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Ventilation-Perfusion Scintigraphy to Predict Postoperative Pulmonary Function in Lung Cancer Patients Undergoing Pneumonectomy

¹ Department of Thoracic Oncology, Papworth Hospital, Papworth Everard, Cambridge, CB3 8RE, United Kingdom.
² Department of Radiology, Papworth Hospital, Cambridge, United Kingdom.
³ Institute of Nuclear Medicine, University College London, London, United Kingdom.
⁴ Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge, United Kingdom.

OBJECTIVE. The American College of Chest Physicians (ACCP) recommends using quantitative perfusion scintigraphy to predict postoperative lung function in lung cancer patients with borderline pulmonary function tests who will undergo pneumonectomy. However, previous scintigraphic data were gathered on small cohorts more than a decade ago, when surgical populations were significantly different with respect to age and sex compared with typical lung cancer patients undergoing pneumonectomy in 2005. We therefore revisited the use of V/Q scintigraphy in pneumonectomy patients in predicting postoperative pulmonary function and the appropriateness of current clinical guidelines.

CONCLUSION. Contrary to ACCP guidelines, we found that ventilation scintigraphy alone provided the best correlation between the predicted and actual postoperative values and recommend its use to predict postoperative lung function. However, scintigraphic techniques may underestimate postoperative lung function, so caution is required before unnecessarily preventing a patient from undergoing surgery that offers a potential cure.

Keywords: bronchogenic carcinoma • cancer • lung disease • nuclear medicine • pneumonectomy • scintigraphy • ventilation-perfusion

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