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Prediction of pulmonary function after lung lobectomy by subsegments counting, computed tomography, single photon emission computed tomography and computed tomography: a comparative study

^a Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan
^b Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan
^c Department of Assistive Diagnostic Technology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, 104-0045 Tokyo, Japan

Received 13 August 2008; received in revised form 20 October 2008; accepted 21 October 2008.

^_* Corresponding author. Tel.: +81 96 373 5533; fax: +81 96 373 5532. (Email: hnomori{at}kumamoto-u.ac.jp).

Objective: The aim of the present study was to determine the optimal method of predicting postoperative pulmonary function (PPF) after lung lobectomy. Methods: The forced expiratory volume in 1 s (FEV₁) was measured in 37 patients before and after lobectomy, and the following three methods of predicting the PPF were evaluated: (1) the number of functioning subsegments to be resected were counted (subsegments counting [SC]); (2) the volume of the functioning lung was calculated using CT images (quantitative CT); and (3) perfusion scintigraphy was performed using co-registered single photon emission computed tomography and CT imaging (SPECT/CT). The FEV₁ values predicted using these three methods were then compared with the measured postoperative FEV₁, and the correlations and differences were analyzed. Results: While a paired t-test showed the SPECT/CT method to have the smallest difference between the measured and the predicted FEV₁ values (0.05 l, p = 0.33), followed by the quantitative CT method (0.07 l, p = 0.07), and finally the SC method (0.15 l, p < 0.001), the difference between the two values was not significantly different between the quantitative CT and SPECT/CT method (p = 0.22). Conclusions: While the SC method is inferior to both the quantitative CT and the SPECT/CT methods for predicting the PPF after lobectomy, the latter two methods are almost equally accurate.

Key Words: Computed tomography • Single photon emission computed tomography • Pulmonary function • Surgery • Lung cancer