Ekrem Cengiz SEYHAN, Sedat ALTIN, Gülşah GÜNLÜOĞLU, Sinem Nedime SÖKÜCÜ, Nurdan VESKE ŞİMŞEK, Levent DALAR

Akciğ er kanseri hastaların ın preoperatif değerlendirmesinde vibration response imaging cihazının yeri

Giriş: Çalışmam ızda, cerrahi rezeksiyon planlanan küçük hücredışı akciğer kanserli hastaların preoperatif de ğerlendirilmesindeikinci basamak testi olarak vibration response imaging (VRI) kullan ım ın ın ve predicted postoperatif zorlu ekspiratuar volüm 1. sn(PPO FEV1 ) tahminindeki yerini ara ş tırmayı amaçladıkMateryal ve Metod: Operasyon planlanan ve çalışmay ı tamamlayan toplam 31 hastaya postoperatif akciğer fonksiyonların ı tahminetmek amacıyla solunum fonksiyon testleri (SFT), VRIxp ve kantitatif akciğer perfüzyon sintigrafisi yapıldı. Postoperatif 4-6. haftalardatekrar SFT ve VRI yapılarak postoperatif FEV1 ve % FEV1 de ğerlerini cerrahi öncesi VRI ve perfüzyon sintigrafisiyle hesaplanan ppo-FEV1 ile karşıla ştırıldı. Postoperatif takibi olan 31 hastan ın verilerinin istatistiksel analizi iki bölümde yapıldı. İlk bölümde operasyonöncesi iki tahmin etme metodu (perfüzyona dayanan PPO ile VRI ile hesaplanan PPO), ikinci bölümde ise tahmini verilerle operasyonsonrası elde edilen gerçek de ğerler (postoperatif spirometrik de ğerler standart kabul edilerek) karş ıla ştırıldı.Bulgular: VRI ile hesaplanan PPO de ğeriyle perfüzyonla hesaplanan ppo aras ında uyum oran ı %52 idi. Bu oran dü şük olarak saptan-sa da, tahmini PPO VRI ve PPO perfüzyon de ğerleri için kestrim de ğeri sırasıyla %84 ve %47'dir. Bu da göstermektedir ki çalışmam ı-za alınan hastalarda 1. ay postoperatif de ğeri tahmin etmede, PPO VRI, kantitatif perfüzyon sintigrafisinden daha anlamlı bulunmu ştur.Sonuç: VRIxp, postoperatif FEV1 tahmininde yüksek do ğruluk oran ına sahiptir. Yatak ba şı uygulama kolaylığı olması, radyasyonsuz venoninvaziv olu şu nedeniyle de preoperatif de ğerlendirmede kantitatif perfüzyon sintigrafisine alternatif gibi görülmektedir.

Place of vibration response imaging in preoperative lung cancer patients

Introduction: In this study, we aimed to investigate the role of the vibration response imaging (VRI) as the second-line test in preop-erative evaluation of the patients with non-small cell lung cancer (NSCLC) and in prediction of the predicted postoperative forcedexpiratory volume in one second (PPO FEV1 ).Materials and Methods: A total of 31 patients scheduled for surgery underwent pulmonary function tests (PFTs), VRIxp and quantita-tive lung perfusion scintigraphy (LPS) in order to predict postoperative lung functions. PFTs and VRI were repeated between 4 th and6 th postoperative weeks and FEV1 and FEV1 % values were compared with preoperative VRI and PPO-FEV1 calculated with perfusionscintigraphy. Statistical analysis of 31 patients under postoperative follow-up was performed in two parts. In the first part, two pre-operative prediction methods (PPO based on perfusion and PPO calculated with VRI), and in the second part, estimated values andpostoperative actual values (considering postoperative spirometric values as standard) were compared.Results: An agreement rate of 52% was found between the PPO values calculated with VRI and with perfusion. This rate was low,although respective predictive values for PPO VRI and PPO perfusion were 84% and 47%, suggesting that PPO VRI was more sig-nificant than LPS for prediction of the 1 st month postoperative value in the patients included in this study.Conclusions: VRIxp has a high-accuracy rate in prediction postoperative FEV1 . It is seemed as an alternative to quantitative perfusionscintigraphy for preoperative evaluation, because it can be easily applied at the bedside as a radiation free and non-invasive method.

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