Imaging of tumor infiltration of the pulmonary artery amenable to sleeve resection

Sleeve resection of the pulmonary artery (PA) is rapidly gaining acceptance as an alterative to pneumonectomy in selected patients with locally advanced lung cancer.1, 2, 3, 4 Contrary to bronchial sleeve resection, for which bronchoscopy is an important preoperative investigation tool, the evaluation of the PA is still uncertain. There is general agreement that computed tomography (CT) with the injection of contrast material is the most accurate technique, but it is often difficult, if not impossible, to discriminate between simple adhesion and infiltration of the vascular wall.4