The use of SPECT in preoperative assessment of patients with lung cancer

Perfusion scintigraphy is the most frequently used method for the regional assessment of pulmonary function in candidates for pulmonary resection with borderline respiratory function. This method provides two-dimensional images, and it considers all the segments of the pulmonary lobes as having the same volume and function, without considering the spatial overlapping of pulmonary areas with different function. As single-photon emission computed tomography (SPECT) provides tomographic imaging, this could be a more precise method for regional assessment. In this study, the postoperative predicted forced expiratory volume in one second (FEV1) (FEV1,ppo) was calculated in 26 patients with lung cancer using FEV1, quantitative lung perfusion scan with planar acquisition (PA) and quantitative lung perfusion scan with tomographic imaging (SPECT). The estimated FEV1,ppo values obtained using both methods were compared with FEV1 values measured after surgery (mean: 48+/-44 days; range: 15-180 days; median: 32 days). The Pearson's linear correlation coefficient was 0.8840 for FEV1,ppo estimated by PA and 0.8791 for FEV1,ppo estimated by SPECT. The linear correlation coefficient for lobectomy was greater than the coefficient for pneumonectomy using both methods. In conclusion, both methods show good correlation for real postoperative pulmonary function without demonstrating single-photon emission computed tomography superiority over planar acquisition, and both methods were more effective for estimating postoperative predicted forced expiratory volume in one second in lobectomies than in pneumonectomies.