Lung Perfusion Imaging Can Risk Stratify Lung Cancer Patients for the Development of Pulmonary Complications after Chemoradiation Isis W. Gayed, MD,

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Lung Perfusion Imaging Can Risk Stratify Lung Cancer Patients for the Development of Pulmonary Complications after Chemoradiation Isis W. Gayed, MD, Joe Chang, MD, PhD, E Edmund Kim, MD, Rodolfo Nuñez, MD, Beth Chasen, MD, H Helen Liu, PhD, Katsuhiro Kobayashi, MD, Yujing Zhang, MD, Zhongxing Liao, MD, Salman Gohar, MD, Melinda Jeter, MD, Louise Henderson, PhD, William Erwin, MS, Ritsuko Komaki, MD Journal of Thoracic Oncology Volume 3, Issue 8, Pages 858-864 (August 2008) DOI: 10.1097/JTO.0b013e31818020d5 Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Coronal slices from lung perfusion SPECTs demonstrating A, Localized perfusion defect in the right upper lung (arrow) equivalent to a score of 1 on the LPS. B, Localized perfusion defect in the left lung equivalent to a score of 2 (short arrow) and in the right lung (long arrow) equivalent to a score of 3 on the LPS. C, Absent left lung after pneumonectomy equivalent to a score of 4 on the LPS. Journal of Thoracic Oncology 2008 3, 858-864DOI: (10.1097/JTO.0b013e31818020d5) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Posterior planar images of the chest demonstrating different patterns of the remaining lung perfusion (A–D) that corresponds to the different points on the LPS (1–4). A, is homogeneous = score of 1, B, is mild heterogeneity = score of 2, C, is moderate heterogeneity = score of 3, D, is marked heterogeneity = score of 4. Journal of Thoracic Oncology 2008 3, 858-864DOI: (10.1097/JTO.0b013e31818020d5) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Lung perfusion SPECT/CT in a patient with a small LUL cancer but poor perfusion in the remaining lung who developed respiratory failure after RT. Journal of Thoracic Oncology 2008 3, 858-864DOI: (10.1097/JTO.0b013e31818020d5) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Receiver operating characteristic (ROC) curves to assess the ability of the lung perfusion score to discriminate between patients with and without pulmonary complications. Journal of Thoracic Oncology 2008 3, 858-864DOI: (10.1097/JTO.0b013e31818020d5) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions