Perfusion Lung Scintigraphy for the Prediction of Postlobectomy Residual Pulmonary Function

Chest. 1997 Jun;111(6):1542-7. doi: 10.1378/chest.111.6.1542.

Abstract

Study objectives: Scintigraphic prediction of the residual pulmonary function following a lobectomy is not widely employed; its accuracy is poorly known. This study aims at determining the accuracy and the clinical value of the scintigraphic prediction of postlobectomy residual function.

Patients and interventions: In this study, 41 patients with bronchial carcinoma underwent a perfusion lung scintigraphy before lobectomy; the functional contribution of each single lobe was computed by an indirect method proposed by Wernly et al.; the results of the scintigraphic prediction were compared with those of the pulmonary function tests performed 1 month after surgery.

Measurements and results: The linear regression analyses of predicted and observed values of FVC and FEV1 showed significant correlations (R2=0.607 and 0.749, respectively); however, an evident scatter of data was obtained, as quantified by the values of imprecision (20.70% and 18.11%, respectively) and global inaccuracy (25.50% and 22.90%, respectively). The estimates of both FVC and FEV1 were significantly better in right lung lobectomies than in left lung lobectomies (mean imprecision and global inaccuracy: 15.43% and 14.94% for the right lung, and 27.27% and 29.00% for the left lung).

Conclusions: The scintigraphic prediction of postlobectomy residual function is easily implemented by the method herein employed; it has a greater margin of uncertainty than that of pneumonectomy, especially for left lobectomies; however, the use of some safety thresholds for predicted values of FEV1 (1.2 L for upper lobectomies and 1 L for lower lobectomies) guarantees a safe clinical use of the test.

Publication types

  • Comparative Study

MeSH terms

  • Carcinoma, Bronchogenic / diagnostic imaging
  • Carcinoma, Bronchogenic / physiopathology
  • Carcinoma, Bronchogenic / surgery
  • Feasibility Studies
  • Forced Expiratory Volume
  • Humans
  • Linear Models
  • Lung / diagnostic imaging*
  • Lung / physiopathology*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / surgery
  • Pneumonectomy*
  • Postoperative Period
  • Prognosis
  • Radionuclide Imaging
  • Technetium Tc 99m Aggregated Albumin
  • Vital Capacity

Substances

  • Technetium Tc 99m Aggregated Albumin