Computer-assisted risk analysis and 3-dimensional reconstruction based on multislice lung computer tomography

Introduction: CT scan of the lung is the gold standard in preoperative evaluation of central lung tumors. Extension of the tumor, infiltration of central lung structures and lung segmentation are decisive parameters to answer the question of a possible operability and the extend of resection. With a new, adated software application (MeVis, Bremen) an enhanced, three-dimensional visualization is now availabe. Methods: Based on high-resolution chest computed tomography (CT) scan the CT data of patients with central lung tumors were evaluated using the specific software mentioned above. In the initial study period the adapted CT data of 10 patients were validated and confirmed by surgery. Along with an improved software, in the second study period (n = 16) the three-dimensional reconstructed CT scan is used to answer the question of risk analysis and technical approach. Results: The amount of findings gained by the threedimensional reconstructed CT scan is both qualitative and quantitative. The three-dimensional visualization of the tumor and its anatomic relation to central pulmonary vessels and airway system was feasible in all cases. 3D Reconstruction in combination with color-coded related lung lobes or lung segments as well as the possibility of separated examination of all anatomic structures results in a clearly improved visualization for the observer and a better preoperative planning for the surgeon. Conclusion: Three-dimensional reconstruction of lung tumors is a new and promising method for preoperative risk analysis of central lung tumors. The three-dimensional visualization with anatomical reformatting and color-coded segmentation enables the surgeon a more precisely strategic approach in central lung tumors.