Objectives We compared the computed tomographic (CT) volumetric analysis and anatomical segmental counting (ASC) for predicting postoperative forced expiratory volume in 1 second (FEV1) and diffusing capacity for carbon monoxide (DLCO) in patients who had segmentectomy for early-stage lung cancer. Methods A total of 175 patients who had segmentectomy for lung cancer and had postoperative pulmonary function test (PFT) were included. CT volumetric analysis was performed by software which could measure total lung and target segment volume from CT images. ASC and CT volumetric analysis were used to determine predicted postoperative (PPO) values and the concordance and difference of these values were assessed. The relationship between PPO values and actual postoperative values was also investigated. Results The PPO-FEV1 and PPO-DLCO showed high concordance between two methods (concordance correlation coefficient = 0.96 for PPO-FEV1 and 0.95 for PPO-DLCO). There was no significant difference between PPO values as determined by two methods (p = 0.53 for PPO-FEV1, p = 0.25 for PPO-DLCO) and actual postoperative values (p = 0.77 (ASC vs actual) and p = 0.20 (CT vs actual) for FEV1; p = 0.41 (ASC vs actual) and p = 0.80 (CT vs actual) for DLCO). We subdivided the patients according to poor PFT, the number of resected segments and location of resected lobe. All subgroup analysis revealed no significant difference between PPO values and actual postoperative values. Conclusions Both CT volumetric analysis and ASC showed high predictability for actual postoperative FEV1 and DLCO in segmentectomy.

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