Comparison of Two Different Segmentation Methods on Planar Lung Perfusion Scan with Reference to Quantitative Value...

Area of Science:

• Nuclear Medicine
• Pulmonary Function Testing
• Medical Imaging Analysis

Background:

• Standardized regional segmentation for planar lung perfusion scans is lacking.
• Planar lung perfusion scans are crucial for preoperative assessment in lung cancer patients.
• Comparison with SPECT/CT provides a more accurate reference for planar scan analysis.

Purpose of the Study:

• To compare two frequently used Society of Nuclear Medicine planar lung perfusion scan segmentation methods (posterior oblique and anterior-posterior).
• To evaluate these methods against lung perfusion SPECT/CT derived values in lung cancer patients.
• To assess the accuracy of predicted postoperative lung function (ppoFEV1%) derived from planar methods.

Main Methods:

• Fifty-five lung cancer patients underwent planar lung perfusion scans and SPECT/CT after Tc-99m-MAA injection.
• Comparison of % uptake and ppoFEV1% between posterior oblique (PO) and anterior-posterior (AP) planar methods versus SPECT/CT.
• Statistical analyses included concordance, paired comparison, reproducibility, and Spearman correlation.

Main Results:

• The PO method demonstrated higher concordance with SPECT/CT for lobar % uptake compared to the AP method.
• Both planar methods showed significantly different lobar % uptake distributions compared to SPECT/CT.
• The PO method showed higher concordance but lower reproducibility for ppoFEV1% compared to the AP method, with SPECT/CT correlating best with actual postoperative FEV1%.

Conclusions:

• The PO method offers better concordance with SPECT/CT for planar lung perfusion scan analysis than the AP method.
• Significant differences in lobar distribution exist between planar methods and SPECT/CT.
• Clinical practice should consider method- and lobe-specific differences for accurate postoperative lung function prediction.