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Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography

Received: 9 May 2013     Published: 20 July 2013
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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.

Published in Science Journal of Clinical Medicine (Volume 2, Issue 4)
DOI 10.11648/j.sjcm.20130204.13
Page(s) 134-140
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Computed Tomography, Respiratory Function Tests, Pneumonectomy

References
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  • APA Style

    CV Papageorgiou, Dimosthenis Antoniou, Georgios Kaltsakas, Foteini Karakontaki, Panagiotis Misthos, et al. (2013). Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography. Science Journal of Clinical Medicine, 2(4), 134-140. https://doi.org/10.11648/j.sjcm.20130204.13

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    ACS Style

    CV Papageorgiou; Dimosthenis Antoniou; Georgios Kaltsakas; Foteini Karakontaki; Panagiotis Misthos, et al. Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography. Sci. J. Clin. Med. 2013, 2(4), 134-140. doi: 10.11648/j.sjcm.20130204.13

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    AMA Style

    CV Papageorgiou, Dimosthenis Antoniou, Georgios Kaltsakas, Foteini Karakontaki, Panagiotis Misthos, et al. Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography. Sci J Clin Med. 2013;2(4):134-140. doi: 10.11648/j.sjcm.20130204.13

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  • @article{10.11648/j.sjcm.20130204.13,
      author = {CV Papageorgiou and Dimosthenis Antoniou and Georgios Kaltsakas and Foteini Karakontaki and Panagiotis Misthos and Iris Tsangaridou and Loukas Thanos and NG Koulouris},
      title = {Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography},
      journal = {Science Journal of Clinical Medicine},
      volume = {2},
      number = {4},
      pages = {134-140},
      doi = {10.11648/j.sjcm.20130204.13},
      url = {https://doi.org/10.11648/j.sjcm.20130204.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20130204.13},
      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.},
     year = {2013}
    }
    

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  • TY  - JOUR
    T1  - Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography
    AU  - CV Papageorgiou
    AU  - Dimosthenis Antoniou
    AU  - Georgios Kaltsakas
    AU  - Foteini Karakontaki
    AU  - Panagiotis Misthos
    AU  - Iris Tsangaridou
    AU  - Loukas Thanos
    AU  - NG Koulouris
    Y1  - 2013/07/20
    PY  - 2013
    N1  - https://doi.org/10.11648/j.sjcm.20130204.13
    DO  - 10.11648/j.sjcm.20130204.13
    T2  - Science Journal of Clinical Medicine
    JF  - Science Journal of Clinical Medicine
    JO  - Science Journal of Clinical Medicine
    SP  - 134
    EP  - 140
    PB  - Science Publishing Group
    SN  - 2327-2732
    UR  - https://doi.org/10.11648/j.sjcm.20130204.13
    AB  - 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.
    VL  - 2
    IS  - 4
    ER  - 

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Author Information
  • Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Department of Respiratory Medicine, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Department of Thoracic Surgery, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Department of Medical Imaging and Interventional Radiology, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Department of Medical Imaging and Interventional Radiology, “Sotiria” Hospital for Chest Diseases, Athens, Greece

  • Respiratory Function Laboratories, National University of Athens Medical School, “Sotiria” Hospital for Chest Diseases, Athens, Greece

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