State-of-the-art radiological techniques improve the assessment of postoperative lung function in patients with non-small cell lung cancer.
OBJECTIVE
The purpose of this study was to compare predictive capabilities for postoperative lung function in non-small cell lung cancer (NSCLC) patients of the state-of-the-art radiological methods including perfusion MRI, quantitative CT and SPECT/CT with that of anatomical method (i.e. qualitative CT) and traditional nuclear medicine methods such as planar imaging and SPECT.


METHODS
Perfusion MRI, CT, nuclear medicine study and measurements of %FEV(1) before and after lung resection were performed for 229 NSCLC patients (125 men and 104 women). For perfusion MRI, postoperative %FEV(1) (po%FEV(1)) was predicted from semi-quantitatively assessed blood volumes within total and resected lungs, for quantitative CT, it was predicted from the functional lung volumes within total and resected lungs, for qualitative CT, from the number of segments of total and resected lungs, and for nuclear medicine studies, from uptakes within total and resected lungs. All SPECTs were automatically co-registered with CTs for preparation of SPECT/CTs. Predicted po%FEV(1)s were then correlated with actual po%FEV(1)s, which were measured %FEV(1)s after operation. The limits of agreement were also evaluated.


RESULTS
All predicted po%FEV(1)s showed good correlation with actual po%FEV(1)s (0.83≤r≤0.88, p<0.0001). Perfusion MRI, quantitative CT and SPECT/CT demonstrated better correlation than other methods. The limits of agreement of perfusion MRI (4.4±14.2%), quantitative CT (4.7±14.2%) and SPECT/CT (5.1±14.7%) were less than those of qualitative CT (6.0±17.4%), planar imaging (5.8±18.2%), and SPECT (5.5±16.8%).


CONCLUSIONS
State-of-the-art radiological methods can predict postoperative lung function in NSCLC patients more accurately than traditional methods.
Ohno
Yoshiharu
Y
Department of Radiology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Hyogo, Japan. yoshiharuohno@aol.com
Koyama
Hisanobu
H
Nogami
Munenobu
M
Takenaka
Daisuke
D
Onishi
Yumiko
Y
Matsumoto
Keiko
K
Matsumoto
Sumiaki
S
Maniwa
Yoshimasa
Y
Yoshimura
Masahiro
M
Nishimura
Yoshihiro
Y
Sugimura
Kazuro
K
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000379:methods* / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome