Robust imaging approach for precise prediction of postoperative lung function in lung cancer patients prior to curative operation

Kim et al. developed a DECT (dual-energy CT) imaging approach to predict postoperative lung function in lung cancer patients. This study included 33 patients who underwent DECT and perfusion scans preoperatively, comparing conventional segment counting and DECT-based ventilation/perfusion (V/Q) mapping among five prediction methods. Aview software was used to automatically segment each lung lobe, exclude airway and vessel regions to focus on pure lung parenchyma, and align inspiratory and expiratory images for accurate V/Q analysis. Results showed that DECT-based V/Q mapping provided greater predictive accuracy than traditional methods. Specifically, segment counting achieved the highest agreement for FVC and FEV1, while the combined variable method, which integrated V/Q data, demonstrated strong predictive capabilities. This study suggests that DECT with Aview offers a non-invasive, precise predictive tool for postoperative lung function, potentially improving surgical planning in lung cancer care.