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Vibration-Response Imaging Versus Quantitative Perfusion Scintigraphy in the Selection of Patients for Lung-Resection Surgery

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BACKGROUND: In patients being considered for lung-resection surgery, quantitative perfusion scintigraphy is used to predict postoperative lung function and guide the determination of lung-resection candidacy. Vibration-response imaging has been proposed as a noninvasive, radiation-free, and simpler method to predict postoperative lung function. We compared vibration-response imaging to quantitative perfusion scintigraphy for predicting postoperative FEV1 and diffusing capacity of the lung for carbon monoxide (DLCO). METHODS: We enrolled 35 candidates for lung resection. Twenty-five patients had preoperative FEV1 and DLCO measurements. RESULTS: The vibration-response-imaging measurements showed strong correlation with the quantitative-perfusion-scintigraphy measurements of predicted postoperative FEV1% (r = 0.87, P < .001), predicted postoperative FEV1 (r = 0.90, P < .001), and predicted postoperative DLCO% (r = 0.90, P < .001). There was a correlation between predicted postoperative FEV1 (% and L) measured via quantitative perfusion scintigraphy and the actual postoperative FEV1 (% and L) (r = 0.47, P = .048, r = 0.73, P < .001). There was no difference between the vibration-response-imaging measurements and the actual postoperative measurements of predicted postoperative FEV1 (% and L). There was a correlation between predicted postoperative FEV1 (% and L) measured via vibration-response imaging and actual postoperative FEV1 (% and L) (r = 0.52, P = .044, r = 0.79, P < .001). The mean differences between the predicted and actual postoperative FEV1 values were 49 mL with vibration-response imaging, versus 230 mL with quantitative perfusion scintigraphy. Neither the vibration-response imaging nor the quantitative perfusion scintigraphy predicted postoperative DLCO% values agreed with the actual postoperative DLCO% values. CONCLUSIONS: Vibration-response imaging may be a good alternative to quantitative perfusion scintigraphy in evaluating lung-resection candidacy.

Keywords: lung carcinoma; lung function; lung resection; preoperative evaluation; quantitative perfusion scintigraphy; vibration-response imaging

Document Type: Research Article

DOI: http://dx.doi.org/10.4187/respcare.01059

Affiliations: Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

Publication date: December 1, 2011

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