Quantitative Dual-Energy CT Perfusion Versus SPECT/CT V/Q Scintigraphy for Preoperative Lung Function Assessment: A...

Area of Science:

• Radiology
• Pulmonary Medicine
• Oncology

Background:

• Accurate preoperative physiological assessment is crucial for high-risk lung resection patients.
• Predicting postoperative lung function aids surgical decision-making.
• Quantitative lobar perfusion mapping is key for this assessment.

Purpose of the Study:

• To compare quantitative dual-energy CT (DECT) perfusion with SPECT/CT for lobar perfusion mapping.
• To evaluate DECT as a potential alternative for preoperative planning in lung resection candidates.
• To assess radiation dose differences between DECT and SPECT/CT.

Main Methods:

• Prospective, single-centre study of 20 high-risk lung resection candidates (FEV1 or DLCO < 80% predicted).
• Both contrast-enhanced DECT and SPECT/CT V/Q were performed.
• Perfusion was quantified for 100 lung lobes; agreement assessed using correlation coefficients and Bland-Altman analysis; effective radiation doses compared.

Main Results:

• DECT perfusion showed strong correlation with SPECT/CT (Pearson's r = 0.94, ICC = 0.93).
• Negligible systematic bias observed, with minor proportional bias where DECT slightly overestimated low-function lobes.
• DECT protocol yielded a statistically significant reduction in mean effective radiation dose (4.42 mSv vs. 4.87 mSv).

Conclusions:

• DECT perfusion imaging closely quantifies lobar function, concordant with SPECT/CT V/Q in high-risk surgical candidates.
• DECT offers potential advantages including superior spatial resolution and reduced radiation exposure.
• DECT shows promise as a resource-efficient alternative for preoperative planning, requiring further validation.