Comparison between lung perfusion scan and single-photon emission computed tomography/computed tomography for predicting postoperative lung function after pulmonary resection in patients with borderline lung function. (3rd September 2020)

• Record Type: Journal Article
• Authors: Na, Kwon Joong; Park, Samina; Lee, Hyun Joo; Park, In Kyu; Kang, Chang Hyun; Kim, Young Tae
• Is Part Of: European journal of cardio-thoracic surgery. Volume 58:Number 6(2020)
• Page Start: 1228
• Page End: 1235
• Publication Date: 2020-09-03
• Subjects: Lung perfusion scan -- Single-photon emission computed tomography -- Predictive postoperative lung function -- Lung resection surgery; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezaa211
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract : Physiological evaluation before pulmonary resection, especially prediction of pulmonary reserve, is important for assessing surgical risk and for evaluating whether a patient can tolerate surgery [1–4]. Abstract: OBJECTIVES: We compared the usefulness of single-photon emission computed tomography/computed tomography (SPECT/CT) and lung perfusion scintigraphy (LPS) for predicting postoperative lung function by comparing patients with borderline lung function. METHODS: A total of 274 patients who underwent simultaneous LPS and SPECT/CT and had a forced expiratory volume in 1 s (FEV1 ) or diffusing capacity for carbon monoxide (DLCO ) under 80% were included. The % uptake by LPS was calculated by the posterior-oblique method. The concordance and difference of the % uptake, predicted postoperative (ppo) FEV1 and ppoDLCO as determined by 2 methods were evaluated. The association between ppo values and actual postoperative FEV1 and DLCO was examined. Subgroup analysis was conducted in redo-operation cases. RESULTS: The % uptake of each lobe, except the right middle lobe, showed fair concordance (concordance correlation coefficients for right upper, middle, lower, left upper and lower lobe = 0.61, 0.37, 0.71, 0.66 and 0.69, respectively). ppoFEV1 and ppoDLCO also revealed high concordance between both methods (concordance correlation coefficient = 0.93 for ppoFEV1 and concordance correlation coefficient = 0.92 for ppoDLCO ) without a significant difference ( P = 0.42 for ppoFEV1 ; P = 0.31 for ppoDLCO ). Both ppoFEV1 and ppoDLCO showed a significantly high correlation with the actual FEV1 ( r = 0.77, P < 0.01 for LPS, r = 0.77, P < 0.01 for SPECT/CT) and DLCO ( r = 0.62, P < 0.01 for LPS, r = 0.62, P < 0.01 for SPECT/CT). High concordance of % uptake, ppoFEV1 and ppoDLCO was present in redo-operation patients. CONCLUSIONS: Both LPS and SPECT/CT showed high predictability for actual postoperative lung function, and LPS showed good performance to estimate ppoFEV1 and ppoDLCO with reference to SPECT/CT, even in redo-operation cases.