Three-dimensional surface displays of perfusion SPET in the evaluation of patients with pulmonary emphysema for thoracoscopic lung volume reduction surgery.
A modified, three-dimensional display was applied to 99Tcm-macroaggregated albumin (99Tcm-MAA) SPET to help assess the effect of thoracoscopic lung volume reduction surgery (LVRS) on regional lung perfusion. Surface-rendered three-dimensional images for 99Tcm-MAA and xenon-133 (133Xe) equilibrium (EQ) SPET were obtained in 11 patients with pulmonary emphysema before and after LVRS. A single three-dimensional fusion display of both images was then reconstructed, and the perfused lungs were transparently visible through the lung contours delineated by the three-dimensional 133Xe EQ image. The extent of preserved perfusion in the lung (the perfusion index) was estimated using the ratio (%) of the total pixel numbers of the segmented perfusion data to those of the 133Xe lung volume data. The three-dimensional fusion display provided an overview of the distribution of hypoperfusion in the lungs with geometric realism and enhanced the perception of anatomic size and configuration compared with multiple tomograms and three-dimensional perfusion images without superimposition of three-dimensional 133Xe image. Post-operatively, it displayed restored perfusion in the remaining lungs, and changes in the perfusion index correlated with %FEV1 (r = 0.731, P = 0.0001) more closely than the perfusion data alone (r = 0.593, P < 0.01). This method is useful for directing LVRS and assessing its effectiveness, as it provides precise tomographic information on regional perfusion.
Suga
K
K
Department of Radiology, Yamaguchi University School of Medicine, Japan.
Nishigauchi
K
K
Matsunaga
N
N
Kawakami
Y
Y
Kume
N
N
Sugi
K
K
Esato
K
K
D000368:Aged; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D012129:Respiratory Function Tests; D013668:Technetium Tc 99m Aggregated Albumin; D013906:Thoracoscopy; D015899:Tomography, Emission-Computed, Single-Photon; D014980:Xenon Radioisotopes
D013668:Technetium Tc 99m Aggregated Albumin; D014980:Xenon Radioisotopes