Breath-hold single-photon emission tomography and computed tomography for predicting residual pulmonary function in patients with lung cancer.
OBJECTIVE
We sought to evaluate the utility of integrated breath-hold single-photon emission tomography and computed tomography imaging compared with that of simple calculation with the lung segment-counting technique for predicting residual pulmonary function in patients undergoing surgical intervention for lung cancer.


METHODS
A prospective series of 22 patients undergoing anatomic lung resection for cancer were enrolled in this study. Postoperative residual forced expiratory volume in 1 second was predicted by measuring the radioactivity counts of the affected lobes or segments to be resected within the entire lungs by placement of regions of interest on single-photon emission tomography and computed tomography images. Residual forced expiratory volume in 1 second was also estimated by using the segment-counting technique.


RESULTS
Both predicted values agreed well with postoperative forced expiratory volume in 1 second. Although the residual forced expiratory volume in 1 second predicted by means of single-photon emission tomography and computed tomography correlated well with that predicted by using segment counting, the values were significantly underestimated by the segment-counting technique in 4 outliers with severe emphysema. There were 2 patients with borderline pulmonary functional reserve whose residual forced expiratory volume in 1 second values were predicted more accurately by means of single-photon emission tomography and computed tomography than by using segment counting.


CONCLUSIONS
Integrated breath-hold single-photon emission tomography and computed tomography images allow the accurate prediction of postoperative pulmonary function but without statistical superiority over the simple segment-counting technique. Further study of the usefulness of single-photon emission tomography and computed tomography in patients with severe emphysema and borderline lung function should prove valuable because the segment-counting technique underestimates pulmonary functional reserve in these patients.
Sudoh
Manabu
M
Division of Thoracic Surgery, Department of Medical Bioregulation, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Ueda
Kazuhiro
K
Kaneda
Yoshikazu
Y
Mitsutaka
Jinbo
J
Li
Tao-Sheng
TS
Suga
Kazuyoshi
K
Kawakami
Yasuhiko
Y
Hamano
Kimikazu
K