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Postoperative Lung Function in Lung Cancer Patients: Comparative Analysis of Predictive Capability of MRI, CT, and SPECT

¹ Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
² Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —63-year-old man with adenocarcinoma in upper lobe of left lung. Routine transverse 5-mm and thin-section (2-mm) CT scans show low-attenuation areas in both lungs. Tumor mass is evident.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —63-year-old man with adenocarcinoma in upper lobe of left lung. Routine transverse 5-mm and thin-section (2-mm) CT scans show low-attenuation areas in both lungs. Tumor mass is evident.

View larger version (106K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —63-year-old man with adenocarcinoma in upper lobe of left lung. Quantitative CT scan shows functional lung (red), pulmonary emphysema (black), and lung cancer (white).

View larger version (11K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —63-year-old man with adenocarcinoma in upper lobe of left lung. Perfusion SPECT image shows heterogeneous uptake but not by lung cancer (arrows).

View larger version (116K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —63-year-old man with adenocarcinoma in upper lobe of left lung. Dynamic perfusion MR images show heterogeneous but well-enhanced pulmonary parenchyma at 5 and 13 seconds in portions of lungs not affected by lung cancer (arrows). Lung cancer also is enhanced after 13 seconds.

View larger version (13K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Correlation between each version of predicted postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and actual postoperative FEV1. Graph shows postoperative FEV1 predicted from perfusion MRI correlates well (r =0.87, p < 0.0001) with actual postoperative FEV1.

View larger version (12K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Correlation between each version of predicted postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and actual postoperative FEV1. Graph shows postoperative FEV1 predicted from quantitative assessment of CT scans correlates well (r =0.88, p < 0.0001) with actual postoperative FEV1.

View larger version (13K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —Correlation between each version of predicted postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and actual postoperative FEV1. Graph shows postoperative FEV1 predicted from qualitative assessment of CT scans correlates well (r = 0.83, p < 0.0001) with actual postoperative FEV1.

View larger version (13K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —Correlation between each version of predicted postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and actual postoperative FEV1. Graph shows postoperative FEV1 predicted from perfusion SPECT correlates well (r =0.83, p < 0.0001) with actual postoperative FEV1.

View larger version (21K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —The limits of agreement between actual postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and each version of predicted postoperative FEV1. Graph shows the limits of agreement are 5.3% ± 11.8% for perfusion MRI.

View larger version (21K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —The limits of agreement between actual postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and each version of predicted postoperative FEV1. Graph shows the limits of agreement are 5.0% ± 11.6% for quantitative assessment of CT scans.

View larger version (22K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —The limits of agreement between actual postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and each version of predicted postoperative FEV1. Graph shows the limits of agreement are 6.8% ± 14.4% for qualitative assessment of CT scans.

View larger version (22K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —The limits of agreement between actual postoperative forced expiratory volume in first second of expiration (FEV1), expressed as percentage of predicted value, and each version of predicted postoperative FEV1. Graph shows the limits of agreement are 5.1% ± 14.0% for perfusion SPECT.

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