The clinical value of novel Hybrid 3D Lobar Quantification SPECT Lung ventilation/perfusion scan in predicting remaining lung function for lobectomy lung cancer patients

Objectives To investigate the clinical value of Hybrid 3D lobar quantification SPECT lung Ventilation /Perfusion scan in predicting the remaining lung function, compared with clinical routine respiratory function test, Pre and post lobectomy Hybrid 3D lobar quantification results were also compared.

Methods 115 patients with suspected lung cancer were enrolled, All the patients underwent an Independent diagnostic CT and SPECT lung V/Q scan before and post lobectomy. Diagnostic CT was co-registered with attenuation corrected SPECT V/Q images. A 3D segmentation algorithm was used to automatically extract the left and right lung from the Diagnostic CT. The lung regions was further split into lobar regions by semi-automatically placing points along the lobar boundaries (fissures). Once the lobar regions were accepted ,they are added to the SPECT V/Q images and the relative percentage contribution of each lobe is computed for both ventilation and perfusion. All the results were compared with clinical routine respiratory function test criterion ( FEV1, VC, FEV1%, MVV ). Pre and post surgery Hybrid 3D lobar quantification lung V/Q results were compared ,The difference between the two methods and two point time scan were tested for significance using nonparametric test or x2 test .

Results The agreement rate of predicting the remaining lung function between lung V/Q Hybrid 3D quantification and clinical routine function test was 97.8%( 101/115; X2=0.158, P>0.05, While pre and post lobectomy lung V/Q Hybrid 3D quantification results were no significant difference ( the remaining Perfusion 75.8±8.71%,78.3±5.39%, X2=1.14 P>0.05 respectively , the remaining ventilation :83.1±3.42%,81.2±5.1% , X2=1.23, P>0.05 respectively)

Conclusions Hybrid 3D lobar quantification of lung V/Q method can predict accurate postoperative pulmonary function in patients undergoing lobectomy.