Coregistered Ventilation and Perfusion SPECT Using Krypton-81m and Tc-99m−Labeled Macroaggregated Albumin With Multislice CT: Utility for Prediction of Postoperative Lung Function in Non−Small Cell Lung Cancer Patients

Ohno, Yoshiharu; Koyama, Hisanobu; Takenaka, Daisuke; Nogami, Munenobu; Kotani, Yoshikazu; Nishimura, Yoshihiro; Yoshimura, Masahiro; Yoshikawa, Takeshi; Sugimura, Kazuro

doi:10.1016/j.acra.2007.03.013

« Previous Next »Academic Radiology
Volume 14, Issue 7 , Pages 830-838, July 2007

Coregistered Ventilation and Perfusion SPECT Using Krypton-81m and Tc-99m−Labeled Macroaggregated Albumin With Multislice CT:

Utility for Prediction of Postoperative Lung Function in Non−Small Cell Lung Cancer Patients

Yoshiharu Ohno, MD, PhD
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
- Address correspondence to: Y.O.
Hisanobu Koyama, MD
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Daisuke Takenaka, MD
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Munenobu Nogami, MD
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Yoshikazu Kotani, MD
- Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Yoshihiro Nishimura, MD
- Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Masahiro Yoshimura, MD
- Division of Cardiovascular, Thoracic and Pediatric Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Takeshi Yoshikawa, MD
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
- Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Kazuro Sugimura, MD
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan

Received 11 January 2006; accepted 23 March 2007.

Rationale and Objective

Coregistered SPECT and CT imaging (SPECT-CT) has potential for more precise evaluation of regional pulmonary function and may be useful for prediction of postoperative lung function in non−small cell lung cancer (NSCLC) patients. The purpose of the present study was to prospectively assess the capability of coregistered SPECT-CT using krypton-81m (Kr-81m) and technetium-99m−labeled macroaggregated albumin (Tc-99m MAA) for prediction of postoperative lung function of NSCLC patients compared with SPECT and planar imaging.

Materials and Methods

Sixty consecutive patients considered candidates for lung resection underwent 16-slice CT, ventilation and perfusion scintigraphy with SPECT examinations, and preoperative and postoperative measurement of FEV₁%. In each subject, SPECT and CT data were automatically fused by using commercially available software. Each postoperative FEV₁% value was predicted from uptakes of Kr-81m and Tc-99m MAA within total and resected lungs. Then, reproducibility coefficients and the limits of agreement between actual and each predicted postoperative lung function were statistically assessed.

Results

Reproducibility coefficients of SPECT-CT (Kr-81m: 5.1%, Tc-99m MAA: 5.2%) were smaller than those of SPECT and planar image using Kr-81m (SPECT: 7.4%, planar image: 12.1%) and using Tc-99m MAA (SPECT: 7.2%, planar image: 11.8%). The limits of agreement for SPECT-CT (Kr-81m: 3.3 ± 10.5%, Tc-99m MAA: 5.4 ± 11.0%) were also smaller than that of SPECT and planar image and small enough for clinical purposes.

Conclusions

Coregistered SPECT-CT using Kr-81m and Tc-99m MAA was able to more reproducibly and accurately predict postoperative lung function compared with SPECT and planar imaging.

Key Words: Lung, CT, functional imaging, SPECT, lung cancer