Is the predicted postoperative FEV1 estimated by planar lung perfusion scintigraphy accurate in patients undergoing pulmonary resection? Comparison of two processing methods

Abstract

PpoFEV1 values predicted by both the zone and LMMs overestimated the actual measured lung volumes in patients undergoing pulmonary resection in the early postoperative period. LMM is not superior to ZM.

Prediction of postoperative lung function in lung cancer patients using perfusion scintigraphy

“…Prediction of postoperative lung function in patients undergoing pulmonary resection is an important factor that may determine the feasibility of the surgery. There have been reports of the usefulness of lung perfusion scintigraphy in predicting postoperative lung function (14,18,19). Tom Holvoet et al.…”

“…The segment method assumes 19 segments of both lungs and calculates the relative function of the segment preserved postoperatively (4). The conventional zone method divides the lung into upper, middle, and lower lung zones and then predicts postoperative lung function using each fraction of the total lung geometric mean counts (19). These segment and conventional zone methods could not fully reflect the structure of the lung and a method of manually drawing the ROI of each lobe like the lobar mapping method has been introduced (19).…”

“…The conventional zone method divides the lung into upper, middle, and lower lung zones and then predicts postoperative lung function using each fraction of the total lung geometric mean counts (19). These segment and conventional zone methods could not fully reflect the structure of the lung and a method of manually drawing the ROI of each lobe like the lobar mapping method has been introduced (19). This lobar mapping method was using anterior and posterior view images.…”

“…The posterior oblique view seems to be more advantageous for delineating the lower lung overlapped by the upper lung. When predicting the residual lung function, underestimation is more useful in the case of borderline FEV1 to ensure adequate postoperative lung function (19). In order to obtain sufficient postoperative pulmonary function, methods that underestimate actual lung function may be useful, but our results show that the most approximate value is most appropriate since the predicted value according to each method does not show a large difference from the actual value.…”

Perfusion lung scintigraphy for the prediction of postoperative residual pulmonary function in patients with lung cancer

“…However, divergent opinions on this issue can be met in the literature. Caglar et al [19] have shown that a thorough delineation of lung lobes in planar lung perfusion scintigrams does not improve accuracy of predicted postoperative FEV1 values as compared with a schematic division of lungs into lobes. Next, several authors applying both planar and SPECT methods did not observe any advantage of the latter in prediction of postoperative residual lung function [11,12,20].…”