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Effect of exercise on lung-perfusion scanning in patients with bronchogenic carcinoma

¹ Service d'Exploration Fonctionnelle Respiratoire et Laboratoire de Physiologie, Faculté de Médecine de Nancy, Nancy, ² Service de Médecine Nucléaire, ³ Service de Chirurgie Thoracique, Centre Hospitalier Universitaire (CHU) de Nancy-Brabois, Nancy, France

CORRESPONDENCE: P. Haouzi, Laboratoire de Physiologie, Faculté de Médecine de Nancy, Avenue de la Forêt de Haye, B.P. 184, 54505, Vandoeuvre-lès-Nancy Cedex, France. Fax: 33 383683739. E-mail: p.haouzi@chu-nancy.fr

Keywords: exercise, lung cancer, pneumonectomy, preoperative perfusion-lung scanning, pulmonary function tests

Received: June 25, 2001
Accepted May 8, 2002

The aim of this study was to determine whether perfusion-scintillation scanning, used as a predictive pre-operative index of lung functionality in patients with lung cancer, is affected by the level of pulmonary blood flow (PBF).

Twenty patients with primary lung cancer underwent spirometry and a radionuclide-perfusion scan (macroaggregated albumin particles labelled with ^99mTechnetium) both at rest and during the last minute of a ramp-like increase in work rate until exhaustion.

On average, the perfusion of the lung with the tumour was significantly reduced by the same magnitude at rest and during exercise (mean±sd: –9±6% versus –10±4% of the cardiac output), regardless of the extent of the tumour. However, subject-by-subject analysis revealed that in two patients, a larger decrease in the perfusion of the lung with the tumour was observed during exercise than at rest (–11% and –17%, respectively). This leads to an underestimation of predictive postoperative functional parameters if resting values are used in these patients.

The use of perfusion scintigraphy at rest therefore gives a clear picture of the functionality of the lung before resection in most patients requiring surgery.