Use of radionuclide scanning in the preoperative estimation of pulmonary function after pneumonectomy.

P A Corris, D A Ellis, T Hawkins, G J Gibson

Twenty eight patients with bronchial carcinoma were studied before pneumonectomy. Measurement of spirometric indices, static lung volumes, transfer factor (TLCO), and transfer coefficient (KCO) was undertaken before and four months after pneumonectomy. Fourteen of the patients also performed a symptom limited progressive exercise test on a cycle ergometer before and four months after pneumonectomy. All patients had standard xenon-133 ventilation and technetium-99m perfusion scans performed before operation. Eleven patients had krypton-81m ventilation scans in addition. Significant correlations were seen between changes in FEV1, TLCO and KCO and the preoperative function of the resected lung as determined by percentage preoperative perfusion to that lung (p less than 0.001). There were mean decreases in FEV1 of 22% and in vital capacity (VC) of 28.7% predicted. Estimation of postoperative FEV1 from the preoperative values showed equally good agreement with measured postoperative values whether 99mTc perfusion or 81mKr ventilation scans were used in the 11 patients in whom both scans were available. Significant correlations were seen between change in maximum exercise ventilation (VEmax) or maximum oxygen uptake (VO2max) after pneumonectomy and percentage preoperative perfusion to the resected lung (p less than 0.001). Estimation of postoperative maximum ventilation and maximum oxygen uptake from the postoperative values on the basis of 99mTc perfusion scans showed good agreement with observed values. Perfusion scans are useful in estimating not only the changes in spirometric indices that follow pneumonectomy for bronchial carcinoma but also changes in carbon monoxide transfer and exercise capacity.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Brunelli, A., Charloux, A., Bolliger, C. T., Rocco, G., Sculier, J-P., Varela, G., Licker, M., Ferguson, M. K., Faivre-Finn, C., Huber, R. M., Clini, E. M., Win, T., De Ruysscher, D., Goldman, L., on behalf of the European Respiratory Society and, (2009). ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J 34: 17-41 [Abstract] [Full Text]  
• Hughes, J.M.B. (2007). Review Series: Lung function made easy: Assessing gas exchange. Chronic Respiratory Disease 4: 205-214 [Abstract]  
• Brunelli, A., Varela, G., Rocco, G., Socci, L., Novoa, N., Gatani, T., Salati, M., Rocca, A. L. (2007). A model to predict the immediate postoperative FEV1 following major lung resections. Eur. J. Cardiothorac. Surg. 32: 783-786 [Abstract] [Full Text]  
• Colice, G. L., Shafazand, S., Griffin, J. P., Keenan, R., Bolliger, C. T. (2007). Physiologic Evaluation of the Patient With Lung Cancer Being Considered for Resectional Surgery: ACCP Evidenced-Based Clinical Practice Guidelines (2nd Edition). Chest 132: 161S-177S [Abstract] [Full Text]  
• Brunelli, A., Refai, M., Salati, M., Xiume, F., Sabbatini, A. (2007). Predicted Versus Observed FEV1 and DLCO After Major Lung Resection: A Prospective Evaluation at Different Postoperative Periods. Ann. Thorac. Surg. 83: 1134-1139 [Abstract] [Full Text]  
• Brunelli, A., Xiume, F., Refai, M., Salati, M., Marasco, R., Sciarra, V., Sabbatini, A. (2007). Evaluation of Expiratory Volume, Diffusion Capacity, and Exercise Tolerance Following Major Lung Resection: A Prospective Follow-up Analysis. Chest 131: 141-147 [Abstract] [Full Text]  
• Win, T., Tasker, A. D., Groves, A. M., White, C., Ritchie, A. J., Wells, F. C., Laroche, C. M. (2006). Ventilation-perfusion scintigraphy to predict postoperative pulmonary function in lung cancer patients undergoing pneumonectomy.. Am. J. Roentgenol. 187: 1260-1265 [Abstract] [Full Text]  
• Piai, D.B., Quagliatto, R. Jr, Toro, I., Cunha Neto, C., Etchbehere, E., Camargo, E. (2004). The use of SPECT in preoperative assessment of patients with lung cancer. Eur Respir J 24: 258-262 [Abstract] [Full Text]  
• Brunelli, A., Monteverde, M., Al Refai, M., Fianchini, A. (2004). Stair climbing test as a predictor of cardiopulmonary complications after pulmonary lobectomy in the elderly. Ann. Thorac. Surg. 77: 266-270 [Abstract] [Full Text]  
• Brunelli, A., Monteverde, M., Borri, A., Salati, M., Al Refai, M., Fianchini, A. (2003). Predicted versus observed maximum oxygen consumption early after lung resection. Ann. Thorac. Surg. 76: 376-380 [Abstract] [Full Text]  
• Datta, D., Lahiri, B. (2003). Preoperative Evaluation of Patients Undergoing Lung Resection Surgery. Chest 123: 2096-2103 [Abstract] [Full Text]  
• Beckles, M. A., Spiro, S. G., Colice, G. L., Rudd, R. M. (2003). The Physiologic Evaluation of Patients With Lung Cancer Being Considered for Resectional Surgery. Chest 123 : 105S-114S [Abstract] [Full Text]  
• Brunelli, A., Al Refai, M., Monteverde, M., Borri, A., Salati, M., Fianchini, A. (2002). Stair Climbing Test Predicts Cardiopulmonary Complications After Lung Resection*. Chest 121: 1106-1110 [Abstract] [Full Text]  
• Hughes, J.M.B., Pride, N.B. (2001). In defence of the carbon monoxide transfer coefficient KCO (TL/VA). Eur Respir J 17: 168-174 [Abstract] [Full Text]  
• British Thoracic Society, , Society of Cardiothoracic Surgeons of Great Britai, , Ireland Working Party, (2001). Guidelines on the selection of patients with lung cancer for surgery. Thorax 56: 89-108 [Full Text]  
• ROBERTSON, R J H (1999). Imaging in the evaluation of emphysema. Thorax 54: 379-379 [Full Text]  
• THURNHEER, R., ENGEL, H., WEDER, W., STAMMBERGER, U., LAUBE, I., RUSSI, E. W., BLOCH, K. E. (1999). Role of Lung Perfusion Scintigraphy in Relation to Chest Computed Tomography and Pulmonary Function in the Evaluation of Candidates for Lung Volume Reduction Surgery. Am. J. Respir. Crit. Care Med. 159: 301-310 [Abstract] [Full Text]  
• Larsen, K. R., Svendsen, U. G., Milman, N., Brenoe, J., Petersen, B. N. (1997). Cardiopulmonary Function at Rest and During Exercise After Resection for Bronchial Carcinoma. Ann. Thorac. Surg. 64: 960-964 [Abstract] [Full Text]  
• Pate, P., Tenholder, M. F., Griffin, J. P., Eastridge, C. E., Weiman, D. S. (1996). Preoperative Assessment of the High-Risk Patient for Lung Resection. Ann. Thorac. Surg. 61: 1494-1500 [Abstract] [Full Text]  
• Cordiner, A., De Carlo, F., De Gennaro, R., Pau, F., Flore, F. (1991). Prediction of Postoperative Pulmonary Function Following Thoracic Surgery for Bronchial Carcinoma. ANGIOLOGY 42: 985-989 [Abstract]