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. 2009 Feb 8;27(1):20–24. doi: 10.1007/s11604-008-0288-x

Influence of hilar deposition in the evaluation of the alveolar epithelial permeability on 99mTc-DTPA aerosol inhaled scintigraphy

Shigeyuki Ogi 1,✉, Eisuke Gotoh 2, Mayuki Uchiyama 1, Kunihiko Fukuda 1, Mitsuyoshi Urashima 3, Nobuyoshi Fukumitsu 4
PMCID: PMC7101729  PMID: 19373527

Abstract

Purpose

We investigated whether hilar radioaerosol deposition affects the clearance rate of technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) from peripheral alveolar regions.

Materials and methods

A total of 38 patients underwent 99mTc-DTPA inhalation lung scintigraphy. Six region of interest (ROI) patterns were adopted: ROI 1 was outlined around the entire hemithorax, and ROIs 2–6 were outlined around the hemithorax but excluded square ROIs of different size in the hilar region. Half-times (T½) were calculated with time-activity curves using onecompartment and two-compartment analyses. The T½ of ROIs 1–5 were plotted against the T½ of ROI 6, and regression lines were obtained with the least-squares method. The absolute values of the differences between surveyed values and regression line were calculated. The Wilcoxon test for trend and a single linear regression model were used to determine statistical significance.

Results

There were significant reductions in the absolute values of the differences between surveyed values and regression line from ROIs 1–5 by one-component analysis and the fast component of two-compartment analysis (P < 0.001).

Conclusion

Our results suggest that the deposition of radioaerosol in the hilar region affects the clearance rate of 99mTc-DTPA from the alveoli in damaged lungs. The hilar region should be excluded from ROIs when alveolar epithelial permeability is evaluated.

Key words: 99mTc-DTPA, Lung clearance, Alveolar epithelial permeability, One-compartment analysis, Two-compartment analysis

References

  • 1.O’Doherty M.J., Peters A.M. Pulmonary technetium-99m diethylene triamine penta-acetic acid aerosol clearance as an index of lung injury. Eur J Nucl Med. 1997;24:81–87. doi: 10.1007/BF01728316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Smith R.J., Hyde R.W., Waldman D.L., Freund G.G., Weber D.A., Utell M.J., et al. Effect of pattern of aerosol inhalation on clearance of technetium-99m-labeled diethylenetriamine pentaacetic acid from the lungs of normal humans. Am Rev Respir Dis. 1992;145:1109–1116. doi: 10.1164/ajrccm/145.5.1109. [DOI] [PubMed] [Google Scholar]
  • 3.Salvaggio J.E. Inhaled particles and respiratory disease. J Allergy Clin Immunol. 1994;94:304–309. [PubMed] [Google Scholar]
  • 4.Agnew J.E., Pavia D., Clarke S.W. Mucus clearance from peripheral and central airways of asymptomatic cigarette smokers. Bull Eur Physiopathol Respir. 1986;22:263–267. [PubMed] [Google Scholar]
  • 5.Krasnow A., Isitman A., Collier D., Effros R., Hellman R., Palmer D., et al. In: Diagnostic applications of radioaerosols in nuclear medicine. Freeman L., et al., editors. New York: Raven; 1993. pp. 123–193. [Google Scholar]
  • 6.Oberdorster G., Utell M.J., Morrow P.E., Hyde R.W., Weber D.A. Bronchial and alveolar absorption of inhaled 99mTc-DTPA. Am Rev Respir Dis. 1986;134:944–950. doi: 10.1164/arrd.1986.134.5.944. [DOI] [PubMed] [Google Scholar]
  • 7.Mogulkoc N., Brutsche M.H., Bishop P.W., Murby B., Greaves M.S., Horrocks A.W., et al. Pulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP) Thorax. 2001;56:916–923. doi: 10.1136/thorax.56.12.916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Waldman D.L., Weber D.A., Oberdorster G., Grago S.R., Utell M.J., Hyde R.W., et al. Chemical breakdown of technetium-99m DTPA during nebulization. J Nucl Med. 1987;28:378–382. [PubMed] [Google Scholar]
  • 9.Dolovich PEng M.A. Influence of inspiratory flow rate, particle size, and airway caliber on aerosolized drug delivery to the lung. Respir Care. 2000;45:597–608. [PubMed] [Google Scholar]
  • 10.Coates G., O’Brodovich H. Extrapulmonary radioactivity in lung permeability measurements. J Nucl Med. 1987;29:903–906. [PubMed] [Google Scholar]
  • 11.Cuzick J. A Wilcoxon-type test for trend. Stat Med. 1985;4:87–90. doi: 10.1002/sim.4780040112. [DOI] [PubMed] [Google Scholar]
  • 12.Bennett W.D., Ilowite J.S. Dual pathway clearance of 99mTc-DTPA from the bronchial mucosa. Am Rev Respir Dis. 1989;139:1132–1138. doi: 10.1164/ajrccm/139.5.1132. [DOI] [PubMed] [Google Scholar]
  • 13.Effros R.M., Mason G.R. Measurements of pulmonary epithelial permeability in vivo. Am Rev Respir Dis. 1983;127:S59–S65. [PubMed] [Google Scholar]
  • 14.Jones J.G., Minty B.D., Royston D. The physiology of leaky lungs. Br J Anaesth. 1982;54:705–721. doi: 10.1093/bja/54.7.705-a. [DOI] [PubMed] [Google Scholar]
  • 15.Mason G.R., Effros R.M., Uszler J.M., Mena I. Small solute clearance from the lungs of patients with cardiogenic and noncardiogenic pulmonary edema. Chest. 1985;88:327–334. doi: 10.1378/chest.88.3.327. [DOI] [PubMed] [Google Scholar]
  • 16.Gellert A., Winter R., Uthayakumar S. Bronchoalveolar lavage and clearance of 99mTc-DTPA in asbestosis. 1984;39:709. [Google Scholar]
  • 17.Susskind H., Rom W.N. Lung inflammation in coal miners assessed by uptake of 67Ga-citrate and clearance of inhaled 99mTc-labeled diethylenetriamine pentaacetate aerosol. Am Rev Respir Dis. 1992;146:47–52. doi: 10.1164/ajrccm/146.1.47. [DOI] [PubMed] [Google Scholar]
  • 18.Rinderknecht J., Shapiro L., Krauthammer M., Taplin G., Wasserman K., Uszler J.M., et al. Accelerated clearance of small solutes from the lungs in interstitial lung disease. Am Rev Respir Dis. 1980;121:105–117. doi: 10.1164/arrd.1980.121.1.105. [DOI] [PubMed] [Google Scholar]
  • 19.Rosso J., Guillon J.M., Parrot A., Denis M., Akoun G., Mayaud C., et al. Technetium-99m-DTPA aerosol and gallium-67 scanning in pulmonary complications of human immunodeficiency virus infection. J Nucl Med. 1992;33:81–87. [PubMed] [Google Scholar]
  • 20.Jefferies A.L., Coates G., O’Brodovich H. Pulmonary epithelial permeability in hyaline-membrane disease. N Engl J Med. 1984;311:1075–1080. doi: 10.1056/NEJM198410253111703. [DOI] [PubMed] [Google Scholar]
  • 21.Wells A.U., Hansell D.M., Harrison N.K., Lawrence R., Black C.M., du Bois R.M. Clearance of inhaled 99mTc-DTPA predicts the clinical course of fibrosing alveolitis. Eur Respir J. 1993;6:797–802. [PubMed] [Google Scholar]
  • 22.Jones J.G., Minty B.D., Lawler P., Hulands G., Crawley J.C., Veall N. Increased alveolar epithelial permeability in cigarette smokers. Lancet. 1980;1:66–68. doi: 10.1016/S0140-6736(80)90493-6. [DOI] [PubMed] [Google Scholar]
  • 23.Susskind H., Weber D.A., Volkow N.D., Hitzemann R. Increased lung permeability following long-term use of free-base cocaine (crack) Chest. 1991;100:903–909. doi: 10.1378/chest.100.4.903. [DOI] [PubMed] [Google Scholar]
  • 24.Susskind H., Weber D.A., Lau Y.H., Park T.L., Atkins H.L., Franceschi D., et al. Impaired permeability in radiationinduced lung injury detected by technetium-99m-DTPA lung clearance. J Nucl Med. 1997;38:966–971. [PubMed] [Google Scholar]
  • 25.Coates G., O’Brodovich H., Dolovich M. Lung clearance of 99mTc-DTPA in patients with acute lung injury and pulmonary edema. J Thorac Imaging. 1988;3:21–27. doi: 10.1097/00005382-198807000-00008. [DOI] [PubMed] [Google Scholar]
  • 26.Steyn P.F., Gillette S., Gillette E.L. Biological half-life of aerosolized Tc-99m diethylenetriaminepentaacetate in various lung regions of clinically normal beagles. Am J Vet Res. 1994;55:1371–1376. [PubMed] [Google Scholar]

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