Perfusion scintigraphy in the evaluation for lung volume reduction surgery: correlation with clinical outcome

Radiology. 1997 Oct;205(1):243-8. doi: 10.1148/radiology.205.1.9314992.


Purpose: To identify preoperative pulmonary perfusion scintigraphic findings that might be associated with clinical outcomes after lung volume reduction surgery.

Materials and methods: Preoperative perfusion scintigrams in 103 patients (56 men, 47 women; age range, 41-76 years; mean age, 61 years +/- 9) were reviewed and graded for emphysematous heterogeneity (from isolated areas to diffuse distribution), extent of maximally perfused lung, and lobar predominance (upper-lobe vs lower-lobe asymmetry). These findings were correlated with clinical outcome on the basis of pulmonary function, arterial blood gas levels, and exercise test results before and 6 months after surgery.

Results: Among the 96 patients who survived surgery, there was an average improvement of 47% in the forced expiratory volume in 1 second (FEV1), of 20% in arterial oxygen tension, and of 20% in the 6-minute walking distance. Scintigraphic markers correlated best with FEV1 improvement. The strongest scintigraphic predictor of increase in FEV1 was upper-lobe predominance (r = .38, P < .001), which was followed by heterogeneity (r = .31, P = .002). The seven patients who died had a significantly lower percentage of maximally perfused lung than the survivors (25% vs 34%, P = .004).

Conclusion: Perfusion scintigraphy can provide modest prognostic information in patients who undergo evaluation for lung volume reduction surgery.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung / diagnostic imaging*
  • Lung / surgery*
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Emphysema / diagnostic imaging*
  • Pulmonary Emphysema / physiopathology
  • Pulmonary Emphysema / surgery
  • Radionuclide Imaging
  • Retrospective Studies