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Clinical application of dual-source CT in the evaluation of patients with lung cancer: correlation with perfusion scintigraphy and pulmonary function tests

Applicazione clinica della TC a doppia sorgente radiogena nei pazienti affetti da tumore del polmone: correlazione con la scintigrafia perfusionale e le prove spirometriche

  • Chest Radiology / Radiologia Toracica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This study was done to assess the diagnostic potential of dual-source computed tomography (DSCT) in the functional evaluation of lung cancer patients undergoing surgical resection. The CT data were compared with pulmonary perfusion scintigraphy and pulmonary function tests (PFTs).

Materials and methods

All patients were evaluated with DSCT, scintigraphy and PFTs. The DSCT scan protocol was as follows: two tubes (80 and 140 kV; Care Dose protocol); 70 cc of contrast material (5 cc/s); 5- to 6-s scan time; 0.6 mm collimation. After the automatic calculation of lung perfusion with DSCT and quantification of air volumes and emphysema with dedicated software applications, the perfusional CT studies were compared with scintigraphy using a visual score for perfusion defects; CT air volumes and emphysema were compared with PFTs.

Results

The values of accuracy, sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of DSCT compared with perfusion scintigraphy as the reference standard were: 0.88, 0.84, 0.90, 0.93 and 0.88, respectively. The McNemar test did not identify significant differences either between the two imaging techniques (p=0.07) or between CT and PFTs (p=0.09).

Conclusions

DSCT is a robust and promising technique that provides important and accurate information on lung function.

Riassunto

Obiettivo

Scopo del nostro studio è stato determinare le potenzialità diagnostiche della tomografia computerizzata dual-source (TC-DS) nella valutazione funzionale polmonare nei pazienti con tumore candidati a chirurgia; i dati ottenuti con la TC sono stati confrontati con la scintigrafia perfusionale e le prove di funzionalità respiratoria (PFTs).

Materiali e metodi

Tutti i pazienti sono stati sottoposti ad una TC-DS, scintigrafia e PFTs. I parametri di acquisizione TC-DS sono stati: doppio tubo radiogeno (80 e 140 kV; protocollo Care Dose); 70 cc di mezzo di contrasto (MdC) (5 cc/s); tempo di scansione 5–6 secondi; collimazione 0,6 mm. Dopo l’elaborazione automatica della perfusione TC e la quantificazione dei volumi aerei e del grado di enfisema mediata da software dedicati, gli studi perfusionali TC-DS sono stati confrontati con la scintigrafia perfusionale con l’utilizzo di uno score visivo per la valutazione dei difetti di perfusione; i dati relativi ai volumi aerei e all’enfisema sono stati confrontati con le PFTs.

Risultati

Sono stai determinati i valori di accuratezza, sensibilità, specificità, valore predittivo positivo (PPV) e valore predittivo negativo (NPV) della TC-DS in confronto alla scintigrafia perfusionale: 0,88, 0,84, 0,90, 0,93 e 0,88, rispettivamente. Il test di McNemar non ha evidenziato differenze statisticamente significative tra le due metodiche (p=0,07) e tra TC e PFTs (p=0,09).

Conclusioni

La TC-DS si presenta accurata e promettente, fornendo importanti informazioni di natura funzionale sul polmone.

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Authors and Affiliations

  1. Department of Radiological Sciences, University of Rome “Sapienza”, V.le Regina Elena 324, 00161, Rome, Italy

    F. Fraioli, G. Serra, S. Liberali, A. Fiorelli, F. Zaccagna, C. Catalano & R. Passariello

  2. Department of Thoracic Surgery, University of Rome “Sapienza”, Rome, Italy

    V. Liparulo

  3. Department of Nuclear Medicine, University of Rome “Sapienza”, Rome, Italy

    G. Ciccariello

Authors
  1. F. Fraioli
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  2. G. Serra
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  3. S. Liberali
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  4. A. Fiorelli
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  5. V. Liparulo
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  6. F. Zaccagna
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  7. G. Ciccariello
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  8. C. Catalano
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  9. R. Passariello
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Corresponding author

Correspondence to F. Fraioli.

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Fraioli, F., Serra, G., Liberali, S. et al. Clinical application of dual-source CT in the evaluation of patients with lung cancer: correlation with perfusion scintigraphy and pulmonary function tests. Radiol med 116, 842–857 (2011). https://doi.org/10.1007/s11547-011-0674-9

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  • DOI: https://doi.org/10.1007/s11547-011-0674-9

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