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  • Title: Quantitative lobar Tc99m-MAA SPECT/CT of the lung in pre-and post-procedural guidance for bronchoscopic lung volume reduction.
    Author: Ide Bolet S, Sisti J, Cheng K, Dadparvar S.
    Journal: Nucl Med Commun; 2024 Sep 01; 45(9):770-778. PubMed ID: 38832427.
    Abstract:
    METHODS: This prospective study included 92 patients who underwent BLVR with quantitative SPECT/CT study pre- and post-procedure between November 2018 and June 2023. The mean age was 70 years (range 56-85). with 51 males and 41 females. SPECT/CT quantified perfusion for each lobe, and the lowest counts/volume ratio determined the procedural target. Postprocedure SPECT/CT assessed total atelectasis and perfusion shifts. The 6-minute walk test and pulmonary function tests were compared pre- and post-BLVR. RESULTS: SPECT/CT-guided BLVR showed clinical benefits (decreased oxygen requirements) and physiological improvements in total lung capacity, forced expiratory volume, and forced vital capacity ( P < 0.05). Significant perfusion shifts were observed away from the target lobe, with unique patterns noted for ipsilateral and contralateral nontarget lobes ( P < 0.05). CONCLUSION: Quantitative lobar SPECT/CT in preprocedural guidance for BLVR proved useful in identifying suitable targets in multi-lobe homogeneous emphysema, resulting in physiological and clinical improvements for this patient group. The perfusion shift information provided by SPECT/CT offers valuable insights for pulmonologists.
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