Tc-99m HMPAO scintigraphy in amiodarone-induced acute lung toxicity: comparison with Tc-99m DTPA inhalation scintigraphy.
OBJECTIVE
This case demonstrates the use of Tc-99m HMPAO scintigraphy in amiodarone (AD)-induced lung toxicity. The aim of this presentation is also to discuss different scintigraphic modalities in the diagnosis and follow up in AD-induced lung toxicity.


METHODS
A 77-year-old man, with a suspicious AD-induced acute lung toxicity, underwent Tc-99m DTPA aerosol inhalation scintigraphy and Tc-99m HMPAO scintigraphy.


RESULTS
Rapid alveolar clearance of Tc-99m DTPA was found during AD therapy and increased lung uptake of Tc-99m HMPAO was also demonstrated. These findings supported the diagnosis AD lung toxicity. After cessation of therapy, Tc-99m DTPA alveolar clearance was decreased. Although there was some decrease in L/H and L/B ratios of Tc-99m HMPAO after 3 weeks of stopping therapy, Tc-99m HMPAO uptake in the lungs was still continued. This finding may be the result of ongoing pulmonary inflammation as a result of the long half-life of AD.


CONCLUSIONS
Compared with Tc-99m DTPA aerosol inhalation scintigraphy, Tc-99m HMPAO scintigraphy may have a role in the diagnosis of AD lung toxicity. Nevertheless, there is a need for longitudinal studies investigating patients under AD therapy using follow-up Tc-9m HMPAO scintigraphy.
Kaya
Gamze Kapa
GK
Department of Nuclear Medicine, Dokuz Eylül University, School of Medicine, Izmir, Turkey. gazme.capa@deu.edu.tr
Ozdogan
O
O
Guneri
S
S
Tamc
B
B
Durak
H
H
D000280:Administration, Inhalation; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008171:Lung Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D019690:Technetium Tc 99m Exametazime; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage*
D000889:Anti-Arrhythmia Agents; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D000638:Amiodarone; D016284:Technetium Tc 99m Pentetate