title: Thallium-201 scintigraphy in the evaluation of graft dysfunction in lung transplantation. Newark Beth Israel Medical Center Lung Transplant Group.
abstract: The object of this study was to evaluate graft dysfunction utilizing thallium-201 scintigraphy in patients who had undergone lung transplantation. We studied 11 patients who had undergone single-lung transplantation and had 44 evaluations for suspected graft dysfunction. All evaluations included a lung thallium-201 scan and chest radiography. In addition, 42 transbronchial biopsies, 19 gallium-67 scans and 28 pulmonary function tests were obtained. Rejection was defined by histopathology and/or the response to an empirical pulse of methylprednisolone, while cultures of protected specimen brushes and blood with a positive chest radiograph were used to define infection. The sensitivity of thallium scintigraphy for diagnosing rejection and/or infection (94%) was higher than that for transbronchial biopsy (86%), gallium scintigraphy (47%), chest radiography (67%), or spirometry testing (30%). Specificity was 100% for thallium scintigraphy and transbronchial biopsy, as compared to chest radiography and spirometry, which were 75 and 80% respectively. This study indicated that thallium-201 scintigraphy is useful for screening lung transplant recipients for episodes of acute rejection and/or infection. A positive scan is confirmation of graft parenchymal dysfunction and may then be followed by empirical treatment or bronchoscopy with transbronchial biopsy and culture to differentiate rejection and infection.
authors.affiliation: Pulmonary and Critical Care Division, Newark Beth Israel Medical Center, NJ-07112, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Karetzky
authors.forename: R R
authors.initials: RR
authors.lastname: Jasani
authors.forename: M A
authors.initials: MA
authors.lastname: Zubair
mesh_terms: D005069:Evaluation Studies as Topic; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D016040:Lung Transplantation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes