open access

Vol 18, No 2 (2015)
Original articles
Published online: 2015-07-31
Submitted: 2015-07-31
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Perfusion lung scintigraphy for the prediction of postoperative residual pulmonary function in patients with lung cancer

Katarzyna Kovacević-Kuśmierek, Józef Kozak, Łukasz Pryt, Małgorzata Bieńkiewicz, Paweł Cichocki, Jacek Kuśmierek, Anna Płachcińska
DOI: 10.5603/NMR.2015.0018
·
Pubmed: 26315866
·
Nucl. Med. Rev 2015;18(2):70-77.

open access

Vol 18, No 2 (2015)
Original articles
Published online: 2015-07-31
Submitted: 2015-07-31

Abstract

BACKGROUND: Accurate prediction of postoperative pulmonary function in patients with non-small cell lung cancer is crucial for proper qualification for surgery, the only effective therapeutic method. The aim of the study was to select the most accurate method for acquisition and processing of lung perfusion scintigraphy (LPS) combined with spirometry for prediction of postoperative pulmonary function in patients qualified for surgery.

MATERIAL AND METHODS: LPS was performed in 70 patients (40 males, 30 females), with preoperative spirometry (mean FEV1preop = 2.26 ± 0.72 L), after administration of 185 MBq of 99mTc-microalbumin/macroaggregate, using planar (appa) and SPECT/CT methods. Predicted postoperative lung function (FEV1pred) was calculated as a part of active lung parenchyma to remain after surgery. A non-imaging segment counting method was also applied. FEV1pred(appa, SPECT, SPECT/CT, segm.) were further compared with actual FEV1postop values obtained from postoperative spirometry.

RESULTS: In the whole studied group (47 lobectomies, 23 pneumonectomies) mean value of FEV1postop was equal to 1.76 (± 0.56) L. FEV1pred(appa, SPECT, SPECT/CT, segm.) were equal to 1.75 (± 0.58) L, 1.71 (± 0.57) L, 1.72 (± 0.57) L and 1.57 (± 0.58) L, respectively. A segment counting method systematically lowered predicted FEV1 values (p < 10–5). Moreover, in 31 patients with FEV1preop < 2 L error of predicted values was assessed with Bland-Altman method. Mean absolute differences FEV1postop – FEV1pred amounted to: appa — (0.04 ± 0.13) L, SPECT — (0.07 ± 0.14) L, SPECT/CT — (0.06 ± 0.14) L and segm. — (0.21 ± 0.19) L, respectively. Lower limit of 95% confidence interval calculated for planar — optimal method, was equal to –220 mL (also determined separately in subgroups after lobectomy and pneumonectomy).

CONCLUSIONS: 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.

Abstract

BACKGROUND: Accurate prediction of postoperative pulmonary function in patients with non-small cell lung cancer is crucial for proper qualification for surgery, the only effective therapeutic method. The aim of the study was to select the most accurate method for acquisition and processing of lung perfusion scintigraphy (LPS) combined with spirometry for prediction of postoperative pulmonary function in patients qualified for surgery.

MATERIAL AND METHODS: LPS was performed in 70 patients (40 males, 30 females), with preoperative spirometry (mean FEV1preop = 2.26 ± 0.72 L), after administration of 185 MBq of 99mTc-microalbumin/macroaggregate, using planar (appa) and SPECT/CT methods. Predicted postoperative lung function (FEV1pred) was calculated as a part of active lung parenchyma to remain after surgery. A non-imaging segment counting method was also applied. FEV1pred(appa, SPECT, SPECT/CT, segm.) were further compared with actual FEV1postop values obtained from postoperative spirometry.

RESULTS: In the whole studied group (47 lobectomies, 23 pneumonectomies) mean value of FEV1postop was equal to 1.76 (± 0.56) L. FEV1pred(appa, SPECT, SPECT/CT, segm.) were equal to 1.75 (± 0.58) L, 1.71 (± 0.57) L, 1.72 (± 0.57) L and 1.57 (± 0.58) L, respectively. A segment counting method systematically lowered predicted FEV1 values (p < 10–5). Moreover, in 31 patients with FEV1preop < 2 L error of predicted values was assessed with Bland-Altman method. Mean absolute differences FEV1postop – FEV1pred amounted to: appa — (0.04 ± 0.13) L, SPECT — (0.07 ± 0.14) L, SPECT/CT — (0.06 ± 0.14) L and segm. — (0.21 ± 0.19) L, respectively. Lower limit of 95% confidence interval calculated for planar — optimal method, was equal to –220 mL (also determined separately in subgroups after lobectomy and pneumonectomy).

CONCLUSIONS: 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.

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Keywords

carcinoma, lung, perfusion imaging, pneumonectomy, scintigraphy, SPECT

About this article
Title

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

Journal

Nuclear Medicine Review

Issue

Vol 18, No 2 (2015)

Pages

70-77

Published online

2015-07-31

DOI

10.5603/NMR.2015.0018

Pubmed

26315866

Bibliographic record

Nucl. Med. Rev 2015;18(2):70-77.

Keywords

carcinoma
lung
perfusion imaging
pneumonectomy
scintigraphy
SPECT

Authors

Katarzyna Kovacević-Kuśmierek
Józef Kozak
Łukasz Pryt
Małgorzata Bieńkiewicz
Paweł Cichocki
Jacek Kuśmierek
Anna Płachcińska

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