Usefulness of 99mTc-Technegas and 133Xe dynamic SPECT in ventilatory impairment.
OBJECTIVE
To assess the usefulness of SPECT images using (99m)Tc-Technegas (Technegas) and (133)Xe dynamic single photon emission computed tomography (SPECT) (Xe gas) and high-resolution computed tomography (HRCT), as compared with pathological assessment in the detection of small-airway disease including pulmonary emphysema.


METHODS
Seventeen patients with lung cancer were studied. All patients who had undergone both Technegas and Xe gas and CT prior to surgery were examined. SPECT and HRCT results were compared with the results of pathological findings. Histopathological analysis was performed in an area distant from cancer in lobectomy specimens obtained at surgery. Pathological analysis was performed in relation to bronchitis, bronchiolitis, fibrosis of the alveoli and disruption in walls of the alveoli.


RESULTS
Pathological abnormality (mild-to-moderate abnormal change) was seen in all 17 cases. Three patients showed low attenuation areas on CT, and abnormal patterns in SPECT images. In 11 of 14 patients who showed normal findings on CT, SPECT imaging depicted abnormal findings. The remaining three patients had no abnormal findings on CT and both SPECT imaging.


CONCLUSIONS
Technegas and (133)Xe SPECT imaging is useful for evaluating small-airway disease including pulmonary emphysema. Furthermore, SPECT imaging is more useful than morphological HRCT imaging in the evaluation of small-airway disease including pulmonary emphysema.
Yokoe
Koiku
K
Department of Radiology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan. koiku@f4.dion.ne.jp
Satoh
Katashi
K
Yamamoto
Yuka
Y
Nishiyama
Yoshihiro
Y
Asakura
Hirofumi
H
Haba
Reiji
R
Ohkawa
Motoomi
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014980:Xenon Radioisotopes
D019275:Radiopharmaceuticals; D014980:Xenon Radioisotopes; C056708:Technegas; D013670:Sodium Pertechnetate Tc 99m