Increased Activity in the Lung Field on Gastroesophageal Scintigraphy Is Not Always Due to Aspiration

Zhao, Xiaofei; Zhuang, Hongming

doi:10.1097/rlu.0000000000001739

Clinical Nuclear Medicine

2017

DOI: 10.1097/rlu.0000000000001739

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Increased Activity in the Lung Field on Gastroesophageal Scintigraphy Is Not Always Due to Aspiration

Xiaofei Zhao

Hongming Zhuang

Abstract: Elevated activity in the lung field on gastroesophageal scintigraphy (milk scan) generally indicates aspiration of the gastric content that has refluxed to the pharynx. An 18-year-old man underwent to gastroesophageal scintigraphy to assess the rate of gastric emptying. Increased activity was noted in the left lower lung field during the image acquisition. Careful analysis of the images showed that this activity was caused by hiatal herniation.

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Cited by 2 publications

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“…Gastroesophageal scintigraphy using 99m Tc can be used to evaluate gastroesophageal reflux, 6,7 but its sensitivity of detecting microaspiration is low 8 . In addition, false-positive interpretation of an aspiration can occur in conventional 99m Tc gastroesophageal scintigraphy 9 . PET/CT technology generally has higher resolution and accuracy than conventional nuclear medicine technique.…”

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confidence: 99%

Gastroesophageal Reflux Revealed by 18F-MFBG PET/CT

He,

Yang,

et al. 2024

Clin Nucl Med

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A 56-year-old woman who had a lung transplant 4 months ago presented frequent vomiting for 1 month. Barium meal and 99mTc gastroesophageal scintigraphy showed no gastroesophageal reflux. The patient was enrolled in a clinical trial and underwent 18F-MFBG PET/CT dynamic imaging. At the seventh minute of dynamic imaging, the images revealed reflux from the cardia into the esophagus and reached the oral cavity.

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confidence: 99%

Gastroesophageal Reflux Revealed by 18F-MFBG PET/CT

He,

Yang,

et al. 2024

Clin Nucl Med

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Use of Static Imaging as a Substitute for Conventional Dynamic Imaging for Salivagrams in Children

Zhao²,

Zhao³

2019

Clin Nucl Med

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Objective Salivagrams are commonly used for detecting pulmonary aspiration. However, conventional dynamic imaging is relatively time-consuming and could be difficult to perform in children with poor compliance. We analyzed the characteristics of conventional dynamic imaging to obtain a simple protocol suitable for use in children. Methods We conducted a retrospective analysis of salivagram data from 1163 patients (783 males, 380 females; age, 1 month to 9.0 years; mean age, 5.7 months) obtained in the past 4.5 years (January 2014 to June 2018). The various timepoint images were used for diagnosis. The positivity rate, missed diagnosis rate, and sensitivity were calculated and compared. Results Dynamic imaging revealed 353 cases of pulmonary aspiration (248 males, 105 females; age, 1 month to 4.5 years; mean age, 6.2 months). The positivity rate was 30.4% (353/1163), and 95.8% (338/353) of patients presented with continuous positive images after pulmonary aspiration. Only 4.2% (15/353) of positive cases showed clearance of pulmonary aspiration. The positivity rates were 11.8%, 18.2%, 21.9%, 25.0%, 27.0%, and 29.2% at 5, 10, 15, 20, 25, and 30 minutes, respectively. About 4.2% (15/353) of positive cases on earlier images showed clearance of pulmonary aspiration on later images, which indicate both early 15-minute and later 30-minute images were necessary. Conclusions Two static images acquired at 15 and 30 minutes might be an effective alternative to conventional salivagram, which mandates dynamic imaging.

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Increased Activity in the Lung Field on Gastroesophageal Scintigraphy Is Not Always Due to Aspiration

Cited by 2 publications

References 13 publications

Gastroesophageal Reflux Revealed by 18F-MFBG PET/CT

Gastroesophageal Reflux Revealed by 18F-MFBG PET/CT

Use of Static Imaging as a Substitute for Conventional Dynamic Imaging for Salivagrams in Children

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