Predictive value of ventilation and perfusion scintigraphy for the postoperative pulmonary function in patients with lung cancer

Objective: To evaluate the value of ventilation and perfusion scintigraphy for predicting the postoperative pulmonary function in patients with lung cancer. Methods: Twenty-six patients with lung cancer, male 21 and female 5, aged from 44 to 86 a, were recruited into the study. Before surgery, 21 patients underwent 99Tcm-DTPA aerosol ventilation and 99Tcm-macroaggregated albumin (MAA) perfusion scintigraphic imaging. The other five patients were studied with perfusion imaging only. Pulmonary function was measured as forced expiratory volume in the first second (FEV1) at about one week before surgery for all patients, and at two months after surgery. The predicted postoperative FEV1 (ppoFEV1) was calculated by Neuhaus' formula based on the ventilation or perfusion function obtained from scintigraphy studies, and compared with the measured post surgery FEV1. Eighteen patients underwent the surgical resection successfully. The t-test and correlation analysis were used. Results: The ppoFEV1 values of ventilation and perfusion were (1.347±0.539) Land (1.410±0.543) L, respectively (n=21, t =0.062, P>0.05). Both the ppoFEV1 values of ventilation and perfusion showed no significant difference with the respective post-surgeryFEV1 (n=13, (1.545±0.588) L vs (1.45±0.521) L, t=0.092, P>0.05; n=18, (1.697±0.546) L vs (1.457±0.488) L, t =0. 017, P>0.05, respectively). Both the ventilation ppoFEV1 (n =13) and perfusion ppoFEV1 (n = 13, n = 18) correlated well with the post-surgery FEV1 respectively (r =0. 950, 0.937, 0.922, all P<0.01). Conclusion: Ventilation and perfusion imaging can predict the postoperative pulmonary function for patients with lung cancer, especially for those with borderline pulmonary function, thus useful for selection of suitable candidates for surgical resection. (authors)