Skip to main content
PMC home page
Springer Nature - PMC COVID-19 Collection logoLink to Springer Nature - PMC COVID-19 Collection
. 1995;9(4):171. doi: 10.1007/BF03168397

Clinical studies of alveolar-capillary permeability using technetium-99m DTPA aerosol

Felix X Sundram 1,✉
PMCID: PMC7101921  PMID: 8770282

Abstract

Soluble radioaerosols such as technetium-99m diethylene triamine pentacetate (DTPA) permit simple quantitative studies of alveolar-capillary permeability to be performed, since the submicronic aerosols are deposited mainly at the lung periphery and are cleared across the alveolar-capillary membrane. Regional alterations in permeability can also be noted using this radionuclide technique. We have measured the pulmonary epithelial permeability in normal subjects and the alteration in smokers, in glue-sniffers, in patients with inhalation burns, in chronic obstructive pulmonary disease (COPD) and in patients with lung metastases from thyroid cancer treated with radioiodine131I. In the normal volunteers, the time taken for 50% of inhaled99mTc DTPA to be cleared from the lungs (T1/2) was 66 minutes ± lsd of 12 mins. The smokers had a mean T1/2 of 20 mins ± lsd 4 min. In the hard-core glue-sniffing group, the majority were smokers who had stopped smoking and gluesniffing for periods varying from 1 day to 42 days, and it was possible to note the changes in clearance times against period of abstinence.

In the patients with inhalation burns, there was change in lung clearance arising from pulmonary epithelial damage; these patients showed increased rate of clearance (short T1/2) with mean T1/2 of 36 min ± 1 sd of 11 mins, while the retention images revealed regional lung damage in moderately severe inhalation burns. Twenty-four patients with COPD had inhalation scans done with Tc-99m tin colloid radioaerosol, and these images were compared with the perfusion lung scans done with99mTc macroaggregated albumin (MAA); in general the perfusion images matched the defects noted in the inhalation scans. The99mTc DTPA clearance rate in these patients was normal i.e. T1/2 = 78 ± 14 mins. In the thyroid cancer patients with lung metastases, who had high doses of radioiodine treatment, the T1/2 values were normal or prolonged slightly, mean T1/2 = 76 min ± 23.

Key words: alveolar-capillary permeability, inhalation burns, COPD (chronic obstructive pulmonary disease), glue sniffers, thyroid cancer lung metastases

Footnotes

Based on an invited lecture at the 35th Annual Scientific Meeting of the Japanese Society of Nuclear Medicine, Yokohama, October, 1995.

References

  • 1.Gorin AB, Stewart PA. Differential permeability of endothelial and epithelial barriers to albumin flux. J Appl Physiol. 1979;48:1315–1324. doi: 10.1152/jappl.1979.47.6.1315. [DOI] [PubMed] [Google Scholar]
  • 2.Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149:818–824. doi: 10.1164/ajrccm.149.3.7509706. [DOI] [PubMed] [Google Scholar]
  • 3.Schuster DP. Measuring pulmonary vascular permeability. J Nucl Med. 1995;36:1442–1444. [PubMed] [Google Scholar]
  • 4.Touya JJ, Rahimian J, Corbus HF, et al. The lung as a metabolic organ. Sem Nucl Med. 1986;16(4):296–305. doi: 10.1016/S0001-2998(86)80016-2. [DOI] [PubMed] [Google Scholar]
  • 5.Drake RE, Laine GA. Pulmonary microvascular permeability to fluid and macromolecules. J Appl Physiol. 1988;64:487–501. doi: 10.1152/jappl.1988.64.2.487. [DOI] [PubMed] [Google Scholar]
  • 6.Pigorini F, Maini CC, Pau T, Giousue S. The influence of age on the pulmonary clearance of Tc-99m-DTPA radioaerosol. Nucl Med Commun. 1988;9:965–971. doi: 10.1097/00006231-198812000-00004. [DOI] [PubMed] [Google Scholar]
  • 7.Jones JG, Lawler P, Crawley JCW, Minty BD, Hinlands G, 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]
  • 8.Kennedy SM, Elwood RK, Wiggs BJR, Pare PD, Hogg Increased airway mucosal permeability of smokers. Am Rev Respir Dis. 1984;129:143–148. doi: 10.1164/arrd.1984.129.1.143. [DOI] [PubMed] [Google Scholar]
  • 9.Minty BD, Jordan C, Jones JG. Rapid improvement in abnormal pulmonary epithelial permeability after stopping cigarettes. Br Med J. 1981;282:1183–1185. doi: 10.1136/bmj.282.6271.1183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Tan WC, Lee ST, Lee CN, Wong S. The role of fibreoptic bronchoscopy in the management of respiratory burns. Ann Acad Med Singapore. 1985;14:434–434. [PubMed] [Google Scholar]
  • 11.Lee MJ, O’Connel DJ. The plain chest radiograph after acute smoke inhalation. Clinical Radiology. 1988;39:33–36. doi: 10.1016/S0009-9260(88)80334-9. [DOI] [PubMed] [Google Scholar]
  • 12.Marks JD, Luce JM, Lazar NM, et al. Effect of increases in lung volume on clearance of aerosolised solute from human lungs. J Appl Physiol. 1985;59:1242–1245. doi: 10.1152/jappl.1985.59.4.1242. [DOI] [PubMed] [Google Scholar]
  • 13.Rinderknecht J, Shapiro L, Krauthammer M, et al. Accelerated clearance of small solutes from the lungs in interstitial lung disease. Am Rev Respir Div. 1980;121:105–109. doi: 10.1164/arrd.1980.121.1.105. [DOI] [PubMed] [Google Scholar]
  • 14.Mason GR, Uszler IM, Effros RM. Differentiation between hemodynamic and non-hemodynamic pulmonary oedema by a scanning procedure (Abstract) Am Rev Respir Dis. 1981;123:238–238. [Google Scholar]
  • 15.Rosso J, Guillon JM, Denis M, Akoun G, et al. Technetium-99m DTPA Aerosol and Gallium-67 scanning in pulmonary complication of human immunodeficiency virus infection. J Nucl Med. 1992;33:81–87. [PubMed] [Google Scholar]
  • 16.Huchon GJ, Montgomery AB, Lipavsky A, Hoeffel JM, Murray JP. Respiratory clearance of aerosolised solutes of varying molecular weight. J Nucl Med. 1987;28:894–894. [PubMed] [Google Scholar]
  • 17.Hendron DN, Barrow RE, Linares HA, et al. Inhalation injury in burned patients: effects and treatment. Burns. 1988;14(5):349–356. doi: 10.1016/0305-4179(88)90002-2. [DOI] [PubMed] [Google Scholar]
  • 18.Sundram FX, Lee ST. Proceedings of International Symposium on Application of Dynamic Functional studies in Nuclear Medicine in Developing Countries, Vienna 1989 IAEA-SM-304/31. Vienna: International Atomic Energy Agency; 1989. Tc-99m DTPA aerosol studies of the lung in inhalation injuries in burns patients; pp. 319–332. [Google Scholar]
  • 19.Sundram FX, Lee ST. Radionuclide lung scanning in the management of respiratory burns. Ann Acad Med Singapore. 1992;21(5):630–634. [PubMed] [Google Scholar]
  • 20.Sundram FX. Clinical application of radioaerosol studies — pulmonary embolism, glue-sniffers, CODP and inhalation burns. In: Bahk YW, Isawa T, editors. Radioaerosol Imaging of the Lung. Korea: Benedict Press; 1994. pp. 136–148. [Google Scholar]
  • 21.Bahk YW, Chung SK. Radioaerosol lung scanning in COPD and related disorders. In: Bahk YW, Isawa T, editors. Radioaerosol Imaging of the Lung. Korea: Benedict Press; 1994. pp. 88–135. [Google Scholar]
  • 22.Nair G, et al. Urban Air pollution and altered lung function—an East, South and South-East Asian regional coordinated study.N Eng J Med 1995 (in press).
  • 23.Rall JE, Alpers JB, Lewallen GG, et al. Radiation pneumonitis and fibrosis: a complication of radioiodine treatment of pulmonary metastases from cancer of the thyroid. J Clin Endocrinol Metab. 1957;17:1263–1276. doi: 10.1210/jcem-17-11-1263. [DOI] [PubMed] [Google Scholar]
  • 24.Frazell EL, Foota FW. Papillary cancer of the thyroid. A review of 25 years of experience. Cancer. 1984;53:982–992. doi: 10.1002/1097-0142(19840215)53:4<982::AID-CNCR2820530427>3.0.CO;2-E. [DOI] [PubMed] [Google Scholar]
  • 25.Samuel AM, Unnikrishnan TP, Baghel NS, Rajashekharrao B. Effect of radioiodine therapy on pulmonary alveolarcapillary membrane integrity. J Nucl Med. 1995;36:783–787. [PubMed] [Google Scholar]
  • 26.Anazawa Y, Isawa T, Teshima T, Miki M, Motomiya M. Changes in pulmonary epithelial permeability due to thoracic irradiation. J Jpn Soc Chest Dis. 1992;30:862–867. [PubMed] [Google Scholar]

Articles from Annals of Nuclear Medicine are provided here courtesy of Nature Publishing Group

RESOURCES