Computed tomography volumetric analysis for predicting postoperative lung function for segmentectomy

Open in a separate window OBJECTIVESWe compared the computed tomographic (CT) volumetric analysis and anatomical segment counting (ASC) for predicting postoperative forced expiratory volume in 1 s (FEV₁) and diffusing capacity for carbon monoxide (D_LCO) in patients who had segmentectomy for early-stage lung cancer.METHODSA total of 175 patients who had segmentectomy for lung cancer and had postoperative pulmonary function test were included. CT volumetric analysis was performed by software, which could measure total lung and target segment volume from CT images. ASC and CT volumetric analysis were used to determine predicted postoperative (PPO) values and the concordance and difference of these values were assessed. The relationship between PPO values and actual postoperative values was also investigated.RESULTSThe PPO-FEV₁ and PPO-D_LCO showed high concordance between 2 methods (concordance correlation coefficient = 0.96 for PPO-FEV₁ and 0.95 for PPO-D_LCO). There was no significant difference between PPO values as determined by 2 methods (P = 0.53 for PPO-FEV₁, P = 0.25 for PPO-D_LCO) and actual postoperative values [P = 0.77 (ASC versus actual) and P = 0.20 (CT versus actual) for FEV₁; P = 0.41 (ASC versus actual) and P = 0.80 (CT versus actual) for D_LCO]. We subdivided the patients according to poor pulmonary function test, the number of resected segments and the location of the resected lobe. All subgroup analyses revealed no significant difference between PPO values and actual postoperative values.CONCLUSIONSBoth CT volumetric analysis and ASC showed high predictability for actual postoperative FEV₁ and D_LCO in segmentectomy.