Lung perfusion scintigraphy prior to lung volume reduction surgery

Purpose: The aim of this study was to evaluate whether lung perfusion scintigraphy (LPS) contributes to the preoperative classification of emphysema heterogeneity in patients undergoing LVRS (lung volume reduction surgery) compared to classification based only on computed tomography (CT). Material and Methods: Forty-five potential candidates for LVRS were examined with CT and LPS. The distribution of emphysema within the lungs was visually classified into three categories: markedly heterogeneous, intermediately heterogeneous, or homogeneous. The results of the two imaging techniques were compared to an objective, CT-based computerized classification of heterogeneity. Results: Visual evaluation of all 90 lungs resulted in 50 correct classifications based on CT, in 40 based on LPS and in 68 correct classifications based on the combination of CT and LPS. The combination was superior to CT alone ( p<0.01) in classification of emphysema heterogeneity. There was no significant difference between the evaluations based on either CT or LPS. Conclusion: The combined information from CT and LPS are superior in assessing emphysema heterogeneity prior to LVRS.