TY - JOUR
T1 - Perfusion scintigraphy in the evaluation for lung volume reduction surgery
T2 - Correlation with clinical outcome
AU - Wang, Samuel C.
AU - Fischer, Keith C.
AU - Slone, Richard M.
AU - Gierada, David S.
AU - Yusen, Roger D.
AU - Lefrak, Stephen S.
AU - Pilgram, Thomas K.
AU - Cooper, Joel D.
PY - 1997/10
Y1 - 1997/10
N2 - PURPOSE: To identify preoperative pulmonary perfusion scintigraphic findings that might be associated with clinical outcome after lung volume reduction surgery. MATERIALS AND METHODS: Preoperative perfusion scintigrams in 103 patients (56 men, 47 women; age range, 41-76 years; mean age, 61 years ± 9) were reviewed and graded for emphysematous heterogeneity (from isolated areas to diffuse distribution), extent of maximally perfused lung, and lobar predominance (upper-lobe vs lower-lobe asymmetry). These findings were correlated with clinical outcome on the basis of pulmonary function, arterial blood gas levels, and exercise test results before and 6 months after surgery. RESULTS: Among the 96 patients who survived surgery, there was an average improvement of 47% in the forced expiratory volume in 1 second (FEV1), of 20% in arterial oxygen tension, and of 20% in the 6-minute walking distance. Scintigraphic markers correlated best with FEV1 improvement. The strongest scintigraphic predictor of increase in FEV1 was upper-lobe predominance (r = .38, P < .001), which was followed by heterogeneity (r = .31, P =.002). The seven patients who died had a significantly lower percentage of maximally perfused lung than the survivors (25% vs 34%, P = .004). CONCLUSION: Perfusion scintigraphy can provide modest prognostic information in patients who undergo evaluation for lung volume reduction surgery.
AB - PURPOSE: To identify preoperative pulmonary perfusion scintigraphic findings that might be associated with clinical outcome after lung volume reduction surgery. MATERIALS AND METHODS: Preoperative perfusion scintigrams in 103 patients (56 men, 47 women; age range, 41-76 years; mean age, 61 years ± 9) were reviewed and graded for emphysematous heterogeneity (from isolated areas to diffuse distribution), extent of maximally perfused lung, and lobar predominance (upper-lobe vs lower-lobe asymmetry). These findings were correlated with clinical outcome on the basis of pulmonary function, arterial blood gas levels, and exercise test results before and 6 months after surgery. RESULTS: Among the 96 patients who survived surgery, there was an average improvement of 47% in the forced expiratory volume in 1 second (FEV1), of 20% in arterial oxygen tension, and of 20% in the 6-minute walking distance. Scintigraphic markers correlated best with FEV1 improvement. The strongest scintigraphic predictor of increase in FEV1 was upper-lobe predominance (r = .38, P < .001), which was followed by heterogeneity (r = .31, P =.002). The seven patients who died had a significantly lower percentage of maximally perfused lung than the survivors (25% vs 34%, P = .004). CONCLUSION: Perfusion scintigraphy can provide modest prognostic information in patients who undergo evaluation for lung volume reduction surgery.
KW - Emphysema, pulmonary
KW - Lung, perfusion
KW - Lung, radionuclide studies
KW - Lung, surgery
UR - http://www.scopus.com/inward/record.url?scp=0030759051&partnerID=8YFLogxK
U2 - 10.1148/radiology.205.1.9314992
DO - 10.1148/radiology.205.1.9314992
M3 - Article
C2 - 9314992
AN - SCOPUS:0030759051
SN - 0033-8419
VL - 205
SP - 243
EP - 248
JO - Radiology
JF - Radiology
IS - 1
ER -