title: A comparison of radiopharmaceutical agents used for the diagnosis of pulmonary embolism.
abstract: Radioactive gas or technetium-99m aerosols are used to perform pulmonary ventilation scintigraphy. The aim of this study was to compare three radiopharmaceuticals, Kryptoscan, Technegas and Venticis II, in terms of their costs and user preferences rather than on the basis of diagnostic efficacy. For each radiopharmaceutical agent, an analysis questionnaire was sent to nuclear medicine departments setting out the criteria (and subcriteria) to be assessed: diagnosis quality: imaging quality, distribution homogeneity, examination procedures and capacity to examine particular patients (e.g. smokers); safety: for patient, paramedical and medical staff and the environment; use: availability in cases of emergency, ergonomics of the apparatus, simplicity and time of preparation. A score, ranging from 0 to 5, and a weighting (importance of one criterion with regard to the others) were assigned to each criterion. The direct cost of a ventilation (drugs, generator systems, disposable materials) was calculated for each radiopharmaceutical agent according to the number of patients examined per day (1-6) and the number of examination days per week (2-5). Fourteen questionnaires concerning at least two of the products were returned out of the 30 mailed. A 'preference score' was calculated using Pharma Decision software. The mean score of Kryptoscan was significantly higher than that of Venticis II (444 vs. 286, P < 0.001) and higher than the mean score of Technegas (444 vs. 344, P < 0.01). For Venticis II and Technegas, the changes in patient direct costs were minor and depended on the number of patients per day and the number of examination days per week. Respectively, they were: $US 117.66 (5 patients.day-1; 5 days.week-1) to $US 147.74 (2 patients.day-1; 2 days.week-1) and $US 56.60 (6 patients.day-1; 5 days.week-1) to $US 132.08 (2 patients.day-1; 2 days.week-1). The direct cost of ventilation using Kryptoscan varied only according to the number of patients examined per day: $US 104.66 (6 patients.day-1) to $US 266.47 (2 patients.day-1). This study shows that Kryptoscan appears to be preferable for ventilation scintigraphy whenever at least four patients are examined daily.
authors.affiliation: Department of Pharmacy, Lariboisière Hospital, Paris, France. nathalie.padoin@lrb.ap-hop-paris.fr
authors.forename: N
authors.initials: N
authors.lastname: Rizzo-Padoin
authors.forename: A
authors.initials: A
authors.lastname: Farina
authors.forename: C
authors.initials: C
authors.lastname: Le Pen
authors.forename: M
authors.initials: M
authors.lastname: Duet
authors.forename: O
authors.initials: O
authors.lastname: Mundler
authors.forename: R
authors.initials: R
authors.lastname: Leverge
mesh_terms: D000336:Aerosols; D000704:Analysis of Variance; D003365:Costs and Cost Analysis; D005602:France; D006801:Humans; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000191:economics; D012414:Rubidium Radioisotopes / Q000008:administration & dosage; D012449:Safety; D013670:Sodium Pertechnetate Tc 99m / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D013667:Technetium / Q000008:administration & dosage
chemical_list: D000336:Aerosols; D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; C056708:Technegas; D013667:Technetium; D013670:Sodium Pertechnetate Tc 99m