Ventilation defect burden predicts lung cancer resection outcomes.

IF 4 3区医学 Q1 RESPIRATORY SYSTEM

ERJ Open Research Pub Date : 2025-08-18 eCollection Date: 2025-07-01 DOI:10.1183/23120541.01317-2024

Nisarg Radadia, Eldar Priel, Yonni Friedlander, Norman B Konyer, Chynna Huang, Mobin Jamal, Troy Farncombe, Christopher Marriott, Christian Finley, John Agzarian, Michael D Noseworthy, Parameswaran Nair, Yaron Shargall, Sarah Svenningsen

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Abstract

Background: Abnormal ventilation prior to lung cancer resection has not been investigated using modern ventilation imaging modalities and may better predict postoperative outcomes than guideline-recommended lung function tests. Our objective was to quantify the burden of ventilation defects observed using Technegas single-photon emission computed tomography (SPECT) and ¹²⁹Xe magnetic resonance imaging (MRI) before lung cancer resection, and to evaluate their association with postoperative pulmonary complications and length of hospital stay.

Methods: This was a prospective, 6-week, observational study of adults undergoing lung cancer resection at a single centre. Before lung resection, participants underwent Technegas-SPECT, ¹²⁹Xe-MRI, spirometry and measurement of diffusing capacity of the lung for carbon monoxide. Preoperative ventilation defect burden was quantified by the Technegas-SPECT and ¹²⁹Xe-MRI ventilation defect percent (VDP). Predictors of complications during the 4-week postoperative period and length of hospital stay were evaluated by logistic and linear regression.

Results: Abnormal ventilation was observed preoperatively by Technegas-SPECT and ¹²⁹Xe-MRI for 58% (60 of 103) and 73% (74 of 102) of participants, respectively. Preoperative VDPs were higher for participants with postoperative complications compared with those without (SPECT: p=0.01; MRI: p=0.0006) and correlated with length of hospital stay (SPECT: r=0.44, p<0.0001; MRI: r=0.51, p<0.0001). Multivariable models revealed preoperative VDP to be the strongest predictor of postoperative complications (SPECT: OR 1.06, 95% CI 1.01-1.11, p=0.02; MRI: OR 1.11, 95% CI 1.02-1.21, p=0.02) and length of hospital stay (SPECT: β=0.16, p<0.001; MRI: β=0.23, p<0.001).

Conclusion: Abnormal ventilation is prevalent prior to lung cancer resection and may be a stronger predictor of postoperative complications and length of hospital stay than standard clinical lung function measures.

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通气缺陷负担预测肺癌切除结果

背景：肺癌切除术前异常通气尚未使用现代通气成像方式进行研究，与指南推荐的肺功能检查相比，异常通气可能更好地预测术后结果。我们的目的是量化肺癌切除术前使用Technegas单光子发射计算机断层扫描（SPECT）和129Xe磁共振成像（MRI）观察到的通气缺陷的负担，并评估其与术后肺部并发症和住院时间的关系。方法：这是一项前瞻性的、为期6周的观察性研究，研究对象是在单一中心接受肺癌切除术的成年人。在肺切除术前，参与者接受了spect、129Xe-MRI、肺活量测定和一氧化碳肺弥散能力的测量。术前采用spect和129Xe-MRI通气缺陷百分率（VDP）量化通气缺陷负担。术后4周并发症及住院时间的预测因素采用logistic和线性回归进行评估。结果：术前通过Technegas-SPECT和129Xe-MRI分别观察到58%（103例中60例）和73%（102例中74例）的参与者出现异常通气。有术后并发症的患者术前vdp高于无术后并发症的患者（SPECT: p=0.01; MRI: p=0.0006），且与住院时间相关（SPECT: r=0.44, p）。结论：肺癌切除术前异常通气普遍存在，与标准临床肺功能指标相比，异常通气可能是术后并发症和住院时间更强的预测因子。

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来源期刊

ERJ Open Research Medicine-Pulmonary and Respiratory Medicine

CiteScore

6.20

自引率

4.30%

发文量

273

审稿时长

8 weeks

期刊介绍： ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.