Hidetake Yabuuchi MD, Presenter: Nothing to Disclose

Satoshi Kawanami MD, Abstract Co-Author: Research Grant, Modest Research Grant, Bayer AG Research Grant, Koninklijke Philips NV

Takeshi Kamitani MD, Abstract Co-Author: Nothing to Disclose

Masato Yonezawa, Abstract Co-Author: Nothing to Disclose

Michinobu Nagao MD, Abstract Co-Author: Research Grant, Bayer AG Research Grant, Koninklijke Philips NV

Hiroshi Honda MD, Abstract Co-Author: Nothing to Disclose

Yuzo Yamasaki MD, Abstract Co-Author: Nothing to Disclose

Yoko Fujita, Abstract Co-Author: Nothing to Disclose

Surgical indication of primary lung cancer based on pulmonary function could be uncertain when the candidate has underlying conditions such as emphysema or interstitial pneumonia, and conventional segment counting method might misjudge the indication. Purpose of this study was to compare the predictive abilities of the sub-segment counting method and lobar volumetry using inspiratory/expiratory MDCT data to assess post-operative pulmonary function after lobectomy for primary lung cancer. 

Twenty-eight patients who underwent lobectomy for primary lung cancer (13 males, 15 females; age range, 53–81 years; mean age, 68 years) were enrolled. Inspiratory/expiratory MDCT and pulmonary function tests within 2 weeks before surgery and post-operative pulmonary function tests within 6–7 months after surgery were performed in all patients. Actual pulmonary function losses (ΔFEV1.0 and ΔVC) were calculated from pre and post-operative pulmonary function test data. Predictive pulmonary function losses (Pred.ΔFEV1.0 and Pred.ΔVC) were calculated from sub-segment counting method and lobar volumetry of inspiratory/expiratory MDCT data using two methods (effective volume at inspiratory phase and volume change between inspiratory and expiratory phases). Correlations between ΔFEV1.0 and Pred.ΔFEV1.0 and those between ΔVC and Pred.ΔVC were tested among three methods; sub-segment counting method, effective volume at inspiratory phase, and volume change between inspiratory/expiratory phases, using Pearson’s correlation coefficient. P < 0.05 was considered a significant difference.

ΔFEV1.0 and Pred.ΔFEV1.0insp-exp were strongly correlated (r = 0.72), whereas ΔFEV1.0 and Pred.ΔFEV1.0count (r=0.586) and ΔFEV1.0 and Pred.ΔFEV1.0eff.vol. (r = 0.599) were moderately correlated, respectively. ΔVC and Pred.ΔVC eff.vol. (r = 0.698) were strongly correlated, whereas ΔVC and Pred.ΔVCcount (r = 0.575), and ΔVC and Pred.ΔVC insp-exp (r=0.576) were moderately correlated, respectively.

Volumetry from inspiratory/expiratory MDCT data could be useful to predict post-operative pulmonary function after lobectomy for primary lung cancer.

Accurate prediction of postoperative pulmonary function using lobar volumetric measurement might be useful in patients with borderline preoperative pulmonary function for primary lung cancer.

Yabuuchi, H, Kawanami, S, Kamitani, T, Yonezawa, M, Nagao, M, Honda, H, Yamasaki, Y, Fujita, Y, Prediction of Post-operative Pulmonary Function after Lobectomy for Primary Lung Cancer: Sub-segment Counting Method vs. Lobar Volumetry using Inspiratory/expiratory MDCT Data.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006964.html