Chest three‐dimensional‐computed tomography imaging data analysis for the variation of exercise capacity after lung lobectomy

Background Postoperative loss of exercise capacity and pulmonary function is a major concern among lung cancer patients. In this study, the time for a stair‐climbing to 12‐m height was used to investigate whether preoperative chest 3D‐computed tomography (CT) could be a useful tool for predicting postoperative variations in exercise capacity and pulmonary function. Methods Seventy‐eight patients undergoing lobectomy for suspected stage I lung cancer were prospectively enroled. Preoperatively, lobe volume and low attenuation volume (LAV) were evaluated using the SYNAPSE VINCENT system. Preoperative data on stair‐climbing time, spirometry and diffusing capacity of the lung for carbon monoxide (DLCO) at baseline and 6‐month postoperative data were used to evaluate variations in exercise capacity and pulmonary function. Maximal oxygen uptake (VO2t) was evaluated based on the stair‐climbing time. Results Significant differences in the variation of exercise capacity at 6 months postoperatively were found between the groups categorized by target lobe volume and LAV status: The large volume/LAV (+) group had a greater decline in VO2t. Mean loss of VO2t was −6.2%, −1.4%, −1.6% and −0.1% in the large volume/LAV (+), large volume/LAV (−), small volume/LAV (+) and small volume/LAV (−) groups, respectively. The large volume/LAV (−) group had a greater decline in forced expiratory volume in 1 s. The small volume/LAV (+) group showed a reduced decline in the DLCO. Conclusions Analysis of chest 3D‐CT scans is a potential tool for predicting the loss of exercise capacity and pulmonary function after lung lobectomy.