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Asian Cardiovasc Thorac Ann 2004;12:33-37
© 2004 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTION

Predicting the Response to Lung Volume Reduction Surgery Using Scintigraphy

Norihisa Shigemura, MD, Akinori Akashi, MD, Tomoyuki Nakagiri, MD, Mitsunori Ohta, MD1, Hikaru Matsuda, MD1

Division of General Thoracic Surgery, Takarazuka Municipal Hospital, Hyogo, Japan
1 Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

For reprint information contact: Norihisa Shigemura, MD Tel: 81 6 6879 3152 Fax: 81 6 6879 3163 Email: n-shige{at}blue.ocn.ne.jp Department of Surgery, Osaka University Graduate School of Medicine, E1, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.

This study was conducted to evaluate the use of quantitative scintigraphy with a newly designed marker to assess and predict the efficacy of lung volume reduction surgery in treating emphysema. In a series of 50 patients with severe emphysema who underwent the operation, ventilation/perfusion scintigraphy was performed and 2 markers of area ratio and lung uniformity were measured before and 6 months after surgery. The markers were correlated with the results of pulmonary function tests. The histopathological subtype of emphysema was also determined in the resected specimen and related to improvement in the markers. The markers were closely related to improvement in forced expiratory volume in 1 second, with the highest correlation being the marker lung uniformity measured by perfusion scintigraphy. Improvement in this marker was significantly greater in centrilobular than in panlobular emphysema. This quantitative method of scintigraphy could provide an excellent reflection of surgical efficacy as well as predict the surgical outcome. Additionally, it provides a mechanistic explanation for the differential improvement between the histopathological subtypes of emphysema following surgery.






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