technetium-tc-99m-sulfur-colloid and Lung-Diseases--Obstructive

Two radiopharmaceuticals, 99mTc-DTPA (D) and 99mTc-rhenium sulfur (R), were evaluated with a nebulizer delivering submicronic particles. Seventy-seven patients were examined (42 D, 35 R). For all patients, the examination began with a ventilation study. Immediately after the last ventilation view, 99mTc MAA was injected. Aerosol performance was assessed in 37 D and 17 R. Nebulization yield was 8.98% for D and 9.31% for R. A lung clearance study was performed in 12 patients for D and in 12 different patients for R. The lung clearance was 0.22%/min for R and 2.35%/min for D. The quality of ventilation and the quantification of bronchial and gastric activity were evaluated; the difference between the two groups was not statistically significant. It may be concluded that radioaerosols allow good quality images to be obtained. The yield of the nebulizer is adequate, so that nebulization of 20 mCi delivers approximately 2 mCi of aerosol activity to the lung. When pulmonary embolism is being investigated, R, due to its slower lung clearance, would appear to be preferable to D for patients suspected of increased bronchoalveolar permeability, especially if the time between nebulization and recording is greater than 10 min.

Topics: Adult; Aerosols; Aged; Aged, 80 and over; Bronchi; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Pentetic Acid; Pulmonary Circulation; Pulmonary Embolism; Radionuclide Imaging; Respiration; Rhenium; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid

We have compared the distribution in the lungs of submicronic aerosols of either Tc-99m sulfur colloid or Tc-99m DTPA immediately after inhalation with the distribution 20 minutes later in 83 patients. Thirty-two of the 83 patients were active smokers. Of the 28 smokers who received Tc-99m DTPA aerosol, the total lung count fell by a mean of 27 +/- 14% between the 0 and 20 minute image. Eleven of these patients also had a major change in distribution of isotope during this time. In the nonsmoking patients total lung counts from Tc-99m DTPA fell by only 16 +/- 8% and none had a major change in distribution pattern. None of the smoking or non-smoking patients who received Tc-99m sulfur colloid had a significant change in count rate or distribution pattern over 20 minutes. The effects on the ventilation images of these rapid changes in count rate and distribution pattern after Tc-99m DTPA aerosol can be minimized by completing the ventilation study as quickly as possible after inhaling Tc-99m DTPA or by using a nondiffusible agent such as Tc-99m sulfur colloid.

Topics: Aerosols; Humans; Lung; Lung Diseases, Obstructive; Pentetic Acid; Radionuclide Imaging; Smoking; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid; Time Factors; Tissue Distribution

Ventilation scintigraphy of the lung, obtained with sufficiently small 99mTc-labelled aerosol particles, provides an image of ventilation distribution that is acceptable in clinical routine. Whether 99mTc-DTPA or 99mTc-sulfur colloid is more suitable as a carrier was studied in 6 smokers and 8 non-smokers with chronic obstructive pulmonary disease. 99mTc-sulfur colloid was not absorbed by the bronchial mucosa and therefore appears to be an almost ideal agent. In contrast, 99mTc-DTPA was absorbed by the bronchial mucosa in all smoking patients more rapidly and inhomogenously than in non-smokers. The quantitative and qualitative comparison of the two dorsal ventilation scans taken both immediately after inhalation and 20 min later, showed in all 6 smoking patients after 20 min significant differences which influenced the diagnosis result. 99mTC-DTPA is therefore not recommended for use in ventilation lung scintigraphy, especially in smoking patients.

Topics: Adolescent; Aerosols; Aged; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Pentetic Acid; Radionuclide Imaging; Smoking; Sulfur; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid

Topics: Adolescent; Adult; Aged; Carcinoma, Bronchogenic; Female; Hemoptysis; Humans; Lung; Lung Diseases, Obstructive; Lung Neoplasms; Male; Middle Aged; Radiography; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tuberculosis, Pulmonary