Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography
Science Journal of Clinical Medicine
Volume 2, Issue 4, July 2013, Pages: 134-140
Received: May 9, 2013; Published: Jul. 20, 2013
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Authors
CV Papageorgiou, Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece
Dimosthenis Antoniou, Department of Respiratory Medicine, “Sotiria” Hospital for Chest Diseases, Athens, Greece
Georgios Kaltsakas, Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece
Foteini Karakontaki, Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece
Panagiotis Misthos, Department of Thoracic Surgery, “Sotiria” Hospital for Chest Diseases, Athens, Greece
Iris Tsangaridou, Department of Medical Imaging and Interventional Radiology, “Sotiria” Hospital for Chest Diseases, Athens, Greece
Loukas Thanos, Department of Medical Imaging and Interventional Radiology, “Sotiria” Hospital for Chest Diseases, Athens, Greece
NG Koulouris, Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece
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Abstract
Background-Aim: Prediction of postoperative FEV1 and diffusion capacity of the lung for carbon monoxide (DLCO) has a key role in the preoperative evaluation of lung resection candidates with impaired lung function. Additionally, dyspnea is a symptom which significantly affects patients’ quality of life. The aim of our study is to evaluate the role of quantitative Computed Tomography (CT) in predicting postoperative FEV1, DLCO, and chronic dyspnea in lung cancer patients undergoing lung resection. Methods: Thirty lung cancer patients were evaluated. Pulmonary function tests (PFTs) and low-dose chest CT scan were performed preoperatively. Fifteen patients (group A) had normal PFTs and fifteen patients (group B) had impaired lung function. Quantitative evaluation of CT using dual threshold of -910 to -500 Hounsfield Units estimated functional lung volumes. Dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Patients were reevaluated 3 months after surgery. Results: Predicted values of FEV1 and DLCO correlate significantly with the actual postoperative measurements in both groups. DLCO is the lung function index that demonstrates the highest correlation with postoperative dyspnea (r= -0.755, p<0.001). Predicted volume loss correlates well with the postoperative mMRC (r=0.662, p<0.001). Dyspnea score increases by one mMRC score unit per 21% of functional lung parenchyma resected during surgery. Conclusion: Quantitative CT is a valuable tool in the preoperative evaluation of lung cancer patients since it can simultaneously be used for staging, prediction of postoperative lung function, and prediction of postoperative chronic dyspnea.
Keywords
Computed Tomography, Respiratory Function Tests, Pneumonectomy
To cite this article
CV Papageorgiou, Dimosthenis Antoniou, Georgios Kaltsakas, Foteini Karakontaki, Panagiotis Misthos, Iris Tsangaridou, Loukas Thanos, NG Koulouris, Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography, Science Journal of Clinical Medicine. Vol. 2, No. 4, 2013, pp. 134-140. doi: 10.11648/j.sjcm.20130204.13
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