sodium-pertechnetate-tc-99m and Pulmonary-Fibrosis

Interstitial lung disease (ILD) is characterized by inflammation within the alveolar walls and interstitium of the lungs. This causes increased alveolar-capillary membrane permeability. The diagnosis is made by clinical features, chest roentgenography, lung function tests, and high-resolution CT, and it is confirmed by lung biopsy. Radionuclide aerosol tracers such as Tc-99m DTPA show increased lung clearance in ILD. The clearance rate of microaerosol pertechnegas (modified Technegas) from the lungs in the assessment of ILD was evaluated.. Thirty-two patients (22 with ILD and 10 with non-ILD) were evaluated with pertechnegas. Pertechnegas is formed by adding 3% oxygen to technegas, a microaerosol ventilation agent. Regions of interest were then drawn around the lungs, and clearance rates were determined from the best exponential fit.. The mean clearance rate of pertechnegas was significantly increased in ILD and measured 5.78 +/- 2.2 minutes compared with non-ILD, which measured 8.53 +/- 2.42 minutes (P < 0.001). The sensitivity and specificity rates of pertechnegas clearance (less than 8 minutes) in ILD were 90% and 60%, respectively. When combined with chest roentgenography, the sensitivity and specificity rates increased to 100% and 90%, respectively.. Pertechnegas is highly effective in determining the presence of active ILD. It differentiates between active ILD and non-ILD, and it is highly sensitive and specific when combined with chest roentgenography. Its potential role in the management of ILD merits further investigation.

Topics: Adult; Aged; Blood-Air Barrier; Female; Graphite; Humans; Lung; Lung Diseases, Interstitial; Male; Middle Aged; Permeability; Pulmonary Fibrosis; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m

Technegas, a newly developed ultra-fine dry dispersion of Tc-99m labeled carbon with a particle size of approximately 5 nm to 20 nm, possesses the properties for lung ventilation imaging using SPECT. The authors observed a discrepancy between krypton-81m gas and technegas lung ventilation SPECT in two patients with idiopathic pulmonary fibrosis who demonstrated heterogeneously decreased distribution of technegas without regions of high count density (focal hot spots) of tracer in their lungs in spite of the almost homogenous distribution of krypton-81m gas. This finding could be explained by the duration of radioactive gas inhalation. Technegas lung ventilation SPECT images reflected lung ventilation with tidal breathing. Conversely, Kr-81m gas lung ventilation SPECT images reflected not only lung ventilation, but also lung volumes. These two radioactive agents for lung ventilation SPECT show different findings.

Topics: Administration, Inhalation; Aged; Female; Humans; Krypton Radioisotopes; Lung; Male; Middle Aged; Pulmonary Fibrosis; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon

Topics: Adenocarcinoma; Aged; Carboplatin; Combined Modality Therapy; Graphite; Humans; Lung; Lung Neoplasms; Male; Pulmonary Fibrosis; Radionuclide Imaging; Radiotherapy; Sodium Pertechnetate Tc 99m

1. We have developed a method for non-invasive measurement of lung tissue mass, thoracic blood and interstitial volumes by a combination of transmission and emission scanning with technetium isotope (99mTc). 2. In a lung model we demonstrated that emission counts could be successfully corrected for attenuation with data obtained by transmission scanning, despite an uneven distribution of radioactivity and attenuation in the model. 3. In dogs we compared regional transthoracic tissue thickness, measured by transmission scanning, and regional 'thickness' of blood measured by transmission/emission scanning with direct gravimetric measurements made post mortem. Scanning and direct measurements correlated significantly. 4. In man we used a [99mTc]pertechnetate (99mTcO4) flood source to obtain antero-posterior transmission scans with a gamma-camera. The thickness of attenuating tissue was estimated in each pixel. Scans were obtained of thoracic blood (by labelling erythrocytes with 99mTcO4) and of interstitium (with 99mTc-labelled diethylenetriaminepenta-acetic acid and subtraction of the blood image). We used a computer program to correct the emission scans for attenuation using the transmission scan derived tissue thickness, pixel by pixel. Finally we took a lateral chest radiograph to estimate chest wall thickness. 5. In normal man lung tissue thickness at hilar level was 3.1 +/- 0.5 cm (n = 8). Thoracic blood thickness increased from the apex downwards in the upright lung, being 1.2 +/- 0.1 cm at the hilar level and 2.0 +/- 0.3 cm at the lung base. Interstitial thickness was 0.8 +/- 0.3 cm at the hilum and 0.85 +/- 0.2 at the base. These values compare well with data in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Dogs; Emphysema; Humans; Lung; Models, Anatomic; Pulmonary Fibrosis; Sarcoidosis; Sodium Pertechnetate Tc 99m; Thorax; Tomography, Emission-Computed; Tomography, X-Ray Computed