Lung Cancer |

The Accuracy of Quantitative CT Scan Based Prediction of Post-Lung Resection FEV1 FREE TO VIEW

Humberto Choi, MD; David Teeters, MD; Daniel Raymond; Xiaofeng Wang; Peter Mazzone
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Cleveland Clinic, Cleveland, OH

Chest. 2015;148(4_MeetingAbstracts):555A. doi:10.1378/chest.2255498
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SESSION TITLE: Lung Cancer Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The predicted postoperative forced expiratory volume in the first second (PPO FEV1) is commonly used to risk stratify lung resection candidates. It can be calculated by the segment method (SM) or by using the results of a quantitative radionuclide perfusion scan (QS). Quantitative analysis of computed tomography of the chest (QCT) is able to estimate the volume of air and tissue of each lung and lobe. The aim of this study is to evaluate the accuracy of QCT based PPO FEV1.

METHODS: Fifteen patients (mean age 67.4 + 15.5 years) with lung cancer who underwent either a lobectomy (n=12) or pneumonectomy (n=3) and had pre and postoperative pulmonary function testing were included. Quantitative analysis of preoperative 1mm slice CT scan was performed using Apollo software (VIDA Diagnostics). We correlated the PPO FEV1 calculated by QCT, SM and QS methods with the actual FEV1 values measured postoperatively.

RESULTS: The mean preoperative FEV1 was 1.89 + 0.39L (79.4 + 20% predicted). The mean measured post-operative FEV1 among patients who underwent lobectomy and pneumonectomy was 1.61 + 0.69 L (71.5 + 21.8% predicted) and 1.29 + 0.33 L (46.3 + 9.5% predicted), respectively. Among patients who underwent lobectomy, PPO FEV1 calculated by QCT had a high correlation with measured postoperative FEV1 (r=0.92), and it was comparable to SM (r=0.94). In the pneumonectomy group, the correlation coefficient with QCT, SM, and QS were r=0.89, r=0.47, and r=0.71 respectively.

CONCLUSIONS: The PPO FEV1 calculated by QCT has a high correlation with actual postoperative FEV1 in patients who undergo lobectomy or pneumonectomy. We plan to expand the size of the study, evaluate the accuracy of quantitative CT analysis in the calculation of predicted postoperative diffusion capacity of carbon monoxide, and explore the clinical application of this technique.

CLINICAL IMPLICATIONS: Quantitative CT analysis is useful in estimating PPO FEV1 in patients with lung cancer being considered for lung resection and potentially more accurate than the routinely used methods.

DISCLOSURE: The following authors have nothing to disclose: Humberto Choi, David Teeters, Daniel Raymond, Xiaofeng Wang, Peter Mazzone

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