Article: 99mTc particle perfusion/99mTc aerosol ventilation imaging using a subtraction technique in suspected pulmonary embolism

It is generally acknowledged that ventilation-perfusion mismatch is diagnostic of pulmonary embolism. Lung ventilation imaging with radioactive gases is a good method for the detection of pulmonary embolism, but it is not in widespread use because of the limited availability of 81mKr gas and the poor physical properties of 133Xe. Aerosols have been proposed, instead of gases for use in lung ventilation imaging. As perfusion and ventilation distributions may change very rapidly, the two imaging procedures should be done in rapid succession. The cheapest way to perform the combined perfusion-ventilation (Q/V) imaging is to use 99mTc-labelled macroaggregates and aerosols. In our method the perfusion imaging was done first, immediately followed by the ventilation imaging with 99mTc-labelled aerosols. A computer program was used to subtract the contribution of the perfusion from the combined Q/V image so that the pure ventilation image alone was obtained. The method was tested in 41 patients with suspected pulmonary embolism.

Citing Articles

Safe Pulmonary Scintigraphy in the Era of COVID-19.

Zuckier L Semin Nucl Med. 2021; 52(1):48-55.

PMID: 34330450 PMC: 8216848. DOI: 10.1053/j.semnuclmed.2021.06.021.

References

1.

McNeil B . A diagnostic strategy using ventilation-perfusion studies in patients suspect for pulmonary embolism. J Nucl Med. 1976; 17(7):613-6. View

2.

Alderson P, Biello D, Khan A, Barth K, MCKNIGHT R, Siegel B . Comparison of 133Xe single-breath and washout imaging in the scintigraphic diagnosis of pulmonary embolism. Radiology. 1980; 137(2):481-6. DOI: 10.1148/radiology.137.2.7433681. View

3.

TAPLIN G, Chopra S . Lung perfusion-inhalation scintigraphy in obstructive airway disease and pulmonary embolism. Radiol Clin North Am. 1978; 16(3):491-513. View

4.

TAPLIN G, POE N . A DUAL LUNG-SCANNING TECHNIC FOR EVALUATION OF PULMONARY FUNCTION. Radiology. 1965; 85:365-8. DOI: 10.1148/85.2.365. View

5.

Biello D, Mattar A, MCKNIGHT R, Siegel B . Ventilation-perfusion studies in suspected pulmonary embolism. AJR Am J Roentgenol. 1979; 133(6):1033-7. DOI: 10.2214/ajr.133.6.1033. View

6.

Sovijarvi A, Poyhonen L, Kellomaki L, MUITTARI A . Effects of acute and long-term bronchodilator treatment on regional lung function in asthma assessed with krypton-81m and technetium-99m-labelled macroaggregates. Thorax. 1982; 37(7):516-20. PMC: 459358. DOI: 10.1136/thx.37.7.516. View

7.

Neumann R, Sostman H, Gottschalk A . Current status of ventilation-perfusion imaging. Semin Nucl Med. 1980; 10(3):198-217. DOI: 10.1016/s0001-2998(80)80002-x. View

8.

TAPLIN G, MACDONALD N . Radiochemistry of macroaggregated albumin and newer lung scanning agents. Semin Nucl Med. 1971; 1(2):132-52. DOI: 10.1016/s0001-2998(71)81013-9. View

9.

Alderson P, Rujanavech N, MCKNIGHT R . The role of 133Xe ventilation studies in the scintigraphic detection of pulmonary embolism. Radiology. 1976; 120(3):633-40. DOI: 10.1148/120.3.633. View

10.

Burdine J, Ryder L, Sonnemaker R, DePuey G, Calderson M . 99mTc-human albumin microspheres (HAM) for lung imaging. J Nucl Med. 1971; 12(3):127-30. View

11.

Hayes M, TAPLIN G . Lung imaging with radioaerosols for the assessment of airway disease. Semin Nucl Med. 1980; 10(3):243-51. DOI: 10.1016/s0001-2998(80)80004-3. View

99mTc Particle Perfusion/99mTc Aerosol Ventilation Imaging Using a Subtraction Technique in Suspected Pulmonary Embolism