Objective: The purpose of this study was to determine the capability of dynamic perfusion MRI as an alternative to pulmonary perfusion scintigraphy for prediction of postoperative lung function in patients with lung cancer. SUBJECTS AND METHODS. Sixty patients with lung cancer (35 men, 25 women) underwent dynamic perfusion MRI, perfusion scintigraphy, and preoperative and postoperative pulmonary function tests (forced expiratory volume in 1 sec [FEV(1)]). Perfusion MRIs were obtained with a 3D turbo field-echo sequence (TR/TE, 2.7/0.6; flip angle, 40 degrees; matrix, 128 x 96) using a 1.5-T scanner. Regional blood flow was calculated from the signal intensity-time curves after bolus injection of contrast medium on MRI (Q(MRI)) and uptake ratios of radioisotope on perfusion scintigraphy (Q(PS)). Postoperative lung functions predicted by MRI (FEV(1,MRI)) and perfusion scintigraphy (FEV(1,PS)) were calculated from preoperative FEV(1) and regional Qs. To determine the capability of MRI as an alternative to scintigraphy, we evaluated correlations and the limits of agreement between predicted FEV(1,MRI) and postoperative FEV(1) and between predicted FEV(1,PS) and postoperative FEV(1).
Results: The correlation coefficient of postoperative FEV(1) with FEV(1,MRI) (r = 0.93, p < 0.0001) was better than that with FEV(1,PS) (r = 0.89, p < 0.0001). The limits of agreement between postoperative FEV(1) and predicted FEV(1,MRI) (0.9% +/- 10.4%) were smaller than those between postoperative FEV(1) and predicted FEV(1,PS) (2.1% +/- 13.2%).
Conclusion: Dynamic perfusion MRI is a feasible alternative to pulmonary perfusion scintigraphy for predicting postoperative lung function in patients with lung cancer.