Academic Radiology
Volume 17, Issue 5 , Pages 607-613, May 2010

Predicting Postoperative FEV1 Using Spiral Computed Tomography

  • Cory M. Yamashita, MD

      Affiliations

    • Division of Respirology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • Lawson Health Research Institute, 268 Grosvenor Street, Room E5-102, London, ON N6A 4V2, Canada
    • Corresponding Author InformationAddress correspondence to: C.M.Y.
    • ,
  • Jonathan Langridge, MD

      Affiliations

    • Division of Respirology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Christopher A. Hergott, MD

      Affiliations

    • Division of Respirology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Richard I. Inculet, MD

      Affiliations

    • Division of Thoracic Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Richard A. Malthaner, MD

      Affiliations

    • Division of Thoracic Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Michael S. Lefcoe, MD

      Affiliations

    • Division of Radiology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Sanjay Mehta, MD

      Affiliations

    • Division of Respirology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Jeffery L. Mahon, MD

      Affiliations

    • Division of Endocrinology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
    • ,
  • Ting Y. Lee, PhD

      Affiliations

    • Robarts Research Institute, London, ON, Canada
    • ,
  • David G. McCormack, MD

      Affiliations

    • Division of Respirology, London Health Sciences Centre, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada

Received 28 October 2009; accepted 6 January 2010. published online 02 March 2010.

Rationale and Objectives

Lung resection for primary bronchogenic carcinoma in the setting of chronic obstructive pulmonary disease often requires a detailed assessment of lung function to avoid perioperative complications and long-term disability. The aim of this study was to test the hypothesis that a novel technique of spiral computed tomographic (CT) subtraction imaging provides accuracy equal to the current standard of radioisotope perfusion scintigraphy in predicting postoperative lung function.

Methods and Materials

Preoperative lung function, radioisotope perfusion scintigraphy, spiral CT subtraction imaging, and assessment of postoperative lung function were performed in 25 patients with surgically resectable primary bronchogenic carcinoma. Comparisons of predicted postoperative lung function between the two modalities and to true postoperative lung function were performed using Pearson's correlation and linear regression analysis.

Results

Among the 25 patients enrolled in the study, there was a high degree of agreement between the predicted value of postoperative forced expiratory lung volume in 1 second (FEV1) generated on novel contrast CT subtraction imaging and that on radioisotope perfusion scintigraphy (r = 0.96, P < .001). Furthermore, there was a strong correlation between the predicted and actual postoperative FEV1 values for both imaging modalities (r = 0.87, P < .001, and r = 0.88, P < .001, respectively), among the 14 patients completing the study protocol.

Conclusion

A novel technique of CT subtraction imaging is equally accurate at predicting postoperative lung function as radioisotope perfusion scintigraphy, which may obviate the need for additional nuclear imaging in the context of the preoperative assessment of resectable lung cancer in high-risk patients.

Key Words: Lung cancer, CT, postoperative FEV1

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 This work was supported by the Resident Research Career Development Program, Department of Medicine and Schulich School of Medicine & Dentistry, University of Western Ontario. The first two authors contributed equally to the preparation of this report.

PII: S1076-6332(10)00012-7

doi:10.1016/j.acra.2010.01.002

Academic Radiology
Volume 17, Issue 5 , Pages 607-613, May 2010

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