Accuracy and precision of perfusion lung scintigraphy versus 133Xe-radiospirometry for preoperative pulmonary functional assessment of patients with lung cancer.
OBJECTIVE
This study sought to determine whether (133)Xe-radiospirometry (XRS) successfully selects patients able to undergo lung resection without postoperative respiratory complications and whether perfusion lung scintigraphy (PLS) is likely to provide a similar selection of patients for certain tumour stages.


METHODS
Two hundred and eighty-four patients with resectable lung cancer underwent preoperative assessment of postoperative forced expiratory volume in 1 s (FEV(1)) by XRS and PLS. Correlations, Bland and Altman analysis and contingency tables were used to analyse the difference between the two predictive techniques.


RESULTS
One hundred and sixty patients underwent lung resection on the basis of XRS preoperative testing only. None of them developed respiratory insufficiency. Despite a close correlation, the limits of agreement between predicted FEV(1) by XRS and PLS exceeded +/-0.3 l/s. For tumour stages T1Nx and T2N0, PLS underestimated postoperative FEV(1) whereas it overestimated this parameter for stage III.


CONCLUSIONS
XRS accurately selects patients able to undergo lung resection without postoperative pulmonary insufficiency. The agreement between XRS and PLS is unacceptable. When only PLS is available, higher thresholds for patients with stage III cancers and lower thresholds for those with stage I cancers should be used to decide on operability.
Mariano-Goulart
Denis
D
Department of Nuclear Medicine, Montpellier University Hospital, Montpellier, France. d-mariano_goulart@chu-montpellier.fr
Barbotte
Eric
E
Basurko
Célia
C
Comte
F
F
Rossi
Michel
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D012129:Respiratory Function Tests / Q000379:methods* / Q000706:statistics & numerical data; D013147:Spirometry / Q000379:methods* / Q000706:statistics & numerical data; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes