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Updated: Jul 15, 2026
Phase-Resolved Functional Lung MRI for Pulmonary Ventilation and Perfusion (V/Q) Assessment
Published on: August 9, 2024
Association of lung perfusion single-photon emission computed tomography (SPECT) with postoperative lung function
Lucas Wilhelm1, Saifeddine Melki1, Laetitia Imbert1,2,3
1Department of Nuclear Medicine, CHRU Nancy, Vandœuvre-lès-Nancy, France.
Background:
Lung perfusion scintigraphy is helpful for predicting a decrease in lung function after lobectomy; however, little is known after segmentectomy. Our study aimed to evaluate the performance of perfusion single-photon emission computed tomography with computed tomography (SPECT/CT) for predicting significantly decreased lung function after segmentectomy.
Methods:
This retrospective observational cohort study included consecutive patients who underwent lung perfusion scintigraphy, recorded using 360° semiconductor SPECT/CT, before a planned segmentectomy for lung nodules. The difference in forced expiratory volume in one second (FEV1) from the presurgery measurement to the 6-month follow-up was predicted using presurgical lung perfusion SPECT/CT, in addition to clinical factors, presurgical pulmonary function tests, lung CT and anatomical segment counting methods. A minimal clinically important difference (MCID) of 100 milliliters in the FEV1 was used.
Results:
This study included 51 patients [aged 67.0 years (IQR: 60-72)], 21 women, 1 segment resected (IQR: 1-2) who were referred for lung SPECT/CT before segmentectomy. Twenty-three (45%) experienced a functional decrease after 6 months that met the MCID threshold. Lung perfusion SPECT/CT was the only multivariate predictor of the change in the 6-month FEV1 (beta-coefficient 1.532, 95% CI: 0.757-2.308, P<0.001) and of a decrease in FEV1 corresponding to the MCID threshold (odds ratio <0.001, 95% CI: <0.001-0.052, P=0.004). The SPECT-based lung perfusion prediction of a decrease in the FEV1 of more than 192 mL had a sensitivity of 83% and a specificity of 64% for predicting an actual 6-month MCID decrease.
Conclusions:
A post-segmentectomy decrease in lung function was significantly associated with segmental lung perfusion using lung perfusion SPECT.
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