Novel imaging modality accurately assesses lung function in cancer patients
· Medical Xpressby Thomas Jefferson University
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Patients with early-stage lung cancer undergo surgery unless preoperative evaluation reveals poor lung function, which is predictive of poor outcomes. Imaging—like MRI or CT scans—isn't the standard of care for conventional evaluation due to issues like cost, the need for contrast and inaccuracy.
Thomas Jefferson University researchers used another imaging modality—four-dimensional computed tomography (4DCT)-ventilation—to preoperatively assess lung function in patients with early-stage lung cancer. 4DCT-ventilation is often used in radiation oncology, but this is the first time it was used in a surgical trial.
Their findings were published in the International Journal of Radiation Oncology*Biology*Physics.
"The conventional method of predicting lung function before surgery assumes that lung function is evenly distributed," says Lydia Wilson, Ph.D., the study's first author. "For patients with conditions affecting lung function, the portion you remove during surgery might not be functioning well, or it might be the only portion that's working very well, which would be detrimental to remove."
This pilot study evaluated data from 30 surgery-eligible patients with early-stage lung cancer. 4DCT-ventilation images didn't influence clinical decision-making because data analysis occurred after the trial.
While undergoing 4DCT, patients are instructed to inhale and exhale to capture real-time lung activity. 4DCT images create a video of the lungs moving during breathing. The researchers use image-processing techniques to convert this movie into a map showing which parts of the lung function well and which don't. These maps could help determine surgical eligibility.
Months after surgery, researchers compared predictions from the conventional technique and 4DCT-ventilation imaging. Both approaches had similar accuracy, but 4DCT-ventilation predictions were more accurate in patients with uneven lung function, which can affect patients with COPD or emphysema.
Using 4DCT-ventilation preoperatively may eventually guide clinical decision-making, but more research is needed.
"The hope is that 4DCT-ventilation is better than existing techniques and could remove the need for imaging modalities that are less patient-friendly, take longer, cost more or require contrast," Wilson says.
Wilson, a member of Sidney Kimmel Medical College, plans to study 4DCT-ventilation imaging on patients with borderline or low lung function to assess their eligibility for surgery.
Jefferson medical physics resident Vikas Aragam, Ph.D., contributed to the research. Interdisciplinary collaborators include Dr. Tyler Grenda, Dr. Julie Barta and Dr. Benjamin Leiby.
Publication details
Lydia J. Wilson et al., Prospective Evaluation of Novel 4DCT-Ventilation Imaging for Preoperative Risk Assessment in Lung Cancer: Results of the LIME Trial, International Journal of Radiation Oncology*Biology*Physics (2026). DOI: 10.1016/j.ijrobp.2026.07.035
Journal information: International Journal of Radiation Oncology*Biology*Physics
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Pulmonary medicineOncologyDiagnostic radiology Provided by Thomas Jefferson University Who's behind this story?
Sadie Harley
BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →
Andrew Zinin
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