[Examination of post operative split lung function using quantitative xenon 133 (133Xe) inhalation scan]

Area of Science:

• Pulmonary Medicine
• Radiology
• Surgical Oncology

Background:

• Pulmonary resection requires accurate preoperative assessment of lung function.
• Predicting postoperative lung function is crucial for patient selection and surgical strategy.
• 133Xe inhalation scans offer detailed regional lung ventilation data.

Purpose of the Study:

• To evaluate the accuracy of predicted postoperative lung function using 133Xe inhalation scans and spirometry.
• To assess changes in lung capacity and ventilation after pulmonary resection.
• To determine the utility of these methods for preoperative surgical planning.

Main Methods:

• 34 patients undergoing pulmonary resection underwent 133Xe inhalation scans and spirometry preoperatively and at 1 and 6 months postoperatively.
• Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1.0) were measured.
• 133Xe scan data provided split lung capacity and T1/2 (ventilation index).

Main Results:

• Predicted FVC and FEV1.0 correlated highly with observed values at 6 months postoperatively (r = 0.895, p < 0.001 and r = 0.897, p < 0.001).
• Operated lung capacity was 80.5% and opposite lung 119.2% at 1 month, normalizing to 111.0% and 96.7% respectively by 6 months.
• Postoperative T1/2 on the operated side was 2.4 times preoperative values at 1 month, recovering by 6 months.

Conclusions:

• 133Xe inhalation scans combined with spirometry provide reliable predictions of postoperative lung function.
• These predictive methods are valuable for preoperative evaluation and surgical decision-making in patients undergoing pulmonary resection.
• Lung function demonstrates significant recovery by six months after surgery.