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

Abstract

This study shows that planar LPS may be applied for prediction of postoperative pulmonary function in patients qualified for pneumonectomy and lobectomy. If actual FEV1postop value is to be ≥ 800 mL, predicted value should exceed 1000 mL.

Comparison of predicted postoperative forced expiratory volume in the first second (FEV1) using lung perfusion scintigraphy with observed forced expiratory volume in the first second (FEV1) post lung resection

“…Many studies have tried to predict the postoperative pulmonary function on the basis of reduced perfusion of the involved lung which is marked for resection. [ 6 14 15 ] Bolliger et al showed that perfusion and quantitative CT-based predictions of postoperative pulmonary function are useful irrespective of the extent of resection, but perfusion-based results were the most accurate. They also concluded that anatomical segment counting calculations for resection should be reserved for resection not exceeding lobectomy.…”

“…Many studies in literature have shown a good correlation of the actual postoperative FEV1 with prediction made from perfusion only studies. [ 6 12 18 ] Researchers also evaluated the role of SPECT and SPECT/CT methods in predicting the postoperative lung function. Kovacević-Kuśmierek et al showed that performing planar perfusion scintigraphy is not inferior to tridimensional methods such as SPECT and SPECT/CT in the quantification of split lung function.…”

“…Patients with FEV1 values >1500 ml for lobectomy and 2000 ml for pneumonectomy, or values >80% predicted for gender, age, height, and body mass are considered to have low risk of complications. [ 4 6 ] When the values are below this, it suggests an increased risk of perioperative complications and demands investigations predicting postoperative FEV1 value. [ 7 ] Predicted postoperative FEV1 (PPO FEV1) has been shown to be an independent predictor of perioperative mortality and morbidity.…”

“…[ 8 ] When PPO FEV1 is >800–1000 ml, the risk of complications following surgical resection is considered low. [ 6 9 ] PPO FEV1 <40% predicted is considered high risk for perioperative complications. [ 4 10 ] The assessment of regional lung function forms an integral part of the preoperative evaluation of patients.…”

Generation of ventilation/perfusion ratio map in surgical patients by dual-energy CT after xenon inhalation and intravenous contrast media

“…Pulmonary function test (PFT) using spirometry is the current standard method of evaluating pulmonary function. While many studies have evaluated the change in lung volume before and after lung resection and correlated this with pulmonary function test results [ 1 – 3 ], there is very little evidence on the changes in ventilation perfusion ratio (V/Q) before and after lung resection. This is considered to be at least in part due to the practical difficulty of frequently performing ventilation perfusion scans using radioneuclides, as well as its low spatial resolution.…”