Prediction of post-operative cardiopulmonary function using perfusion scintigraphy in patients with bronchogenic carcinoma.
Both ventilation and perfusion scintigraphy are accurate predictors of post-operative ventilatory function. Previous attempts to predict post-operative exercise capacity after lung resection using radioisotope scintigraphy are few and results are conflicting. We studied 32 patients before and 6 months after pulmonary resection for bronchogenic carcinoma to assess the value of lung perfusion scintigraphy for the prediction of post-operative forced lung volumes and parameters on maximum exercise, including maximum ventilation and maximum oxygen uptake. Nine patients were lost to follow-up, and these patients differed from the reinvestigated patients only in the staging of the pulmonary carcinoma and not in preoperative lung function or exercise capacity. We found a clear relationship between the values predicted from a preoperative perfusion scintigraphy, spirometry and a maximum exercise study and the observed values measured 6 months post-operatively. The method underestimated the post-operative values of both spirometric and exercise measurements, especially in the higher range. Only in a few cases were the post-operative observed values less than the predicted values, and in these cases the difference was without clinical significance. Unexpected post-operative respiratory insufficiency was not observed. In conclusion, in patients in whom a pulmonary resection was performed, not only the post-operative spirometric values, but also the more functional related maximum exercise data can be predicted through the knowledge of a preoperative perfusion scintigraphy.
Larsen
K R
KR
Department of Pulmonary Medicine, Gentofte Hospital, University of Copenhagen, Denmark.
Lund
J O
JO
Svendsen
U G
UG
Milman
N
N
Petersen
B N
BN
D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000601:surgery*; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000502:physiology; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D011013:Pneumonectomy; D011184:Postoperative Period; D011379:Prognosis; D011877:Radionuclide Imaging; D015656:Respiratory Mechanics; D013147:Spirometry