Comparison of Predicted Postoperative Lung Function in Pneumonectomy Using Computed Tomography and Lung Perfusion Scans

Abstract

Background Predicting postoperative lung function after pneumonectomy is essential. We retrospectively compared postoperative lung function to predicted postoperative lung function based on computed tomography (CT) volumetry and perfusion scintigraphy in patients who underwent pneumonectomy. Methods Predicted postoperative lung function was calculated based on perfusion scintigraphy and CT volumetry. The predicted function was compared to the postoperative lung function in terms of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1 ), using 4 parameters FVC, FVC%, FEV 1 , and FEV 1 %. Results The correlations between postoperative function and predicted function based on CT volumetry were r=0.632 (p=0.003) for FVC% and r=0.728 (p<0.001) for FEV 1 %. The correlations between postoperative function and predicted postoperative function based on perfusion scintigraphy were r=0.654 (p=0.002) for FVC% and r=0.758 (p<0.001) for FEV 1 %. The preoperative Eastern Cooperative Oncology Group (ECOG) scores were significantly higher in the group in which the gap between postoperative FEV 1 and predicted postoperative FEV 1 analyzed by CT was smaller than the gap analyzed by perfusion scintigraphy (1.2±0.62 vs. 0.4±0.52, p=0.006). Conclusion This study affirms that CT volumetry can replace perfusion scintigraphy for preoperative evaluation of patients needing pneumonectomy. In particular, it was found to be a better predictor of postoperative lung function for poor-performance patients (i.e., those with high ECOG scores).

Rapid Recovery of Postoperative Pulmonary Function in Patients With Lung Cancer and Influencing Factors

“…Hence, the preoperative measurement of pulmonary function and calculation of predicted postoperative values can be instrumental in effectively evaluating surgical feasibility and predicting postoperative pulmonary function recovery and pulmonary complications. There are several ways to predict postoperative lung function, including counting residual lung lobes, perfusion scintillation to calculate residual lung function, or imaging to calculate the area ( 8 ). The American College of Chest Physician’s evidence-based clinical practice guidelines (3rd edition) recommend the use of perfusion to calculate and predict lung function, using the following formulas:…”