99mTc-DTPA clearance measured by a dual head gamma camera in healthy subjects and patients with sarcoidosis

Thunberg, Stefan; Larsson, Kjell; Eklúnd, Anders; Blaschke, Eleonora

doi:10.1007/bf00702622

Cited by 13 publications

(11 citation statements)

References 33 publications

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“…The measurement of pulmonary technetium-99m-diethylenetriamine pentaacetate (DTPA) clearance is noninvasive and simple and has been demonstrated to be reproducible [22]. In the clinical setting of assessing breathless systemic sclerosis patients with isolated diffusion deficits on lung function testing, technetium-99m-DTPA scans may be a useful additional noninvasive measure to high-resolution computed tomography in confirming the suspicion of vascular disease rather than early fibrosing alveolitis being present in systemic sclerosis.…”

Section: These Results Show That the 99mmentioning

confidence: 99%

Clearance of inhaled technetium-99m-DTPA as a clinical index of pulmonary vascular disease in systemic sclerosis

et al. 1999

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Clearance of inhaled technetium-99m-DTPA as a clinical index of pulmonary vascular disease in systemic sclerosis. O.M. Kon, Z. Daniil, C.M. Black, R.M. du Bois. #ERS Journals Ltd 1999. ABSTRACT: This study evaluated the utility of the clearance time of inhaled diethylenetriamine pentaacetate (DTPA) to distinguish pulmonary vascular disease from early fibrosing alveolitis (FA) in patients with systemic sclerosis (SSc). It was hypothesized that this would be preserved in patients with vascular disease compared with FA, despite similar gas-transfer deficits and matching lung volumes, because of the preservation of alveolar epithelial integrity.All patients had SSc and were categorized into a control group (C; n=9), pulmonary vascular group (VAS; n=14) or FA group (n=14) dependent on the appearance on a computed tomography (CT) scan and the transfer factor of the lung for carbon monoxide (TL,CO) (VAS and FA #70%, C $80%). All patients had a forced vital capacity (FVC) of >80%.The TL,CO (median) was similar in the VAS (57.5%) and FA (60%) groups. There was a significant difference in median DTPA clearance half-times between FA (21.25 min) and VAS (46.5 min) (p=0.014) and between FA and C (84.5 min) (p=0.0004). No difference was found between VAS and C (p=0.0778). Follow-up data from the VAS group showed no subsequent development of FA on the CT scan and no decrease in FVC (n=13, mean 42 months).These results suggest that clearance of diethylenetriamine pentaacetate is preserved in patients likely to have pulmonary vascular disease and may be useful in distinguishing fibrosing alveolitis from vascular disease in systemic sclerosis. Eur Respir J 1999; 13: 133±136.

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Section: These Results Show That the 99mmentioning

confidence: 99%

Clearance of inhaled technetium-99m-DTPA as a clinical index of pulmonary vascular disease in systemic sclerosis

et al. 1999

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“…An anterior-posterior difference has been described in the supine position, with more rapid clearance posteriorly. This is thought to be due to the increased perfusion in the dependent dorsal regions [26]. 99m Tc-DTPA clearance is also affected by increased blood flow [17] and is increased by exercise, perhaps through the recruitment of capillaries [27].…”

Section: Discussionmentioning

confidence: 99%

“…Certain methods of measuring epithelial absorption, such as the urinary excretion of 99m Tc-DTPA after inhalation, or the application of factor analysis, may permit the study of the individual components, although clearance by mucociliary transport is too slow to have affected our studies. None the less, in our study we ensured that epithelial absorption was measured, as the optimal particle size for alveolar deposition was used [26,29].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of intra-individual coefficients of variation (CV) have ranged from 7-18% [16,20,26,31,32]. RIZK et al [17] studied five anaesthetized, paralysed and ventilated dogs using an uncorrected method of 99m Tc-DTPA lung clearance.…”

Section: Discussionmentioning

confidence: 99%

“…SMITH et al [20] recommended that submicronic particles with a GSD of less than 1.6 µm should be employed to minimize variability. Measurements of tot-al lung projections also improve repeatability [26].…”

Section: Discussionmentioning

confidence: 99%

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A comparison of three methods of measuring 99mTc-DTPA lung clearance and their repeatability

Morrison¹,

Skwarski²,

Am³

et al. 1998

Eur Respir J

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The lung clearance of technetium-99m diethylenetriamine penta-acetic acid (99mTc-DTPA) is a measure of respiratory epithelial permeability. Many factors may contribute to the wide range of normal values, including the method of correction for background activity. The aim of this study was to compare three methods of analysis, including their repeatability. 99mTc-DTPA lung clearance imaging was performed on eight nonsmokers (age 32+/-2 yrs, forced expiratory volume in one second (FEV1) 102.8+/-3.3% predicted yrs, mean+/-SEM and seven smokers (age 46+/-4 yrs, p<0.01, versus nonsmokers; FEV1 88.9+/-8.9%, p<0.05 versus nonsmokers) on two occasions each. The smokers were asked to refrain from smoking for 12 h. An uncorrected analysis was compared with two methods corrected for recirculating background activity using an intravenous correction and inter-renal and shoulder background regions of interest. The uncorrected method gave higher mean values for 50% lung clearance of 99mTc-DTPA (t50) values than the inter-renal (p<0.001) and shoulder (p<0.001) methods of correction in nonsmokers and the inter-renal method gave lower values than the shoulder-corrected method (p<0.05). In smokers there was no difference. There were no differences in mean t50 values obtained on two separate visits. There was no difference in the repeatability of the three methods of analysis. The three methods of analysis produced comparable results with no differences in repeatability.

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Different kinetics of lung clearance of technetium-99m labelled diethylene triamine penta-acetic acid in patients with sarcoidosis and smokers

et al. 1994

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The rate of clearance from the lungs of inhaled technetium-99m labelled diethylene triamine penta-acetic acid (99mTc-DTPA) is often increased in interstitial lung disease as well as in smoking. In smokers a bi-exponential clearance course of 99mTc-DTPA when measured over 3 h has previously been shown. This study was performed to compare the kinetics of clearance of 99mTc-DTPA, measured for 3 h, in sarcoid patients and healthy smokers. Forty-one never-smoking patients with sarcoidosis and radiological signs of intrathoracic disease were studied. The results were compared with those of 16 healthy current smokers and of 14 healthy never-smokers reported previously. A mono-exponential clearance equation described the clearance in 22 of the sarcoid patients and all normal never-smokers, but with a shorter average tracer half-life in the patients (P < 0.05). In 19 patients and all smokers a bi-exponential equation gave a significantly better curve fit. The rate of clearance of the slow component was higher in patients with sarcoidosis than in smokers (P < 0.05). The fraction of the tracer cleared by the fast clearance component was smaller in patients with sarcoidosis than in smokers (P < 0.01). Differences in kinetics of clearance of 99mTc-DTPA in sarcoidosis and smoking could thus be demonstrated, suggesting that the abnormal clearance is caused by diverging pathophysiological mechanisms.

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99mTc-DTPA clearance measured by a dual head gamma camera in healthy subjects and patients with sarcoidosis

Cited by 13 publications

References 33 publications

Clearance of inhaled technetium-99m-DTPA as a clinical index of pulmonary vascular disease in systemic sclerosis

Clearance of inhaled technetium-99m-DTPA as a clinical index of pulmonary vascular disease in systemic sclerosis

A comparison of three methods of measuring 99mTc-DTPA lung clearance and their repeatability

Different kinetics of lung clearance of technetium-99m labelled diethylene triamine penta-acetic acid in patients with sarcoidosis and smokers

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