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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 6/2010

01-07-2010 | Original Article

Is the predicted postoperative FEV1 estimated by planar lung perfusion scintigraphy accurate in patients undergoing pulmonary resection? Comparison of two processing methods

Authors: Meltem Caglar, Murat Kara, Tamer Aksoy, Pinar Ozgen Kiratli, Erdem Karabulut, Rıza Dogan

Published in: Annals of Nuclear Medicine | Issue 6/2010

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Abstract

Background

Estimation of postoperative forced expiratory volume in 1 s (FEV1) with radionuclide lung scintigraphy is frequently used to define functional operability in patients undergoing lung resection. We conducted a study to outline the reliability of planar quantitative lung perfusion scintigraphy (QLPS) with two different processing methods to estimate the postoperative lung function in patients with resectable lung disease.

Methods

Forty-one patients with a mean age of 57 ± 12 years who underwent either a pneumonectomy (n = 14) or a lobectomy (n = 27) were included in the study. QLPS with Tc-99m macroaggregated albumin was performed. Both three equal zones were generated for each lung [zone method (ZM)] and more precise regions of interest were drawn according to their anatomical shape in the anterior and posterior projections [lobe mapping method (LMM)] for each patient. The predicted postoperative (ppo) FEV1 values were compared with actual FEV1 values measured on postoperative day 1 (pod1 FEV1) and day 7 (pod 7 FEV1).

Results

The mean of preoperative FEV1 and ppoFEV1 values was 2.10 ± 0.57 and 1.57 ± 0.44 L, respectively. The mean of Pod1FEV1 (1.04 ± 0.30 L) was lower than ppoFEV1 (p < 0.0001) but increased on day 7 (1.31 ± 0.32 L) (p < 0.0001); however, it never reached the predicted values. Zone and LMMs estimated mean ppoFEV1 as 1.56 ± 0.45 and 1.57 ± 0.44 L, respectively. Both methods overestimated the actual value by 50% (ZM), 51% (LMM) and 19% (ZM), 20% (LMM) for pod 1 and pod 7, respectively. This overestimation was more pronounced in patients with chronic lung disease and hilar tumors. No significant differences were observed between ppoFEV1 values estimated by ZM or by LMM (p > 0.05).

Conclusions

PpoFEV1 values predicted by both the zone and LMMs overestimated the actual measured lung volumes in patients undergoing pulmonary resection in the early postoperative period. LMM is not superior to ZM.
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Metadata
Title
Is the predicted postoperative FEV1 estimated by planar lung perfusion scintigraphy accurate in patients undergoing pulmonary resection? Comparison of two processing methods
Authors
Meltem Caglar
Murat Kara
Tamer Aksoy
Pinar Ozgen Kiratli
Erdem Karabulut
Rıza Dogan
Publication date
01-07-2010
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 6/2010
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-010-0378-6

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