State-of-the-art radiological techniques improve the assessment of postoperative lung function in patients with non-small cell lung cancer

Abstract

Purpose The purpose of this study was to compare predictive capabilities for postoperative lung function in non-small cell lung cancer (NSCLC) patients of the state-of-the-art radiological methods including perfusion MRI, quantitative CT and SPECT/CT with that of anatomical method (i.e. qualitative CT) and traditional nuclear medicine methods such as planar imaging and SPECT. Materials and methods Perfusion MRI, CT, nuclear medicine study and measurements of %FEV 1 before and after lung resection were performed for 229 NSCLC patients (125 men and 104 women). For perfusion MRI, postoperative %FEV 1 (po%FEV 1) was predicted from semi-quantitatively assessed blood volumes within total and resected lungs, for quantitative CT, it was predicted from the functional lung volumes within total and resected lungs, for qualitative CT, from the number of segments of total and resected lungs, and for nuclear medicine studies, from uptakes within total and resected lungs. All SPECTs were automatically co-registered with CTs for preparation of SPECT/CTs. Predicted po%FEV 1s were then correlated with actual po%FEV 1s, which were measured %FEV 1s after operation. The limits of agreement were also evaluated. Results All predicted po%FEV 1s showed good correlation with actual po%FEV 1s (0.83 ≤ r ≤ 0.88, p < 0.0001). Perfusion MRI, quantitative CT and SPECT/CT demonstrated better correlation than other methods. The limits of agreement of perfusion MRI (4.4 ± 14.2%), quantitative CT (4.7 ± 14.2%) and SPECT/CT (5.1 ± 14.7%) were less than those of qualitative CT (6.0 ± 17.4%), planar imaging (5.8 ± 18.2%), and SPECT (5.5 ± 16.8%). Conclusions State-of-the-art radiological methods can predict postoperative lung function in NSCLC patients more accurately than traditional methods.