Coregistered ventilation and perfusion SPECT using krypton-81m and Tc-99m-labeled macroaggregated albumin with multislice CT utility for prediction of postoperative lung function in non-small cell lung cancer patients.
OBJECTIVE
Co-registered SPECT and CT imaging (SPECT-CT) has potential for more precise evaluation of regional pulmonary function and may be useful for prediction of postoperative lung function in non-small cell lung cancer (NSCLC) patients. The purpose of the present study was to prospectively assess the capability of co-registered SPECT-CT using krypton-81m (Kr-81m) and technetium-99m-labeled macroaggregated albumin (Tc-99m MAA) for prediction of postoperative lung function of NSCLC patients compared with SPECT and planar imaging.


METHODS
Sixty consecutive patients considered candidates for lung resection underwent 16-slice CT, ventilation and perfusion scintigraphy with SPECT examinations, and preoperative and postoperative measurement of FEV(1)%. In each subject, SPECT and CT data were automatically fused by using commercially available software. Each postoperative FEV(1)% value was predicted from uptakes of Kr-81m and Tc-99m MAA within total and resected lungs. Then, reproducibility coefficients and the limits of agreement between actual and each predicted postoperative lung function were statistically assessed.


RESULTS
Reproducibility coefficients of SPECT-CT (Kr-81m: 5.1%, Tc-99m MAA: 5.2%) were smaller than those of SPECT and planar image using Kr-81m (SPECT: 7.4%, planar image: 12.1%) and using Tc-99m MAA (SPECT: 7.2%, planar image: 11.8%). The limits of agreement for SPECT-CT (Kr-81m: 3.3 +/- 10.5%, Tc-99m MAA: 5.4 +/- 11.0%) were also smaller than that of SPECT and planar image and small enough for clinical purposes.


CONCLUSIONS
Co-registered SPECT-CT using Kr-81m and Tc-99m MAA was able to more reproducibly and accurately predict postoperative lung function compared with SPECT and planar imaging.
Ohno
Yoshiharu
Y
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. yosirad@kobe-u.ac.jp
Koyama
Hisanobu
H
Takenaka
Daisuke
D
Nogami
Munenobu
M
Kotani
Yoshikazu
Y
Nishimura
Yoshihiro
Y
Yoshimura
Masahiro
M
Yoshikawa
Takeshi
T
Sugimura
Kazuro
K
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007472:Iohexol; D007727:Krypton Radioisotopes; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008175:Lung Neoplasms / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013668:Technetium Tc 99m Aggregated Albumin; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007727:Krypton Radioisotopes; D013668:Technetium Tc 99m Aggregated Albumin; D007472:Iohexol