Background Surgery is the primary form of definitive treatment for early-stage lung cancer. Poor lung function before surgery places patients at high risk of pulmonary complications after resection. Surgeons evaluate patient fitness for surgery using pulmonary function tests (PFTs) to calculate the predicted postoperative PFT (ppoPFT). Conventional ppoPFT calculations assume homogeneous lung function, which can be inaccurate. 4DCT-ventilation is a novel lung function imaging modality developed in radiation oncology that uses 4DCT data to calculate high-resolution ventilation maps.https://jdc.jefferson.edu/radoncposters/1001/thumbnail.jp