In this prospective study of 433 patients undergoing surgery for bronchial carcinoma 3 main factors influencing the operative risk were identified: (1) extent of resection, (2) pulmonary function and (3) age. The 30-day mortality rate was 8.3% in the whole group which comprised a high percentage of patients over 70 years of age (27%) and with a disturbed pulmonary function (45%). The value of various functional criteria proposed in the extensive literature is assessed and compared with the results of the study in which the use of FEV1 and quantitative regional analysis by perfusion scanning and 'regions of interest' proved to be highly efficient, allowing, in addition, the prediction of postoperative lung function even in sleeve resections. A new formula for estimation of the additional loss of function in the early postoperative phase after lobectomies is proposed along with a flow sheet for routine preoperative evaluation of pulmonary function.
Freise, G., Gabler, A., and Liebig, S. (1978). Thorax, 33,[228][229][230][231][232][233][234] (Table 1). Thirty-eight patients (8%) had tumours which were not resectable. Sixty-three (13-4%) died within the first four weeks after operation. Follow-up was not possible after discharge from hospital in 10 cases. The remaining 398 patients were followed up at outpatient consultations or from information sent by practitioners or other hospitals. One hundred and twenty-five patients (28-9%) survived five years; this survival rate is similar to those in other published studies. ResultsThe incidence of bronchial carcinoma in women is less than in men. In our series, females represented 10% of all thoracotomies, which is an average rate (Buchberger and Jenny, 1967;Sriboonma, 1967;Kutschera, 1968). The reason why women have a better prognosis (Berndt, 1965;Watson, 1965) is uncertain. Our five-year survival rate in women is 34% and in men 27%. The women
After a primary operation for bronchial carcinoma, 17 patients underwent reoperation for local recurrence or intrathoracic metastasis (nine squamous cell, five alveolar cell, and three adenocarcinomas). One year ago, the work of Schulte et a12 induced us to analyse our own cases. We were also influenced by the work published by Abbey Smith34 and Neptune et a15 as well as that of Doring6 who in 1976 reported on the largest number of cases. We found that in the last 25 years, 11 reoperations for bronchial carcinoma had been performed at our hospital. In the same year, after we had reported our findings at a meeting of the Berlin Pneumologists,5 six additional reoperations for recurrent bronchial carcinoma were performed.In this paper we consider only those cases where a reoperation for recurrent bronchial carcinoma was performed after a previous resection for bronchial carcinoma. We are not concerned with the many possible alternative surgical procedures after resection of the lung because of bronchial carcinoma.
This study aimed to assess a hypothetical minimum administered activity of 124 I required to achieve comparability between pretherapeutic radioiodine uptake (RAIU) measurements by 124 I PET/CT and by 131 I RAIU probe, the clinical standard. In addition, the impact of different reconstruction algorithms on 124 I RAIU and the evaluation of pixel noise as a parameter for image quality were investigated. Methods: Different scan durations were simulated by different reconstruction intervals of 600-s list-mode PET datasets (including 15 intervals up to 600 s and 5 different reconstruction algorithms: filtered-backprojection and 4 iterative techniques) acquired 30 h after administration of 1 MBq of 124 I. The Bland-Altman method was used to compare mean 124 I RAIU levels versus mean 3-MBq 131 I RAIU levels (clinical standard). The data of 37 patients with benign thyroid diseases were assessed. The impact of different reconstruction lengths on pixel noise was investigated for all 5 of the 124 I PET reconstruction algorithms. A hypothetical minimum activity was sought by means of a proportion equation, considering that the length of a reconstruction interval equates to a hypothetical activity. Results: Mean 124 I RAIU and 131 I RAIU already showed high levels of agreement for reconstruction intervals of as short as 10 s, corresponding to a hypothetical minimum activity of 0.017 MBq of 124 I. The iterative algorithms proved generally superior to the filteredbackprojection algorithm. 124 I RAIU showed a trend toward higher levels than 131 I RAIU if the influence of retrosternal tissue was not considered, which was proven to be the cause of a slight overestimation by 124 I RAIU measurement. A hypothetical minimum activity of 0.5 MBq of 124 I obtained with iterative reconstruction appeared sufficient both visually and with regard to pixel noise. Conclusion: This study confirms the potential of 124 I RAIU measurement as an alternative method for 131 I RAIU measurement in benign thyroid disease and suggests that reducing the administered activity is an option. CT information is particularly important in cases of retrosternal expansion. The results are relevant because 124 I PET/CT allows additional diagnostic means, that is, the possibility of performing fusion imaging with ultrasound. 124 I PET/CT might be an alternative, especially when hybrid 123 I SPECT/CT is not available.
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