Comparison between lung perfusion scan and single-photon emission computed tomography/computed tomography for...

Area of Science:

• Pulmonary Medicine
• Radiology
• Nuclear Medicine

Background:

• Accurate prediction of postoperative lung function is crucial for patients undergoing lung surgery, especially those with borderline lung function.
• Lung perfusion scintigraphy (LPS) and single-photon emission computed tomography/computed tomography (SPECT/CT) are imaging modalities used to assess lung function.

Purpose of the Study:

• To compare the diagnostic usefulness of SPECT/CT and LPS in predicting postoperative lung function in patients with borderline lung function.
• To evaluate the concordance and correlation of predicted postoperative lung function values derived from both imaging techniques with actual postoperative outcomes.

Main Methods:

• A study included 274 patients with forced expiratory volume in 1 second (FEV1) or diffusing capacity for carbon monoxide (DLCO) under 80% who underwent simultaneous LPS and SPECT/CT.
• The percentage uptake by LPS was calculated using the posterior-oblique method.
• Concordance and differences in % uptake, predicted postoperative (ppo) FEV1, and ppoDLCO between LPS and SPECT/CT were evaluated, along with their association with actual postoperative FEV1 and DLCO.

Main Results:

• Fair concordance was observed for the % uptake of individual lung lobes between LPS and SPECT/CT.
• High concordance (concordance correlation coefficient = 0.93 for ppoFEV1, 0.92 for ppoDLCO) and no significant difference were found for ppoFEV1 and ppoDLCO between the two methods.
• Both ppoFEV1 and ppoDLCO derived from LPS and SPECT/CT showed significant high correlations with actual postoperative FEV1 (r=0.77) and DLCO (r=0.62).
• High concordance was also noted in redo-operation patients.

Conclusions:

• Both LPS and SPECT/CT are highly predictive of actual postoperative lung function.
• LPS demonstrates good performance in estimating ppoFEV1 and ppoDLCO, comparable to SPECT/CT, even in patients requiring redo-operations.