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Y. Hirai



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    P2.16 - Surgery (ID 717)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P2.16-010 - Removing the Chest Tube on the First Day after Surgery Does Not Contribute to the Early Discharge from the Hospital (ID 8962)

      09:30 - 09:30  |  Author(s): Y. Hirai

      • Abstract

      Background:
      Postoperative chest tube drainage is essential in pulmonary surgery. After chest tube removal, the patient can be discharged from the hospital promptly. Therefore, it should be a close relationship between hospital stay and drainage duration. Removing chest tube in the early postoperative period leads to reduction of pain and early discharge from the hospital. However, there are few reports about removal chest tube on the first day after surgery. In this study, we examined cases where chest tube was removed on the first day after surgery.

      Method:
      From January to December 2016, 48 patients with lung cancer underwent lobectomy in our institute. They were consisted of 35 males, 13 females, and median age was 72 (53-87) years old. Among them, chest tube was removed on the postoperative day (POD) 1 in 24 patients (Group 1) and on the POD2 in 24 patients (Group 2). Patients complicated of postoperative lung fistula and infection were excluded.

      Result:
      Patients were discharged from the hospital on 5.4 days after surgery in Group 1 and on 5.6 days in Group 2. There was no significant difference between them (p=0.48). The CRP values on POD1, 2, and 3 were 5.49±2.38, 12.0±4.71, and 11.6±6.12 mg/dl in Group 1, and 7.27±3.28, 15.5±6.31, 12.9±5.87 mg/dl in Group 2, respectively (p=0.03, p=0.03, p=0.46). In addition, the period until CRP peaked out was 2.5 days in Group 1, and 2.1 days in Group 2. Group 2 showed obviously short period until CRP peaked out (p=0.03).

      Conclusion:
      Removing the chest tube on the first day after surgery will not lead to an early hospital discharge, conversely it will prolong the inflammatory response such as CRP.

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    P3.13 - Radiology/Staging/Screening (ID 729)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P3.13-012 - Fast Fourier Transform Analysis for the Outline of Pulmonary Nodules on Computed Tomography Images (ID 8592)

      09:30 - 09:30  |  Author(s): Y. Hirai

      • Abstract

      Background:
      Primary lung cancers show more complicated outline on computed tomography (CT) images of the chest than metastatic lung tumors or benign inflammatory lung disease. This feature is proving to be useful for clarifying the diagnosis of pulmonary nodules. The degree of complexity of pulmonary nodules seen on chest CT images is usually described subjectively by such designations as spiculated, irregular, and so on. Up to now there have been no established methods for evaluating a tumor outline numerically. In this study, we applied fast Fourier transform (FFT) analysis to pulmonary nodules on CT images to evaluate variations in the outlines of primary versus metastatic lesions or benign inflammatory lesions.

      Method:
      Sequential cases of 72 histologically proven primary lung cancers (group PL), 54 metastatic lung tumors (group MT), and benign inflammatory nodule (group BN) were included in the study. The average ± SD diameters of tumors in groups PL, MT, and BN were 18.9±7.4 mm, 12.2±6.1 mm, and 18.0±5.3 mm, respectively. For the measurements, the outline of each tumor on chest CT images was described using polar coordinates. The data were converted to rectangular coordinates, yielding wave data of the tumor outline. The FFT was then used to analyze the wave data. The complexity index (Cxi) and high frequency percent (HF%) were determined for each tumor. The Cxi was defined as the sum of the amplitude of all harmonics over a fundamental frequency. The HF% was defined as the percent of the high frequency components against Cxi.

      Result:
      The Cxi was 10.3±6.7 mm, 3.2±2.4 mm, and 8.0±3.8 mm, in groups PL, MT, and BN, respectively. The Cxi was significantly smaller in group MT than group PL (p<0.0001) and group BN (p=0.0003). Cxi was significantly correlated with tumor diameter in each group. Discriminant analysis showed a significant difference (P<0.0001) in Cxi between groups PL and MT with regard to tumor diameter. “Cutoff=0.127*DT+2.23” provided the cutoff value that yielded the highest diagnostic accuracy for distinguishing primary lung cancers from metastatic lung tumors. Use of this cutoff line resulted in a sensitivity of 95.8%, specificity of 81.5%, and accuracy of 89.7%. The HF% was 1.82±2.23%, 3.78±3.93%, and 5.29±1.28, in groups PL, MT, and BN, respectively. The HF% was significantly (p<0.0001) smaller in group PL than group BN.

      Conclusion:
      Fast Fourier transform analysis of tumor outlines appears useful for distinguishing primary lung cancer from the other diseases.