Prediction of probability of pneumonectomy for lung cancer using Tc-99m MAA perfusion lung imaging

Pulmonary perfusion scintigraphy with Tc-99m MAA was performed on 182 patients, on whom either pneumonectomy or lobectomy was performed, because of primary nonsmall-cell lung carcinoma. Among them, 76 underwent pneumonectomy, and 106 underwent lobectomy. The mean value of the perfusion fraction (PF) of the affected lung of the patients undergoing pneumonectomy was 32.3 ± 13.6% (range, 4%-50%) and was less than that of the patients undergoing lobectomy, 43.5 ± 4.5% (range, 27%-50%). The difference was statistically significant (t-test, t = 6.82; P <0.001). Among the 28 patients whose PF of the affected lung was equal to or less than 30%, 26 underwent pneumonectomy and only 2 had a lobectomy. Among the 154 patients whose PF of the affected lung was more than 30%, 50 underwent pneumonectomy and 104 had a lobectomy. These result suggest that '30%' can be a cutoff value (Yates correction X2 test, X2 = 33.09; P <0.001).