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1 Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2
Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
2 Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline
Ave., Boston, MA 02115.
3 Department of Radiology, Kobe Ekisaikai Hospital, 1-21-1 Manabigaoka,
Tarumi-ku, Kobe 655-30004, Japan.
4 Division of Cardiovascular and Respiratory Medicine, Department of Internal
Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017,
Japan.
5 Division of Cardiovascular, Thoracic and Pediatric Surgery, Kobe University
Graduate School of Medicine, Kobe 650-0017, Japan.
OBJECTIVE. The purpose of this study was to determine the capability of dynamic perfusion MRI as an alternative to pulmonary perfusion scintigraphy for prediction of postoperative lung function in patients with lung cancer.
SUBJECTS AND METHODS. Sixty patients with lung cancer (35 men, 25 women) underwent dynamic perfusion MRI, perfusion scintigraphy, and preoperative and postoperative pulmonary function tests (forced expiratory volume in 1 sec [FEV1]). Perfusion MRIs were obtained with a 3D turbo field-echo sequence (TR/TE, 2.7/0.6; flip angle, 40°; matrix, 128 x 96) using a 1.5-T scanner. Regional blood flow was calculated from the signal intensity–time curves after bolus injection of contrast medium on MRI (QMRI) and uptake ratios of radioisotope on perfusion scintigraphy (QPS). Postoperative lung functions predicted by MRI (FEV1,MRI) and perfusion scintigraphy (FEV1,PS) were calculated from preoperative FEV1 and regional Qs. To determine the capability of MRI as an alternative to scintigraphy, we evaluated correlations and the limits of agreement between predicted FEV1,MRI and postoperative FEV1 and between predicted FEV1,PS and postoperative FEV1.
RESULTS. The correlation coefficient of postoperative FEV1 with FEV1,MRI (r = 0.93, p < 0.0001) was better than that with FEV1,PS (r = 0.89, p < 0.0001). The limits of agreement between postoperative FEV1 and predicted FEV1,MRI (0.9% ± 10.4%) were smaller than those between postoperative FEV1 and predicted FEV1,PS (2.1% ± 13.2%).
CONCLUSION. Dynamic perfusion MRI is a feasible alternative to pulmonary perfusion scintigraphy for predicting postoperative lung function in patients with lung cancer.
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