WCLC 2025 - Posters & ePosters-P1.07.29 Prediction of Postoperative Pulmonary Function and Blood Flow Redistribution Using SPECT/CT in Patients Undergoing Lobectomy

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This pilot retrospective observational study from St. Vincent’s Hospital, The Catholic University of Korea, evaluated the use of perfusion SPECT/CT imaging to predict postoperative pulmonary function and assess pulmonary blood flow redistribution in patients with non-small cell lung cancer (NSCLC) undergoing lobectomy. The study included 63 patients, average age 68.2 years, predominantly with adenocarcinoma, undergoing video-assisted or robotic-assisted thoracoscopic lobectomy.<br /><br />Traditionally, postoperative lung function prediction relies on segment count-based formulas that are limited in accuracy and do not consider blood flow redistribution. This study aimed to assess whether perfusion SPECT/CT could better predict postoperative forced expiratory volume in one second (FEV1) and diffusing capacity of the lungs for carbon monoxide (DLCO) and characterize changes in pulmonary perfusion distribution after lobectomy.<br /><br />Preoperative and one-month postoperative pulmonary function tests (PFTs) and perfusion SPECT/CT scans were performed. Predicted postoperative lung function values based on preoperative perfusion fractions were compared with actual postoperative PFT results. The correlation between predicted and actual FEV1 was weak but statistically significant (r=0.27, p=0.03), while the correlation for DLCO was moderate (r=0.33, p=0.007).<br /><br />Pulmonary blood flow redistribution analysis revealed that overall right lung perfusion increased by 2.4% postoperatively, while left lung perfusion decreased. When stratified by lobectomy side, right-sided lobectomy showed a 17% decrease in right pulmonary flow, whereas left-sided lobectomy demonstrated a 21.8% increase in right pulmonary flow. These findings indicate significant physiological adaptations in pulmonary perfusion after lobectomy.<br /><br />The study concludes that perfusion SPECT/CT is a feasible tool for predicting postoperative pulmonary function and provides valuable insights into blood flow redistribution following lobectomy in NSCLC patients. Further long-term follow-up and volumetric lung assessments are planned to expand understanding of postoperative physiological changes and improve clinical care. This work highlights the potential for personalized, imaging-guided lung function prediction to enhance surgical planning and postoperative management.

Asset Subtitle

Deog Gon Cho

Meta Tag

Speaker Deog Gon Cho

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

perfusion SPECT/CT

postoperative pulmonary function

non-small cell lung cancer

lobectomy

pulmonary blood flow redistribution

forced expiratory volume (FEV1)

diffusing capacity of the lungs (DLCO)

video-assisted thoracoscopic surgery

robotic-assisted thoracoscopic surgery

pulmonary function tests