SPECT/CT Accurately Predicts Postoperative Lung Function in Patients with Limited Pulmonary Reserve Undergoing...

Area of Science:

• Pulmonary Medicine
• Radiology
• Thoracic Surgery

Background:

• Accurate preoperative prediction of postoperative pulmonary function is crucial for lung cancer patients undergoing anatomical resection.
• Traditional methods for predicting lung function have limitations in accuracy.
• Hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) offers a potential improvement.

Purpose of the Study:

• To compare the accuracy of SPECT/CT with traditional methods (segment counting, planar perfusion scintigraphy) in predicting postoperative pulmonary function.
• To evaluate the utility of SPECT/CT in identifying eligible candidates for anatomical lung resection.

Main Methods:

• Retrospective analysis of 120 patients undergoing major anatomical lung resection.
• Application of segment counting, planar perfusion scintigraphy (PPS), and SPECT/CT for lung function quantification.
• Comparison of predicted postoperative pulmonary function with actual postoperative measurements (FEV1, DLCO).

Main Results:

• SPECT/CT-based quantification showed highly accurate predictions of postoperative FEV1 and DLCO.
• SPECT/CT predicted postoperative lung function more accurately than segment counting or PPS.
• SPECT/CT identified more patients qualifying for anatomical lung resection (58/82) compared to PPS (56/82) and segment counting (47/82).
• SPECT/CT predictions were particularly accurate in emphysema patients, with some showing improved lung function post-surgery.

Conclusions:

• Anatomically driven methods like SPECT/CT provide accurate predictions of postoperative pulmonary function.
• SPECT/CT enhances the identification of patients suitable for lung resection.
• SPECT/CT is recommended as the preferred method for evaluating surgical eligibility in patients with compromised pulmonary function.