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Ventilation-perfusion scintigraphy to predict postoperative pulmonary function in lung cancer patients undergoing pneumonectomy.

Win T, Tasker AD, Groves AM, White C, Ritchie AJ, Wells FC, Laroche CM

Department of Thoracic Oncology, Papworth Hospital, Papworth Everard, Cambridge, CB3 8RE, United Kingdom. drthidawin@hotmail.com

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.

Published 23 October 2006 in AJR Am J Roentgenol, 187(5): 1260-5.
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