ArticleJournal of thoracic disease2026
Association of lung perfusion single-photon emission computed tomography (SPECT) with postoperative lung function decline after segmentectomy.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Lung perfusion scintigraphy is helpful for predicting a decrease in lung function after lobectomy; however, little is known after segmentectomy. Our study aimed to evaluate the performance of perfusion single-photon emission computed tomography with computed tomography (SPECT/CT) for predicting significantly decreased lung function after segmentectomy. Methods: This retrospective observational cohort study included consecutive patients who underwent lung perfusion scintigraphy, recorded using 360° semiconductor SPECT/CT, before a planned segmentectomy for lung nodules. The difference in forced expiratory volume in one second (FEV1) from the presurgery measurement to the 6-month follow-up was predicted using presurgical lung perfusion SPECT/CT, in addition to clinical factors, presurgical pulmonary function tests, lung CT and anatomical segment counting methods. A minimal clinically important difference (MCID) of 100 milliliters in the FEV1 was used. Results: This study included 51 patients [aged 67.0 years (IQR: 60-72)], 21 women, 1 segment resected (IQR: 1-2) who were referred for lung SPECT/CT before segmentectomy. Twenty-three (45%) experienced a functional decrease after 6 months that met the MCID threshold. Lung perfusion SPECT/CT was the only multivariate predictor of the change in the 6-month FEV1 (beta-coefficient 1.532, 95% CI: 0.757-2.308, P<0.001) and of a decrease in FEV1 corresponding to the MCID threshold (odds ratio <0.001, 95% CI: <0.001-0.052, P=0.004). The SPECT-based lung perfusion prediction of a decrease in the FEV1 of more than 192 mL had a sensitivity of 83% and a specificity of 64% for predicting an actual 6-month MCID decrease. Conclusions: A post-segmentectomy decrease in lung function was significantly associated with segmental lung perfusion using lung perfusion SPECT.
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