Prediction of functional reserves after lung resection: Comparison between quantitative computed tomography, scintigraphy, and anatomy
Date
2002
Authors
Bolliger C.T.
Guckel C.
Engel H.
Stohr S.
Wyser C.P.
Schoetzau A.
Habicht J.
Soler M.
Tamm M.
Perruchoud A.P.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background and Objectives: We prospectively compared five techniques to estimate predicted postoperative function (ppo F) after lung resection: recently proposed quantitative CT scans (CT), perfusion scans (Q), and three anatomical formulae based on the number of segments (S), functional segments (FS), and subsegments (SS) to be removed. Methods: Four parameters were assessed: FEV1, FVC, DLCO and VO2max, measured preoperatively and 6 months postoperatively in 44 patients undergoing pulmonary resection, comparing their ppo value to the postoperatively measured value. Results: The correlations (r) obtained with the five methods were for CT: FEV1 = 0.91, FVC = 0.86, DLCO = 0.84, VO2max = 0.77; for Q: 0.92, 0.90, 0.85, 0.85; for S: 0.88, 0.86, 0.84, 0.75; for FS: 0.88, 0.85, 0.85, 0.75, and for SS: 0.88, 0.86, 0.85, 0.75, respectively. The mean difference between ppo values and postoperatively measured values was smallest for Q estimates and largest for anatomical estimates using S. Stratification of the extent of resection into lobectomy (n = 30) + wedge resections (n = 4) versus pneumonectomy (n = 10) resulted in persistently high correlations for Q and CT estimates, whereas all anatomical correlations were lower after pneumonectomy. Conclusions: We conclude that both Q- and CT-based predictions of postoperative cardiopulmonary function are useful irrespective of the extent of resection, but Q-based results were the most accurate. Anatomically based calculations of ppo F using FS or SS should be reserved for resections not exceeding one lobe. Copyright © 2002 S. Karger AG, Basel.
Description
Keywords
accuracy, adult, aged, anatomy, article, clinical article, clinical trial, computer assisted tomography, controlled clinical trial, controlled study, correlation analysis, female, forced expiratory volume, human, intermethod comparison, lobectomy, lung function, lung resection, male, prediction, priority journal, quantitative analysis, scintigraphy, Aged, Female, Forced Expiratory Volume, Humans, Lung, Male, Middle Aged, Oxygen Consumption, Pneumonectomy, Postoperative Period, Prospective Studies, Respiratory Function Tests, Spirometry, Tomography, X-Ray Computed, Vital Capacity
Citation
Respiration
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