title: Ventilation and perfusion lung imaging--which nebulizer?
abstract: Three commercially available 99Tcm-diethylenetriamine pentaacetate (99Tcm-DTPA) aerosol delivery nebulizers for lung ventilation imaging were investigated. Two were air-jet systems, 'Optimist' (Medicaid) and 'Microcirrus' (Amersham), and one was an ultrasonic device (Europlus). Altogether, 112 consecutive patients were scanned, 37 using the Optimist, 40 using the Microcirrus and 35 the Europlus. The age mix, FEV1, FVC and PEFR measurements of the patients in each group were similar. Each contained a proportion of patients with poor respiratory function, with PEFR rates ranging from 30 to 582 l min-1 for patients studied with all systems. Ease of use, image quality and cost were evaluated as well as radioactive and microbiological contamination. The Optimist system gave the best combination of image quality and cost, and was associated with the lowest level of radioactive contamination. It also proved the most popular. Airborne contamination for all nebulizers was lower than previously reported and was largely dependent on patient compliance. With poorly compliant patients, the contamination levels are sufficient to warrant an extraction device. There was no evidence of bacterial contamination of the nebulizers or tubing on repeated use over 5 days.
authors.affiliation: Kent and Canterbury Hospital NHS Trust, Kent, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Carter
authors.forename: C N
authors.initials: CN
authors.lastname: Eustance
authors.forename: A G
authors.initials: AG
authors.lastname: Kettle
authors.forename: S F
authors.initials: SF
authors.lastname: Barrington
authors.forename: C J
authors.initials: CJ
authors.lastname: Page
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Doherty
authors.forename: A J
authors.initials: AJ
authors.lastname: Coakley
mesh_terms: D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008961:Models, Structural; D009330:Nebulizers and Vaporizers; D012123:Pulmonary Ventilation; D011877:Radionuclide Imaging; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage* / Q000627:therapeutic use; D014692:Ventilation-Perfusion Ratio; D014797:Vital Capacity
chemical_list: D016284:Technetium Tc 99m Pentetate