Comparative Analysis of Different Scintigraphic Approaches to Assess Pulmonary Ventilation
| Autor: | Etienne Lemarié, M. de Monte, E Boissinot, C Valat, Daniel Grimbert, Laurent Vecellio, Julie Magnant, Patrice Diot, D Guilloteau |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Pathology medicine.medical_specialty Scintigraphy Sensitivity and Specificity Pulmonary Disease Chronic Obstructive Predictive Value of Tests Image Processing Computer-Assisted medicine Humans Pharmacology (medical) Particle Size Respiratory system Radionuclide Imaging Lung Aged Sodium Pertechnetate Tc 99m Aged 80 and over COPD medicine.diagnostic_test business.industry Respiratory disease Krypton Radioisotopes Middle Aged Pentetic Acid respiratory system medicine.disease Aerosol medicine.anatomical_structure Multivariate Analysis Breathing Technetium Tc 99m Pentetate Female Radiopharmaceuticals Pulmonary Ventilation Nuclear medicine business Deposition (chemistry) Xenon Radioisotopes |
| Zdroj: | Journal of Aerosol Medicine. 19:148-159 |
| ISSN: | 1557-9026 0894-2684 |
| DOI: | 10.1089/jam.2006.19.148 |
| Popis: | A study was carried out to investigate the predictive value of 81-metastable-krypton (81mKr) distribution, high-size 99-metastable-technetium (99mTc) aerosol deposition and low-size 99mTc aerosol (Technegas) deposition on the pulmonary ventilation evaluated by 133-xenon (133Xe) lung scintigraphy, and to assess the correlation between the 81mKr distribution, the 99mTc aerosols deposition, and the respiratory parameters of patients with chronic obstructive pulmonary disease (COPD). Twenty COPD patients were included. The 81mKr, 133Xe, and 99mTc aerosol lung scintigraphies were successively carried out. The 81mKr distribution and 99mTc deposition were compared to the 133Xe distribution at equilibrium and to the 133Xe clearance. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 81mKr and Technegas lung scintigraphies to detect alterations in ventilation revealed by 133Xe were defined. The 81mKr distribution and 99mTc deposition according to respiratory parameters were described using a principal component analysis. Compared to 133Xe distribution, a significantly higher distribution of 81mKr in the upper parts of the lungs in the more severe patients (p = 0.05), a significantly higher deposition of Technegas in the lower parts of the lungs (p = 0.0008), and a significantly higher deposition in the central parts of the high-size 99mTc aerosol were observed (p = 0.0001). The PPV and the NPV were, respectively, 0.54 and 0.58 for 81mKr and 0.54 and 0.55 for Technegas. There was a significant negative correlation between 81mKr distribution and 133Xe clearance (p = 0.0001) between Technegas deposition and 133Xe clearance (p = 0.0007), and between 99mTc diethylene-triamino-penta-acetate (DTPA) deposition and 133Xe clearance (p = 0.001). Both the 81mKr peripheral distribution and Technegas peripheral deposition correlated negatively with increased obstruction, as measured by forced expiratory volume in 1 sec (FEV1). Peripheral deposition of the high-size 99mTc aerosol deposition correlated with the inspiration/expiration time ratio. In conclusion, 81mKr and 99mTc aerosols' lung scintigraphies do not reflect exactly the pulmonary ventilation as measured by 133Xe scintigraphy. |
| Databáze: | OpenAIRE |
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