Role of quantitative CT in predicting postoperative FEV1 and chronic dyspnea in patients undergoing lung resection

  • Chrysovalantis V. Papageorgiou Respiratory Function Laboratories, 1st Dept. of Respiratory Medicine, National University of Athens Medical School, Athens, Greece.
  • Dimosthenis Antoniou First NHS Department of Respiratory Medicine, “Sotiria” Hospital for Chest Diseases, Athens, Greece.
  • Georgios Kaltsakas Respiratory Function Laboratories, 1st Dept. of Respiratory Medicine, National University of Athens Medical School, Athens, Greece.
  • Nikolaos G. Koulouris | koulnik@med.uoa.gr Respiratory Function Laboratories, 1st Dept. of Respiratory Medicine, National University of Athens Medical School, Athens, Greece.

Abstract

Lung resection is the mainstay of treatment in patients with early stage non-small cell lung cancer. However, lung cancer patients often suffer from comorbidities and the respiratory reserve should be carefully evaluated preoperatively in order to avoid postoperative complications. Forced expiratory vol- ume in 1 second (FEV1) is considered to be an index that depicts the patient’s respiratory efficacy and its prediction has a key role in the preoperative evaluation of lung cancer patients with impaired lung function. Prediction of postoperative FEV1 is currently possible with the use of perfusion radionuclide lung scanning. Quantitative CT is the analysis of data acquired during nor- mal chest CT scan using the system’s software. By applying a dual threshold of -500 to -910 Hounsfield Units, functional lung volumes are estimated and postoperative FEV1 can be predicted by reducing the preoperative measurement by the fraction of the part to be resected. Studies have shown that preoperative predictions correlate well with the actual postoperative measurements. Additionally, quantitative CT results are in good agreement with perfusion scintigraphy predictions. Newer radiological techniques such as perfusion MRI and co-registered SPECT/CT have also been used in the preoperative evaluation with similar results. In conclusion, chest CT which is obligatory for staging, can be used for quantitative analysis of the already available data. It is technically simple, providing an accurate prediction of postoperative FEV1. Thus, quantitative CT appears to be a useful tool in the preoperative evaluation of lung cancer patients undergoing lung resection.

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Published
2010-09-08
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Section
Technical Notes
Keywords:
Lung cancer, lung resection, predicted postoperative FEV1, quantitative CT.
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How to Cite
Papageorgiou, C. V., Antoniou, D., Kaltsakas, G., & Koulouris, N. G. (2010). Role of quantitative CT in predicting postoperative FEV1 and chronic dyspnea in patients undergoing lung resection. Multidisciplinary Respiratory Medicine, 5(1). https://doi.org/10.4081/mrm.2010.526