Predicted postoperative (PPO) lung function is most important for estimating the risk of morbidity, mortality, and long-term disability after pulmonary resection. In this study, we investigated the capability of vibration response imaging (VRI) as a simpler alternative to pulmonary perfusion and ventilation scintigraphy for prediction of postoperative lung function in patients with intrathoracic malignancies.
Fifty-eight patients (27 men and 31 women) with intrathoracic malignancies, considered candidates for lung resection, were prospectively studied with quantitative VRI, ventilation and perfusion lung scintigraphy, and pulmonary function tests to predict PPO.
Predictions by VRI correlated well with perfusion and ventilation scintigraphy predictions for post pneumonectomy FEV1 (n = 51, r =0.78) and DLCO (n = 50, r = 0.78) and post lobectomy FEV1 (n = 48, r =0.94) and DLCO (n = 47, r = 0.94). In the subset of patients who had surgery and postoperative lung function testing (n = 19), VRI and ventilation and perfusion scintigraphy PPO values correlated well with actual values FEV1 (%) (r = 0.69 vs. r = 0.83 vs r = 0.86) and DLCO (%) (r = 0.75 vs. r = 0.80 vs r = 0.79) (p > 0.05) measured at postoperative day 38 ± 7.
Although VRI measures acoustic energy, not lung perfusion or ventilation, the calculation process to arrive to predicted postoperative lung function values is analogous to quantitative lung scintigraphy. VRI predictions correlated well with both perfusion predictions and with actual results.
VRI is a non-invasive test that does not require administration of radioisotopes. It is office-based, simpler and less expensive than radionuclide studies, and within scope of practice of chest physician.
Rodolfo Morice, Grant monies (from industry related sources) The Pulmonary Department at The University of Texas MD Anderson Cancer Center received grant monies to conduct this study from Deep Breeze Ltd.; Product/procedure/technique that is considered research and is NOT yet approved for any purpose. VRI technique is considered research and is not yet approved for estimation of postoperative lung function.