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

Abstract

Background Predicting postoperative lung function is critical in lung cancer patients. Perfusion scintigraphy has been used to estimate postoperative function after lung resection. Purpose To evaluate the usefulness of the posterior oblique method in relation to other conventional processing methods for predicting postoperative lung function using lung perfusion scintigraphy. Material and Methods Fifty-five patients with non-small-cell lung cancer who underwent lobectomy were enrolled. Forced expiratory volume in 1 s (FEV1) values were obtained from preoperative and postoperative pulmonary function tests. After performing lung perfusion scintigraphy, predicted FEV1 values were calculated using the segment, conventional, posterior, and posterior oblique methods. Postoperative FEV1 values were compared with predicted FEV1 values. Results The mean value of the preoperative FEV1 was 2.29 L and that of the postoperative FEV1 was 1.89 L. The mean values of the predicted postoperative FEV1 values for the segment, conventional, posterior, and posterior oblique were 1.83 L, 1.94 L, 1.88 L, and 1.89 L, respectively. Between the observed and predicted FEV1 values, there was a strong correlation without significant difference except for conventional method. Bland-Altman analysis showed that segment and posterior methods underestimated the FEV1, whereas conventional and posterior oblique methods overestimated the FEV1. Conclusion Predictions with each processing method of lung perfusion scintigraphy showed nearly similar results to the actual postoperative lung function. The posterior oblique method of lung perfusion scintigraphy showed a very small difference to such an extent as to be equal to the observed FEV1, implying that this method may be applied for predicting postoperative lung function in lung cancer patients.

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

“…The posterior oblique view reflected the lobar anatomy more precisely than conventional anteroposterior images. [ 21 ] With the widespread availability of hybrid machines, it is now possible to combine radionuclide SPECT imaging techniques with the quantitative CT perfusion techniques. This technique can be successfully used to examine the zone-wise distribution of perfusion defect and to estimate the function of the remaining normally perfused lung parenchyma.…”

Pemeriksaan Radionuklir Pada Penyakit Paru

“…LPS dengan metode posterior oblik dapat memprediksi fungsi paru pada pasien kanker paru yang telah dilakukan reseksi paru. (Win et al, 2006;Yoo et al, 2019) Ventilasi perfusi PET/CT dengan radioisotop 68Ga juga digunakan untuk menilai fungsi paru pada pasien kanker paru yang akan dilakukan operasi. Pasien kanker paru secara umum adalah perokok atau bekas perokok sehingga akan menyebabkan terjadinya PPOK yang akan meningkatkan risiko setelah operasi seperti meninggal saat dioperasi atau peningkatan sesak setelah dioperasi, dengan menggunakan V/Q PET ini kita bisa memprediksi fungsi paru regional pada pasien kanker paru sebelum dilakukan operasi untuk menjelaskan prognosis dan komplikasi yang akan terjadi setelah dioperasi.…”