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

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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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Authors and Affiliations

  1. Department of Nuclear Medicine, Hacettepe University Medical Faculty, Sihhiye, 06100, Ankara, Turkey

    Meltem Caglar, Tamer Aksoy & Pinar Ozgen Kiratli

  2. Department of General Thoracic Surgery, Hacettepe University Medical Faculty, Ankara, Turkey

    Murat Kara & Rıza Dogan

  3. Department of Biostatistics, Hacettepe University Medical Faculty, Ankara, Turkey

    Erdem Karabulut

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  1. Meltem Caglar
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  2. Murat Kara
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Correspondence to Meltem Caglar.

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Caglar, M., Kara, M., Aksoy, T. et al. Is the predicted postoperative FEV1 estimated by planar lung perfusion scintigraphy accurate in patients undergoing pulmonary resection? Comparison of two processing methods. Ann Nucl Med 24, 447–453 (2010). https://doi.org/10.1007/s12149-010-0378-6

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  • DOI: https://doi.org/10.1007/s12149-010-0378-6

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