

Conclusions: Dual-phase CT imaging provides a comprehensive and precise preoperative lung function evaluation of patients who underwent operations for early-stage NSCLC.