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T. Igarashi



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    P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P2.02-012 - Prediction of Postoperative Pulmonary Function Using CT Volumetry (ID 2515)

      09:30 - 17:00  |  Author(s): T. Igarashi

      • Abstract
      • Slides

      Background:
      According to some guidelines, prediction of postoperative pulmonary function is important in preoperative assessment for the lung cancer resection. Generally, it used to be calculated the function by Segmental method (S method) or Subsegmental method (SS method). But, the volume of pulmonary (sub) segments varies between individuals. The purpose of this study is to evaluate the efficacy of the prediction of postoperative pulmonary function using CT volumetry.

      Methods:
      This study included 29 cases who were performed segmentectomy or (bi) lobectomy for primary lung cancer from August 2013 to June 2014. Actual pulmonary function obtained at 6 months postoperation (VC, %VC, FVC, %FVC, FEV1.0, %FEV1.0, DLco’, % DLco’, DLco’/Na’, %DLco’/Na’) was compared with the predicted pulmonary function calculated by S method, SS method and CT volumetry method (CTV method), respectively. CTV method was calculated by Image analysis software (Synapse Vincent; Fuji Film, Japan) which used the preoperative chest CT scan data (mediastinum conditions, 0.5mm thickness).

      Results:
      The median age of patient was 69 years old, ranging 47 to 83 years old. Seven patients underwent thoracotomy and 22 underwent VATS. Upper lobectomy or upper and middle bilobectomy / upper segmentectomy / middle or lower lobectomy / lower segmentectomy were 12/3/10/4 cases, respectively. These 3 methods were found to have a good correlation with actual pulmonary function. In particular, the CTV method’s function was better correlated with actual VC, %VC, FVC, %FVC, FEV1.0, %FEV1.0(r = 0.909, 0.839, 0.913, 0.849, 0.935, 0.875, respectively). On the other hand, SS method’s function has better correlated with actual DLco’, DLco’/Na’, %DLco’/Na’ (r=0.916, 0.817, 0.789, respectively). The cases of upper lobectomy or upper segmentectomy (U group) were found to overestimate on DLco’/Na’, %DLco’/Na’ (t =4.714, 4.634). The other cases (non-U group) were found to overestimate on FVC, FEV1.0, %FEV1.0 (t=2.446, 3.797, 5.657) .

      Conclusion:
      CTV method may be better correlated evaluation of the ventilation ability than conventional methods, but the evaluation of the diffusion ability is not. Therefore, in the poor pulmonary function case, it is necessary to selectively use these methods in order to make more accurate predictions. And, you should take care that there is pulmonary function to be overestimated or underestimated by the location.

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