Evaluation of regional perfusion as an indicator of resectability in patients with centrally located bronchogenic carcinoma
Ratto, G.B.; Brusasco, V.; Crimi, P.
Minerva Chirurgica 44(17): 1921-1925
1989
ISSN/ISBN: 0026-4733 PMID: 2586803 Document Number: 340579
The value of using regional ventilation (V) and perfusion (Q) tests as signs of resectability has been analysed in 17 patients with centrally located lung cancers who underwent thoracotomy. The criteria for inclusion into the study were the following: (1) histological diagnosis of non-oat-cell carcinoma, (2) no distant metastases, (3) Q in the affected lung less than 40% and (4) evaluation by computed tomography of the extent of the tumor. Regional perfusion was investigated by intravenously injected 133 Xenon. CT scan proved to be the most sensitive test (90%) in order to identify non-resectable lesions; in 2 cases, however, the tumor was erroneously judged non-operable (specificity = 71%). For the evaluation of V and Q data, two parameters were assumed as a non-resectability index: (1) Q less than or equal to 30% and (2) V/Q greater than or equal to 1.5. Sensitivity was 80% for the former and 70% for the latter parameter, while specificity was 85% and 100% respectively. In conclusion, V and Q study may provide highly specific informations on the resectability of centrally located lung cancers, especially when assuming V/Q greater than or equal to 1.5 as discriminating value.