Use of quantitative CT to predict postoperative lung function in patients with lung cancer.

Abstract

To evaluate the effectiveness of quantitative computed tomography (CT) for predicting postoperative lung function in patients with lung cancer. Preoperative spirometry and conventional CT of the chest were performed in 38 patients. A postprocessing CT program was applied to quantitate the volume of whole-lung parenchyma with attenuations of -500 to -910 HU; this was defined as total functional lung volume (TFLV). The regional functional lung volume (RFLV) of the lobes or lung to be resected was quantitated separately. CT-predicted postoperative forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were derived by multiplying the preoperative spirometry values by (1 - RFLV/TFLV). CT-predicted values correlated well with postoperatively measured results (FEV1: r = .93, P < .001; FVC: r = .86, P < .001) in patients who underwent pneumonectomy or lobectomy, regardless of the patient's preoperative ventilation status. This method is effective in the prediction of postoperative FEV1 and FVC in patients undergoing pulmonary resection.