Quantitative Computed Tomography Versus Spirometry in Predicting Air Leak Duration After Major Lung Resection for Cancer Kazuhiro Ueda, MD, Yoshikazu.

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Quantitative Computed Tomography Versus Spirometry in Predicting Air Leak Duration After Major Lung Resection for Cancer Kazuhiro Ueda, MD, Yoshikazu Kaneda, MD, Manabu Sudo, MD, Jinbo Mitsutaka, MD, Tao-Sheng Li, MD, Kazuyoshi Suga, MD, Nobuyuki Tanaka, MD, Kimikazu Hamano, MD The Annals of Thoracic Surgery Volume 80, Issue 5, Pages 1853-1858 (November 2005) DOI: 10.1016/j.athoracsur.2005.05.006 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Images obtained from a 65-year-old man with panlobular emphysema. (A) Three-dimensional shaded surface display of the lungs, representing attenuation values of −600 to −1024 HU. (B) Volume-rendering three-dimensional images of the low-attenuation areas, representing attenuation values of less than −910 HU. Note that the tracheobronchial and gastrointestinal tracts have been selectively removed. With this model, the proportion of voxels with attenuation values representing emphysema is readily determined by defining a threshold value. (C) Axial computed tomography image shows upper lobar emphysema, indicated by areas of low attenuation (−910 to −1,024 HU) highlighted in red. The Annals of Thoracic Surgery 2005 80, 1853-1858DOI: (10.1016/j.athoracsur.2005.05.006) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Time to air leak stop in all patients (n = 62). Two patients required postoperative interventions for pulmonary complication before air leak stopped, and these patients were flagged (open circles). Median time to air leak stop was 2 days. The Annals of Thoracic Surgery 2005 80, 1853-1858DOI: (10.1016/j.athoracsur.2005.05.006) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Time to air leak stop in patients with upper resections (n = 38), according to low-attenuation area (LAA). Median time to air leak stop in patients with LAA less than 1% (solid line) was 1 day, that in patients with LAA 1% to 10% (dotted line) was 3 days, and that in patients with LAA greater than 10% (dashed line) was 5 days (log-rank test, p < 0.01). Flagged cases (n = 2) are denoted by open circles. The Annals of Thoracic Surgery 2005 80, 1853-1858DOI: (10.1016/j.athoracsur.2005.05.006) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Time to air leak stop in patients with lower resections (n = 24), according to low-attenuation area (LAA). Median time to air leak stop in patients with LAA less than 1% (solid line) was 1 day, that in those with LAA 1% to 10% (dotted line) was 1 day, and that in those with LAA greater than 10% (dashed line) was 3 days (log-rank test, p = 0.026). The Annals of Thoracic Surgery 2005 80, 1853-1858DOI: (10.1016/j.athoracsur.2005.05.006) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions