Abstract
Aim: Preoperative evaluation of lung function before lung resection is necessary in order to avoid postsurgery morbidity. The aim of the study is to evaluate the role of quantitative CT in predicting postoperative FEV1 and patient's chronic dyspnoea.
Methods: Twenty-eight patients with non-small cell lung cancer have been evaluated. Lung function tests (LFTs) and chest CT scan were performed preoperatively. Fifteen patients (group A) had normal LFTs, thirteen patients (group B) had impaired lung function, requiring further testing. Quantitative evaluation of CT using dual threshold (-910 up to -500 Hounsfield Units) estimated total functional lung volume and the volume of the lobe(s) to be resected. Postoperative FEV1 was predicted by reducing the preoperative value by the same fraction that the resected part contributed to the total lung volume, in both groups. Postoperative LFTs were performed 3 months after surgery. Postoperative dyspnoea was evaluated using the modified Medical Research Council (mMRC) scale.
Results: The postoperative predicted and postoperative actual values of FEV1 were significantly correlated in both groups (Group A: r=0.897, p<0.0001, Group B: r=0.940, p<0.0001). Predicted volume loss as a percentage of total lung volume correlated significantly with postoperative mMRC (r=0.647, p<0.001).
Conclusion: Quantitative CT in patients undergoing lung resection appears to be a useful tool in evaluating postoperative patient's status as it predicts postoperative FEV1 and postoperative mMRC.
- © 2011 ERS