Perfusion scintigraphy in the evaluation for lung volume reduction surgery: Correlation with clinical outcome

Samuel C. Wang, Keith C. Fischer, Richard M. Slone, David S. Gierada, Roger D. Yusen, Stephen S. Lefrak, Thomas K. Pilgram, Joel D. Cooper

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


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.

Original languageEnglish
Pages (from-to)243-248
Number of pages6
Issue number1
StatePublished - Oct 1997


  • Emphysema, pulmonary
  • Lung, perfusion
  • Lung, radionuclide studies
  • Lung, surgery


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