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Poster Presentations: Wednesday, October 26, 2011 |

Estimating Postoperative Lung Function and Surgical Risk of Lung Resection by Quantitative Breath Sound Measurements and Operation Planning Software FREE TO VIEW

Frank Detterbeck, MD; Merav Gat, MSCE; Daniel Miller, MD; Seth Force, MD; Cynthia Chin, MD; Hiran Fernando, MD; Joshua Sonett, MD; Rodolfo Morice, MD
Chest. 2011;140(4_MeetingAbstracts):849A. doi:10.1378/chest.1117508
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Abstract

PURPOSE: Prediction of functional loss after lung resection (PPO-FEV1 and PPO-DLCO), by regional perfusion and spirometry is well established. A non-invasive, non-radiation Vibration Response Imaging (VRIxp) device analyzes lung sounds and quantifies regional acoustic energy; with PPO lung function automatically calculated by operation planning software (“O-Plan”). A multi-center study is underway to corroborate single-center results showing excellent ability of VRIxp to predict PPO lung function.

METHODS: Of 120 enrolled patients at 6 USA sites, 95 were eligible for analysis. All underwent spirometry, quantitative perfusion and VRIxp testing before resection (84 lobectomies, 12 pneumonectomies) for cancer. PPO values were calculated by subtracting the percent functional perfusion or percent acoustic energy (VRI) of the lung segments to be resected from the total ipsilateral lung segments; calculations for both methods were compared at baseline and also to actual post-operative spirometry.

RESULTS: : High correlation was found between predictions based on VRI vs. perfusion (r=0.98 for PPO-FEV1% and 0.99 for PPO-DLCO%). The agreement rate was 92% for PPO-FEV1% and 87% for PPO-DLCO%; 96% (91/95) of the estimations were within 10%. There was 100% agreement for the 16 estimations of high surgical risk (PPO-FEV1 <=40%). There was good agreement between the two methods by the Bland-Altman plot (-6.1% to 8.3% for PPO-FEV1%; mean difference 1.1%±7.2% and -4.9% to 6.8% for PPO-DLCO%; mean difference 0.96%±5.9%). Actual FEV1% of 62%±13% (4.6±2 months post-op) compared well with the PPO predictions of 54%±13% by perfusion and 55±16% by VRI (20 patients). VRI predictions correlated better with actual values than perfusion (r=0.7 and 0.6). Actual post-op DLCO% was 58%±20% compared to 50%±18% for VRI and 49±16% for perfusion. VRI had higher correlation than perfusion (r=0.8 and 0.7).

CONCLUSIONS: Predictions based on lung function testing and quantitative breath sound measurements demonstrated high correlations with quantitative perfusion estimations and corroborate previously published results. Given the non-radiation, non-invasive nature and ease of use of VRIxp testing, it could be a good alternative to quantitative perfusion in preoperative lung resection assessment.

CLINICAL IMPLICATIONS: Improved patient selection for surgery.

DISCLOSURE: Frank Detterbeck: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

Merav Gat: Employee: Deepbreeze, LTD

Daniel Miller: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

Seth Force: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

Cynthia Chin: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

Hiran Fernando: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

Joshua Sonett: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

Rodolfo Morice: Grant monies (from industry related sources): providing compensation for multicenter study being reported in abstract

No Product/Research Disclosure Information

09:00 AM - 10:00 AM


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