Prediction of pulmonary function after lung lobectomy by subsegments counting, computed tomography, single photon emission computed tomography and computed tomography: a comparative study.
OBJECTIVE
The aim of the present study was to determine the optimal method of predicting postoperative pulmonary function (PPF) after lung lobectomy.


METHODS
The forced expiratory volume in 1s (FEV(1)) was measured in 37 patients before and after lobectomy, and the following three methods of predicting the PPF were evaluated: (1) the number of functioning subsegments to be resected were counted (subsegments counting [SC]); (2) the volume of the functioning lung was calculated using CT images (quantitative CT); and (3) perfusion scintigraphy was performed using co-registered single photon emission computed tomography and CT imaging (SPECT/CT). The FEV(1) values predicted using these three methods were then compared with the measured postoperative FEV(1), and the correlations and differences were analyzed.


RESULTS
While a paired t-test showed the SPECT/CT method to have the smallest difference between the measured and the predicted FEV(1) values (0.05 l, p=0.33), followed by the quantitative CT method (0.07 l, p=0.07), and finally the SC method (0.15 l, p<0.001), the difference between the two values was not significantly different between the quantitative CT and SPECT/CT method (p=0.22).


CONCLUSIONS
While the SC method is inferior to both the quantitative CT and the SPECT/CT methods for predicting the PPF after lobectomy, the latter two methods are almost equally accurate.
Yoshimoto
Kentaro
K
Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan.
Nomori
Hiroaki
H
Mori
Takeshi
T
Kobayashi
Hironori
H
Ohba
Yasuomi
Y
Shibata
Hidekatsu
H
Shiraishi
Shinya
S
Kobayashi
Toshiaki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D021621:Imaging, Three-Dimensional; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals