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Prediction of postoperative lung function in patients with lung cancer: comparison of quantitative CT with perfusion scintigraphy.
Prediction of postoperative lung function in patients with lung cancer: comparison of quantitative CT with perfusion scintigraphy.
- Source :
-
AJR. American journal of roentgenology [AJR Am J Roentgenol] 2002 Mar; Vol. 178 (3), pp. 667-72. - Publication Year :
- 2002
-
Abstract
- Objective: Prediction of postoperative lung function is important in preoperative evaluation of patients with lung cancer. Perfusion scintigraphy is the current method to assess the fractional contribution of lung function of the remaining lung. We developed a quantitative CT method and compared it with perfusion scintigraphy for predictions of postoperative forced expiratory volume in 1 sec (FEV1) in patients with lung cancer.<br />Subjects and Methods: Forty-four patients with lung cancer undergoing lung resection with preoperative CT and perfusion scintigraphy were enrolled. Quantitative CT used a dual threshold (-500 and -910 H) on standard preoperative CT to semiautomatically extract lung volume without emphysema or tumor and atelectasis, which we defined as "functional lung volume." Prediction was calculated from preoperative FEV1 multiplied by the fractional contribution of functional lung volume of the remaining lung by quantitative CT. Perfusion scintigraphy was the standard method. Predictions were correlated with postoperatively measured FEV1.<br />Results: Both quantitative CT and perfusion scintigraphy predicted postoperative FEV1 well in patients who underwent pneumonectomy (n = 28, r = 0.88 vs r = 0.86) and in lobectomy (n = 16, r = 0.90 vs r = 0.80) (both, p < 0.001). There was good agreement between the two methods by the Bland-Altman method. In the four patients with low measured postoperative FEV1 (<40% predicted normal), quantitative CT had true-positive prediction in four and perfusion scintigraphy, in only two.<br />Conclusion: Given its simplicity, we proposed that quantitative CT be widely used in predicting postoperative FEV1.
- Subjects :
- Carcinoma, Non-Small-Cell Lung diagnostic imaging
Carcinoma, Non-Small-Cell Lung physiopathology
Contrast Media
Forced Expiratory Volume
Humans
Linear Models
Lung Neoplasms diagnostic imaging
Lung Neoplasms physiopathology
Lung Volume Measurements
Predictive Value of Tests
Radionuclide Imaging
Radiopharmaceuticals
Sensitivity and Specificity
Spirometry
Technetium Tc 99m Aggregated Albumin
Carcinoma, Non-Small-Cell Lung surgery
Lung diagnostic imaging
Lung Neoplasms surgery
Pneumonectomy
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 0361-803X
- Volume :
- 178
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- AJR. American journal of roentgenology
- Publication Type :
- Academic Journal
- Accession number :
- 11856695
- Full Text :
- https://doi.org/10.2214/ajr.178.3.1780667