Prediction of pulmonary function after lung lobectomy by subsegments counting, computed tomography, single photon...

The aim of the present study was to determine the optimal method of predicting postoperative pulmonary function (PPF) after lung lobectomy.

The forced expiratory volume in 1s (FEV(1)) was measured in 37 patients before and after lobectomy, and the following three methods of predicting the PPF were evaluated: (1) the number of functioning subsegments to be resected were counted (subsegments counting [SC]); (2) the volume of the functioning lung was calculated using CT images (quantitative CT); and (3) perfusion scintigraphy was performed using co-registered single photon emission computed tomography and CT imaging (SPECT/CT). The FEV(1) values predicted using these three methods were then compared with the measured postoperative FEV(1), and the correlations and differences were analyzed.

While a paired t-test showed the SPECT/CT method to have the smallest difference between the measured and the predicted FEV(1) values (0.05 l, p=0.33), followed by the quantitative CT method (0.07 l, p=0.07), and finally the SC method (0.15 l, p<0.001), the difference between the two values was not significantly different between the quantitative CT and SPECT/CT method (p=0.22).

While the SC method is inferior to both the quantitative CT and the SPECT/CT methods for predicting the PPF after lobectomy, the latter two methods are almost equally accurate.