Radioaerosol Inhalation Lung Scan in Pulmonary Emphysema

International Nuclear Information System (INIS)

Jeon, Jeong Soo; Park, Yong Ha; Chung Soo Kyo; Bahk, Yong Whee

1990-01-01

Perfusion and ventilation imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonary emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebuliser with 15 mCi of 99m Tc-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to 10-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with 99m Tc-MAA was performed in 12 patients. In five patients, we performed follow-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was

Lung scan abnormalities in asthma and their correlation with lung function

International Nuclear Information System (INIS)

Vernon, P.; Burton, G.H.; Seed, W.A.; Charing Cross Hospital, London

1986-01-01

We have used asthma as a model of airways disease to test how well an automated, quantitative method of analysis of lung scans correlates with physiological measurements of disturbed lung function and gas exchange. We studies 25 asthmatics (age 16-73) of widely differing severity (forced expiratory volume in 1-s FEV 1 22%-123% of predicted value), who had airways tests, arterial blood gas analysis, and krypton-technetium lung scans within a short time of each other. In all patients with airways obstruction and in some with normal function during remission, scans showed the typical appearances of multiple defects of ventilation and perfusion. The severity of ventilation defects was assessed from the posterior view of the krypton scan compared to an age- and sex-matched normal range to yield an underventilation score. This correlated closely with the severity of airways obstruction as measured by forced expiratory manouevres. Ventilation and perfusion defects were usually imperfectly matched; the severity of this was computed using a subtraction method applied to the counts on the posterior krypton and technetium scans. The degree of mismatch was inversely related to the arterial partial pressure of oxygen (r=-0.86). The results suggest that computer scan analysis can provide usual functional information about the lung in airways disease. (orig.)

Perfusion lung scintigraphy in primary pulmonary hypertension

International Nuclear Information System (INIS)

Ogawa, Yoji; Nishimura, Tsunehiko; Kumita, Shin-ichirou; Hayashida, Kohei; Uehara, Toshiisa; Shimonagata, Tsuyoshi; Ohno, Akira

1991-01-01

Fifteen cases with primary pulmonary hypertension (PPH) were classified into two groups by using the perfusion lung scan pattern. Eight cases had multiple, small, ill-defined defects (mottled pattern), and remaining seven cases had no mottled pattern. These two groups were compared with mean pulmonary arterial pressure (mean PAP), right ventricular ejection fraction (RVEF), blood gas at room air (PaO 2 ), and alveolar-arterial O 2 difference (A-aDo 2 ). The cases with mottled pattern showed a significant increase in mean PAP. There were no significant differences in RVEF, PaO 2 , and A-aDo 2 , between the groups. The survival rate of the patients with mottled pattern was significantly lower than that without mottled pattern (p<0.05). We concluded that perfusion lung scan is very useful for evaluation of the prognosis in primary pulmonary hypertension. (author)

Counting the mismatches - lung ventilation/perfusion subtraction index

International Nuclear Information System (INIS)

Anderson, T.C.; Evans, S.G.; Larcos, G.; Farlow, D.C.

1998-01-01

Full text: There is potential for interobserver variability in interpretation of ventilation/perfusion (V/Q) scans. Objective quantification of V/Q mismatch could be useful. Thus, the aim of this study is to determine the validity of image subtraction in a group of 27 patients (11 men, 8 women; mean age 59.4 years [range 21-81 years])investigated by V/Q scans for suspected pulmonary emboli. A standard 6 view V/Q scan was obtained with two cobalt markers used on the anterior and posterior surfaces for image alignment. Ventilation images were normalised to the perfusion using an area of normal ventilation and perfusion. With the use of automated, and if required, manual alignment, perfusion images were subtracted from ventilation, with a median filter applied. A summed index of mismatch for each lung scan was calculated from the difference. This index was then retrospectively compared to the result reported by one of four experienced physicians. Two patients with chronic obstructive airways disease were excluded from analysis. We conclude that high probability V/Q scans can be differentiated from low probability studies using this index; further prospective investigation in a larger cohort is warranted

Comparison of two different segmentation methods on planar lung perfusion scan with reference to quantitative value on SPECT/CT

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Suh, Min Seok; Kang, Yeon Koo; Ha, Seung Gyun [Dept. of Nuclear Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); and others

2017-06-15

Until now, there was no single standardized regional segmentation method of planar lung perfusion scan. We compared planar scan based two segmentation methods, which are frequently used in the Society of Nuclear Medicine, with reference to the lung perfusion single photon emission computed tomography (SPECT)/computed tomography (CT) derived values in lung cancer patients. Fifty-five lung cancer patients (male:female, 37:18; age, 67.8 ± 10.7 years) were evaluated. The patients underwent planar scan and SPECT/CT after injection of technetium-99 m macroaggregated albumin (Tc-99 m-MAA). The % uptake and predicted postoperative percentage forced expiratory volume in 1 s (ppoFEV1%) derived from both posterior oblique (PO) and anterior posterior (AP) methods were compared with SPECT/CT derived parameters. Concordance analysis, paired comparison, reproducibility analysis and spearman correlation analysis were conducted. The % uptake derived from PO method showed higher concordance with SPECT/CT derived % uptake in every lobe compared to AP method. Both methods showed significantly different lobar distribution of % uptake compared to SPECT/CT. For the target region, ppoFEV1% measured from PO method showed higher concordance with SPECT/CT, but lower reproducibility compared to AP method. Preliminary data revealed that every method significantly correlated with actual postoperative FEV1%, with SPECT/CT showing the best correlation. The PO method derived values showed better concordance with SPECT/CT compared to the AP method. Both PO and AP methods showed significantly different lobar distribution compared to SPECT/CT. In clinical practice such difference according to different methods and lobes should be considered for more accurate postoperative lung function prediction.

Clinical significance of ventilation/perfusion scans in collagen disease patients

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Suzuki, Kenzo; Kobayashi, Takeshi [Tokyo Metropolitan Hiro-o Hospital (Japan); Kamata, Noriko; Inokuma, Shigeko; Terada, Hitoshi; Yokoyama, Yoshiaki; Abe, Katsumi; Mochizuki, Takao

2000-12-01

The purpose of this study was to detect disturbances in pulmonary circulation in collagen disease patients by means of a non-invasive technique. Ventilation/perfusion scans with {sup 133}Xe gas and {sup 99m}Tc-macroaggregated albumin (MAA) were performed in 109 patients with various collagen diseases. Functional images of V, Vol, Q and V/Q ratio were obtained at total lung capacity. Wash-out time was calculated from the wash-out curve. Whole body scans were performed in 65 patients to evaluate intra-pulmonary shunts. Increased V/Q areas were observed in 74 patients (67.9%), suggesting some impairment of pulmonary perfusion. Decreased perfusion, probably due to vasculitis or intravascular microcoagulation, was observed often, even in patients without pulmonary fibrosis. Shunt ratios over 10% were observed in 8 of the 65 patients (12.3%), indicating formation of PA-PV shunts secondary to peripheral vascular impairment. Wash-out time was prolonged in 37 patients (33.9%), shortened in 18 (16.5%), and within the normal range in 54 (49.6%). The prolonged and normal wash-out times in the patients with pulmonary fibrosis may represent obstructive changes in the small airways superimposed on the fibrosis. Ventilation/perfusion scans are a very useful tool for evaluating collagen lung diseases, and they might contribute to treatment decisions for the patients. (author)

Framework for radiation pneumonitis risk stratification based on anatomic and perfused lung dosimetry

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Dhami, Gurleen; Zeng, Jing; Patel, Shilpen A.; Rengan, Ramesh [University of Washington School of Medicine, Department of Radiation Oncology, Seattle, WA (United States); Vesselle, Hubert J.; Kinahan, Paul E.; Miyaoka, Robert S. [University of Washington School of Medicine, Department of Radiology, Seattle, WA (United States); Bowen, Stephen R. [University of Washington School of Medicine, Department of Radiation Oncology, Seattle, WA (United States); University of Washington School of Medicine, Department of Radiology, Seattle, WA (United States)

2017-05-15

To design and apply a framework for predicting symptomatic radiation pneumonitis in patients undergoing thoracic radiation, using both pretreatment anatomic and perfused lung dose-volume parameters. Radiation treatment planning CT scans were coregistered with pretreatment [{sup 99m}Tc]MAA perfusion SPECT/CT scans of 20 patients who underwent definitive thoracic radiation. Clinical radiation pneumonitis was defined as grade ≥ 2 (CTCAE v4 grading system). Anatomic lung dose-volume parameters were collected from the treatment planning scans. Perfusion dose-volume parameters were calculated from pretreatment SPECT/CT scans. Equivalent doses in 2 Gy per fraction were calculated in the lung to account for differences in treatment regimens and spatial variations in lung dose (EQD2{sub lung}). Anatomic lung dosimetric parameters (MLD) and functional lung dosimetric parameters (pMLD{sub 70%}) were identified as candidate predictors of grade ≥ 2 radiation pneumonitis (AUC > 0.93, p < 0.01). Pairing of an anatomic and functional dosimetric parameter (e.g., MLD and pMLD{sub 70%}) may further improve prediction accuracy. Not all individuals with high anatomic lung dose (MLD > 13.6 GyEQD2{sub lung}, 19.3 Gy for patients receiving 60 Gy in 30 fractions) developed radiation pneumonitis, but all individuals who also had high mean dose to perfused lung (pMLD{sub 70%} > 13.3 GyEQD2) developed radiation pneumonitis. The preliminary application of this framework revealed differences between anatomic and perfused lung dosimetry in this limited patient cohort. The addition of perfused lung parameters may help risk stratify patients for radiation pneumonitis, especially in treatment plans with high anatomic mean lung dose. Further investigations are warranted. (orig.) [German] Erstellung und Anwendung eines Rahmenwerks zur Vorhersage symptomatischer Strahlenpneumonitis bei Patienten mit einer Thorax-Bestrahlung anhand anatomischer und perfundierter Lungendosis-Volumen-Parameter in der

Prediction of postoperative respiratory function of lung cancer patients using quantitative lung scans

International Nuclear Information System (INIS)

Konishi, Hiroshi

1982-01-01

Quantitative sup(99m)Tc-MISA inhalation scan and sup(99m)Tc-MAA perfusion scan were performed in 35 patients with lung cancer who underwent lobectomies. Quantitative 133 Xe ventilation-perfusion scans were also performed in 34 patients with lung cancer who underwent lobectomies. To predict functional loss after lobectomy, the proportion of the No. of segments in the lobe to be resected to the No. of entire segments of that lung was provided for the study. Postoperative FVC, FEVsub(1.0) and MVV were predicted in the study, and which were compared to the respiratory function at one month after operation and more than four months after operation. The predicted postoperative respiratory function was highly correlated with the actually observed postoperative respiratory function (0.7413 lt r lt 0.9278, p lt 0.001). In this study, the postoperative respiratory function was proven to be quite accurately predicted preoperatively with combination of quantitative lung scans and spirometric respiratory function. Therefore this method is useful not only for judgement of operative indication but also for choice of operative method and for counterplan of postoperative respiratory insufficiency. (J.P.N.)

Lung perfusion scintigraphy in the diagnosis of peripheral pulmonary stenosis in patients after repair of Fallot tetralogy

International Nuclear Information System (INIS)

Sabiniewicz, R.; Chojnicki, M.; Alszewicz-Baranowska, J.; Erecinski, J.; Romanowicz, G.; Lass, P.; Bandurski, T.

2002-01-01

The frequency of peripheral pulmonary artery stenosis in patients after surgical repair of tetralogy of Fallot (TOF) ranges from 20 to 40%. This can be either primary or secondary to the surgical intervention. The influence of resulting lung perfusion alterations on the life quality of patients is difficult to predict. The aim of this study was to compare the utility of the diagnostic procedures in this group of patients, with particular focus on lung perfusion scintigraphy. This study comprised 104 patients who underwent repair of TOF at ages from 5 months to 25 years. The patients have been followed up for from 4.2 to 25 years. On the basis of chest X-ray peripheral pulmonary artery stenosis was suspected in 11 patients, in 12 on the basis of echocardiography examination. Lung perfusion scintigraphy has been performed on 87 patients. The disturbances in lung perfusion (mostly in the left lung) were show by means of lung perfusion scintigraphy in 43 (49%) of patients. In 27 of them heart catheterisation has been performed. Angiography revealed stenosis of the lung artery branch in 15/43 (34.9%) patients with abnormal perfusion lung scan and in 4/44 (9%) in patients with normal perfusion lung scan. Intervention procedures were carried out on 10 patients. Lung perfusion scintigraphy may prove a valuable, non-invasive screening tool in the assessment of patients after TOF repair, although both false-negative and false positive results may happen. Therefore, it should play an auxiliary role together with other diagnostic modalities. (author)

[Lung perfusion studies after percutaneous closure of patent ductus arteriosus using the Amplatzer Duct Occluder in children].

Science.gov (United States)

Parra-Bravo, José Rafael; Apolonio-Martínez, Adriana; Estrada-Loza, María de Jesús; Beirana-Palencia, Luisa Gracia; Ramírez-Portillo, César Iván

2015-01-01

The closure of patent ductus arteriosus with multiple devices has been associated with a reduction in lung perfusion. We evaluated the pulmonary perfusion after percutaneous closure of patent ductus arteriosus with the Amplatzer Duct Occluder device using perfusion lung scan. Thirty patients underwent successful percutaneous patent ductus arteriosus occlusions using the Amplatzer Duct Occluder device were included in this study. Lung perfusion scans were preformed 6 months after the procedure. Peak flow velocities and protrusion of the device were analyzed by Doppler echocardiography. A left lung perfusionductus arteriosus and the minimum and maximum diameter/length of the ductus arteriosus ratio were statistically significant in patients with abnormalities of lung perfusion. It was observed protrusion the device in 6 patients with a higher maximum flow rate in the left pulmonary artery. The left lung perfusion may be compromised after percutaneous closure of patent ductus arteriosus with the Amplatzer Duct Occluder. The increased flow velocity in the origin of the left pulmonary artery can be a poor indicator of reduction in pulmonary perfusion and can occur in the absence of protrusion of the device. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

Quantitative lung perfusion evaluation using Fourier decomposition perfusion MRI.

Science.gov (United States)

Kjørstad, Åsmund; Corteville, Dominique M R; Fischer, Andre; Henzler, Thomas; Schmid-Bindert, Gerald; Zöllner, Frank G; Schad, Lothar R

2014-08-01

To quantitatively evaluate lung perfusion using Fourier decomposition perfusion MRI. The Fourier decomposition (FD) method is a noninvasive method for assessing ventilation- and perfusion-related information in the lungs, where the perfusion maps in particular have shown promise for clinical use. However, the perfusion maps are nonquantitative and dimensionless, making follow-ups and direct comparisons between patients difficult. We present an approach to obtain physically meaningful and quantifiable perfusion maps using the FD method. The standard FD perfusion images are quantified by comparing the partially blood-filled pixels in the lung parenchyma with the fully blood-filled pixels in the aorta. The percentage of blood in a pixel is then combined with the temporal information, yielding quantitative blood flow values. The values of 10 healthy volunteers are compared with SEEPAGE measurements which have shown high consistency with dynamic contrast enhanced-MRI. All pulmonary blood flow (PBF) values are within the expected range. The two methods are in good agreement (mean difference = 0.2 mL/min/100 mL, mean absolute difference = 11 mL/min/100 mL, mean PBF-FD = 150 mL/min/100 mL, mean PBF-SEEPAGE = 151 mL/min/100 mL). The Bland-Altman plot shows a good spread of values, indicating no systematic bias between the methods. Quantitative lung perfusion can be obtained using the Fourier Decomposition method combined with a small amount of postprocessing. Copyright © 2013 Wiley Periodicals, Inc.

Evaluation of Pulmonary Perfusion Scan in Heart Disease

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Lee, J T; Kim, C K; Park, C Y; Choi, B S [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1973-09-15

Pulmonary perfusion scan with radioactive {sup 113m}In-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of artial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductras arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

Evaluation of Pulmonary Perfusion Scan in Heart Disease

International Nuclear Information System (INIS)

Lee, J. T.; Kim, C. K.; Park, C. Y.; Choi, B. S.

1973-01-01

Pulmonary perfusion scan with radioactive 113m In-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of artial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductras arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

Preliminary studies of pulmonary perfusion scanning in patients with pulmonary hypertension

International Nuclear Information System (INIS)

Shi Rongfang; Liu Xiujie; Wang Yanqun

1986-01-01

A comparative analysis of pulmonary perfusion scanning through cardiac catheterization of 57 patients including 32 patients with congenital heart disease, 8 patients with chronic pulmonary thromboembolism and 7 patients with primary pulmonary hypertension is reported. The lung scintigram obtained with In-113m or Tc-99m-MAA represents the distribution of pulmonary blood. It has been found that the lung scintigram was abnormal in patients of congenital heart disease with pulmonary hypertension (i. e. pulmonary artery pressure between 41-80 mmHg) and the extent of radoiactive regional defects is proportional to the level of pulmonary hypertension. The results of the analysis indicated that pulmonary perfusion scanning being a noninvasive technique would be a useful method in evaluating the level of pulmonary hypertension in patients with left to right shunt before and after surgical operation

Metabolic lung scanning with N-isopropyl-I-123-p-iodoamphetamine

International Nuclear Information System (INIS)

Touya, J.; Akber, S.F.; Rashimian, J.; Bennett, L.R.

1982-01-01

The mechanisms of uptake of N-Isopropyl-I-123-p-Iodoamphetamine (IMP) in the lung was studied in dogs. It has been concluded that this amine is taken in low specificity - high capacity endothelial receptors. Competitive effect of propranolol guanethidine, amphetamine and ketanine for the binding sites of IMP in the pulmonary endothelial cells was observed. These results show that IMP can be an agent for nonparticulate lung perfusion scans as well as for metabolic lung scans

Radiation-Induced Reductions in Regional Lung Perfusion: 0.1-12 Year Data From a Prospective Clinical Study

International Nuclear Information System (INIS)

Zhang Junan; Ma Jinli; Zhou Sumin; Hubbs, Jessica L.; Wong, Terence Z.; Folz, Rodney J.; Evans, Elizabeth S.; Jaszczak, Ronald J.; Clough, Robert; Marks, Lawrence B.

2010-01-01

Purpose: To assess the time and regional dependence of radiation therapy (RT)-induced reductions in regional lung perfusion 0.1-12 years post-RT, as measured by single photon emission computed tomography (SPECT) lung perfusion. Materials/Methods: Between 1991 and 2005, 123 evaluable patients receiving RT for tumors in/around the thorax underwent SPECT lung perfusion scans before and serially post-RT (0.1-12 years). Registration of pre- and post-RT SPECT images with the treatment planning computed tomography, and hence the three-dimensional RT dose distribution, allowed changes in regional SPECT-defined perfusion to be related to regional RT dose. Post-RT follow-up scans were evaluated at multiple time points to determine the time course of RT-induced regional perfusion changes. Population dose response curves (DRC) for all patients at different time points, different regions, and subvolumes (e.g., whole lungs, cranial/caudal, ipsilateral/contralateral) were generated by combining data from multiple patients at similar follow-up times. Each DRC was fit to a linear model, and differences statistically analyzed. Results: In the overall groups, dose-dependent reductions in perfusion were seen at each time post-RT. The slope of the DRC increased over time up to 18 months post-RT, and plateaued thereafter. Regional differences in DRCs were only observed between the ipsilateral and contralateral lungs, and appeared due to tumor-associated changes in regional perfusion. Conclusions: Thoracic RT causes dose-dependent reductions in regional lung perfusion that progress up to ∼18 months post-RT and persists thereafter. Tumor shrinkage appears to confound the observed dose-response relations. There appears to be similar dose response for healthy parts of the lungs at different locations.

Study on incidence of pulmonary embolism in patients with cardiac pacemakers using lung perfusion mapping and ventilation scanning

International Nuclear Information System (INIS)

Yamashina, Hideki; Higo, Masanori; Sueda, Takashi

1990-01-01

We investigated pulmonary perfusion mapping and ventilation scanning employing 99mTC-MMA and 81mKr-Gas in patients with DDD and VVI cardiac pacemaker implantation. In 51 cases among 175 patients we observed some defects which matched the results from lung perfusion scanning in the pulmonary segments and sub-segments. These were diagnosed as pulmonary embolism after the possibility of other pulmonary diseases was rejected. The incidence rate of pulmonary embolism in patients with VVI (Ventricular pacing/sensing, inhibited type) pacemakers was 47 out of 138, or 34.1%, especially for those who received a pulmonary scanning examination whithin 6 months after pacemaker implantation. In contrast, those who were examined after 6 months had lower rates as well as chronological factors. The incidence rate of pulmonary embolism in 37 patients with DDD (Double chamber pacing/sensing, double modes of response) pacemakers was 10.8%, considerably lower than that for patients with VVI pacemakers. Therefore, one main factor of pulmonary embolism in patients with pacemakers could be the non-physiological phase of the contractions of both atria and ventricles. Other factors, such as the presence of foreign bodies in the endocardium, aging, and hypertension, could also promote pulmonary embolism. (author)

Dual energy CT for the assessment of lung perfusion-Correlation to scintigraphy

International Nuclear Information System (INIS)

Thieme, Sven F.; Becker, Christoph R.; Hacker, Marcus; Nikolaou, Konstantin; Reiser, Maximilian F.; Johnson, Thorsten R.C.

2008-01-01

Purpose of this study was to determine the diagnostic value of dual energy CT in the assessment of pulmonary perfusion with reference to pulmonary perfusion scintigraphy. Thirteen patients received both dual energy CT (DECT) angiography (Somatom Definition, Siemens) and ventilation/perfusion scintigraphy. Median time between scans was 3 days (range, 0-90). DECT perfusion maps were generated based on the spectral properties of iodine. Two blinded observes assessed DECT angiograms, perfusion maps and scintigrams for presence and location of perfusion defects. The results were compared by patient and by segment, and diagnostic accuracy of DECT perfusion imaging was calculated regarding scintigraphy as standard of reference. Diagnostic accuracy per patient showed 75% sensitivity, 80% specificity and a negative predictive value of 66%. Sensitivity per segment amounted to 83% with 99% specificity, with 93% negative predictive value. Peripheral parts of the lungs were not completely covered by the 80 kVp detector in 85% of patients. CTA identified corresponding emboli in 66% of patients with concordant perfusion defects in DECT and scintigraphy. Dual energy CT perfusion imaging is able to display pulmonary perfusion defects with good agreement to scintigraphic findings. DECT can provide a pulmonary CT angiogram, high-resolution morphology of the lung parenchyma and perfusion information in one single exam

Dual energy CT for the assessment of lung perfusion-Correlation to scintigraphy

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Thieme, Sven F.; Becker, Christoph R. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany); Hacker, Marcus [Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich (Germany); Nikolaou, Konstantin; Reiser, Maximilian F. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany); Johnson, Thorsten R.C. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany)], E-mail: thorsten.johnson@med.uni-muenchen.de

2008-12-15

Purpose of this study was to determine the diagnostic value of dual energy CT in the assessment of pulmonary perfusion with reference to pulmonary perfusion scintigraphy. Thirteen patients received both dual energy CT (DECT) angiography (Somatom Definition, Siemens) and ventilation/perfusion scintigraphy. Median time between scans was 3 days (range, 0-90). DECT perfusion maps were generated based on the spectral properties of iodine. Two blinded observes assessed DECT angiograms, perfusion maps and scintigrams for presence and location of perfusion defects. The results were compared by patient and by segment, and diagnostic accuracy of DECT perfusion imaging was calculated regarding scintigraphy as standard of reference. Diagnostic accuracy per patient showed 75% sensitivity, 80% specificity and a negative predictive value of 66%. Sensitivity per segment amounted to 83% with 99% specificity, with 93% negative predictive value. Peripheral parts of the lungs were not completely covered by the 80 kVp detector in 85% of patients. CTA identified corresponding emboli in 66% of patients with concordant perfusion defects in DECT and scintigraphy. Dual energy CT perfusion imaging is able to display pulmonary perfusion defects with good agreement to scintigraphic findings. DECT can provide a pulmonary CT angiogram, high-resolution morphology of the lung parenchyma and perfusion information in one single exam.

The effect of irradiation on lung function and perfusion in patients with lung cancer

International Nuclear Information System (INIS)

Abratt, Raymond P.; Willcox, Paul A.

1995-01-01

Purpose: To prospectively study the changes in lung function in patients with lung carcinoma treated with relatively high doses of irradiation. Methods and Materials: Lung function was assessed prior to and at 6 and 12 months following radiation therapy by a clinical dyspnea score, formal pulmonary function tests (lung volume spirometry and diffusion capacity) as well as an ipsilateral hemithorax lung perfusion scan. Changes in dyspnea score were evaluated by the chi-square and the Fishers exact test. Changes in formal lung function tests were compared with the t-test for dependent data and correlations with the t-test for independent data. Fifty-one patients were entered into the study. There were 42 evaluable patients at 6 months after irradiation and 22 evaluable patients at 12 months after irradiation. Results: A worsening of dyspnea score from 1 to 2, which is clinically acceptable, occurred in 50% or more of patients. However, a dyspnea score of 3, which is a serious complication, developed in only 5% of patients. The diffusion capacity (DLCO) decreased by 14% at 6 months and 12% at 12 months) (p < 0.0001). The forced vital capacity and total lung capacity decreased between 6% and 8% at 6 month and 12 months, which was statistically significant. The forced expiratory volume in 1 s decreased between 2 and 3% at 6 month and 12 months, which was not statistically significant. The ipsilateral hemithorax perfusion decreased by 17 and 20% at 6 and 12 months (p < 0.0001). There was no correlation between the initial hemithorax perfusion, or its decrease at follow up and the decrease in DLCO. Conclusion: Lung irradiation results in some loss of lung function in patients with lung cancer with a projected survival of 6 months or more. The pretreatment DLCO assessment should be useful in predicting clinical tolerance to irradiation

Lung perfusion scintigraphy by SPECT

International Nuclear Information System (INIS)

Hirayama, Takanobu

1990-01-01

The initial study reports the characteristic performance using lung segmental phantom filled in Tc-99m pertechnetate. To evaluate the segmental defect in lung perfusion scintigraphy, we applied Bull's-eye analysis in addition to planar image set. Bull's-eye analysis especially facilitated the interpretation in both middle and lower lobes. Subsequently, to evolute the clinical application of Bull's-eye analysis, pulmonary scintigraphy was performed on 10 normal subjects and 60 patients with several pulmonary diseases. Of interest, Bull's-eye analysis, however, encouraged the interpretation in both lower lobes. To calculate the extention and severity of perfusion defect, the present study describes Bull's-eye analysis. Quantitative scoring showed higher in patients with lung cancer than those with pulmonary tuberculosis. The present study focus that Bull's-eye analysis can be useful for evaluating perfusion in patients with a couple of pulmonary diseases. (author)

Prediction of postoperative pulmonary function following thoracic operations. Value of ventilation-perfusion scanning

International Nuclear Information System (INIS)

Bria, W.F.; Kanarek, D.J.; Kazemi, H.

1983-01-01

Surgical resection of lung cancer is frequently required in patients with severely impaired lung function resulting from chronic obstructive pulmonary disease. Twenty patients with obstructive lung disease and cancer (mean preoperative forced expiratory volume in 1 second [FEV1] . 1.73 L) were studied preoperatively and postoperatively by spirometry and radionuclide perfusion, single-breath ventilation, and washout techniques to test the ability of these methods to predict preoperatively the partial loss of lung function by the resection. Postoperative FEV1 and forced vital capacity (FVC) were accurately predicted by the formula: postoperative FEV1 (or FVC) . preoperative FEV1 X percent function of regions of lung not to be resected (r . 0.88 and 0.95, respectively). Ventilation and perfusion scans are equally effective in prediction. Washout data add to the sophistication of the method by permitting the qualitative evaluation of ventilation during tidal breathing. Criteria for patients requiring the study are suggested

Serial perfusion in native lungs in patients with idiopathic pulmonary fibrosis and other interstitial lung diseases after single lung transplantation.

Science.gov (United States)

Sokai, Akihiko; Handa, Tomohiro; Chen, Fengshi; Tanizawa, Kiminobu; Aoyama, Akihiro; Kubo, Takeshi; Ikezoe, Kohei; Nakatsuka, Yoshinari; Oguma, Tsuyoshi; Hirai, Toyohiro; Nagai, Sonoko; Chin, Kazuo; Date, Hiroshi; Mishima, Michiaki

2016-04-01

Lung perfusions after single lung transplantation (SLT) have not been fully clarified in patients with interstitial lung disease (ILD). The present study aimed to investigate temporal changes in native lung perfusion and their associated clinical factors in patients with ILD who have undergone SLT. Eleven patients were enrolled. Perfusion scintigraphy was serially performed up to 12 months after SLT. Correlations between the post-operative perfusion ratio in the native lung and clinical parameters, including pre-operative perfusion ratio and computed tomography (CT) volumetric parameters, were evaluated. On average, the perfusion ratio of the native lung was maintained at approximately 30% until 12 months after SLT. However, the ratio declined more significantly in idiopathic pulmonary fibrosis (IPF) than in other ILDs (p = 0.014). The perfusion ratio before SLT was significantly correlated with that at three months after SLT (ρ = 0.64, p = 0.048). The temporal change of the perfusion ratio in the native lung did not correlate with those of the CT parameters. The pre-operative perfusion ratio may predict the post-operative perfusion ratio of the native lung shortly after SLT in ILD. Perfusion of the native lung may decline faster in IPF compared with other ILDs. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Short Period of Ventilation without Perfusion Seems to Reduce Atelectasis without Harming the Lungs during Ex Vivo Lung Perfusion

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Sandra Lindstedt

2013-01-01

Full Text Available To evaluate the lung function of donors after circulatory deaths (DCDs, ex vivo lung perfusion (EVLP has been shown to be a valuable method. We present modified EVLP where lung atelectasis is removed, while the lung perfusion is temporarily shut down. Twelve pigs were randomized into two groups: modified EVLP and conventional EVLP. When the lungs had reached 37°C in the EVLP circuit, lung perfusion was temporarily shut down in the modified EVLP group, and positive end-expiratory pressure (PEEP was increased to 10 cm H2O for 10 minutes. In the conventional EVLP group, PEEP was increased to 10 cm H2O for 10 minutes with unchanged lung perfusion. In the modified EVLP group, the arterial oxygen partial pressure (PaO2 was 18.5 ± 7.0 kPa before and 64.5 ± 6.0 kPa after the maneuver (P<0.001. In the conventional EVLP group, the PaO2 was 16.8 ± 3.1 kPa and 46.8 ± 2.7 kPa after the maneuver (P<0.01; P<0.01. In the modified EVLP group, the pulmonary graft weight was unchanged, while in the conventional EVLP group, the pulmonary graft weight was significantly increased. Modified EVLP with normoventilation of the lungs without ongoing lung perfusion for 10 minutes may eliminate atelectasis almost completely without harming the lungs.

Technetium /sup 99m/Tc macroaggregated albumin lung scans. Use in chronic childhood asthma

International Nuclear Information System (INIS)

Hyde, J.S.; Koch, D.F.; Isenberg, P.D.; Werner, P.

1976-01-01

Serial roentgenograms and technetium /sub 99m/Tc macroaggregated albumin lung scans were done simultaneously in 30 bronchodilator-dependent asthmatic children and young adults during both relative remission and attacks of status asthmaticus. When chest roentgenograms showed air trapping and increased peribronchial vascular markings associated with persistent perfusion defects, the children benefited from further laboratory studies and continuous comprehensive therapy. Serial scans provided information about underperfusion that was not discernible either by roentgenograms or by usual blood gas studies. Also, lung scans are easier to obtain in children with long-standing asthma than are detailed pulmonary tests. In our study, technetium /sup 99m/Tc macroaggregated albumin scans showed persistent regional perfusion defects in 20 children with chronic asthma during relative remission and exacerbations

Regional assessment of treatment in lung cancer using lung perfusion and ventilation images

International Nuclear Information System (INIS)

Horikoshi, Masaki; Teshima, Takeo; Yanagimachi, Tomohiro; Ogata, Yuuko; Nukiwa, Toshihiro

2000-01-01

In 30 patients with lung cancer undergoing non-surgical treatment, we performed perfusion lung imaging using 99m Tc-MAA and inhalation lung studies using Technegas before and after treatment and evaluated regional perfusion and ventilation status in the lung regions where bronchogenic carcinoma was located. Regional ventilation status was preserved rather than perfusion counterpart (V>P) in 18 patients (18/30=60.0%) before treatment, while the former was better than the latter in 27 patients (27/30=90.0%) after treatment, indicating that regional ventilation status improved more significantly than regional perfusion counterpart after treatment (P=0.005). We also classified the therapeutic effect for regional perfusion and ventilation status as improved, unchanged, or worsened, respectively; improvement in regional perfusion status was observed in 17 patients (56.7%) and that in regional ventilation status in 24 patients (80.0%). There was a statistically significant correlation between improved regional perfusion and ventilation status (P=0.0018) when therapeutic effect was recognized. The patients who showed improvement in regional perfusion status after treatment always showed improved regional ventilation status, but 7 patients showed either unchanged or worsened regional perfusion status after treatment, although regional ventilation status was improved. In conclusion the pulmonary vascular beds seem more vulnerable to bronchogenic carcinoma and improvement in regional perfusion status was revealed to be more difficult than that in regional ventilation status after treatment. (author)

The relationship between ventilatory lung motion and pulmonary perfusion shown by ventilatory lung motion imaging

International Nuclear Information System (INIS)

Fujii, Tadashige; Tanaka, Masao; Nakatsuka, Tatsuya; Yoshimura, Kazuhiko; Hirose, Yoshiki; Hirayama, Jiro; Kobayashi, Toshio; Handa, Kenjiro

1991-01-01

Using ventilatory lung motion imaging, which was obtained from two perfusion lung scintigrams with 99m Tc-macroaggregated albumin taken in maximal inspiration and maximal expiration, the lung motion (E-I/I) of the each unilateral lung was studied in various cardiopulmonary diseases. The sum of (E-I)/I(+) of the unilateral lung was decreased in the diseased lung for localized pleuropulmonary diseases, including primary lung cancer and pleural thickening, and in both lungs for heart diseases, and diffuse pulmonary diseases including diffuse interstitial pneumonia and diffuse panbronchiolitis. The sum of (E-I)/I(+) of the both lungs, which correlated with vital capacity and PaO 2 , was decreased in diffuse interstitial pneumonia, pulmonary emphysema, diffuse panbronchiolitis, primary lung cancer, pleural diseases and so on. (E-I)/I(+), correlated with pulmonary perfusion (n=49, r=0.51, p 81m Kr or 133 Xe (n=49, r=0.61, p<0.001) than pulmonary perfusion. The ventilatory lung motion imaging, which demonstrates the motion of the intra-pulmonary areas and lung edges, appears useful for estimating pulmonary ventilation of the perfused area as well as pulmonary perfusion. (author)

Hypercapnic acidosis modulates inflammation, lung mechanics, and edema in the isolated perfused lung.

Science.gov (United States)

De Smet, Hilde R; Bersten, Andrew D; Barr, Heather A; Doyle, Ian R

2007-12-01

Low tidal volume (V(T)) ventilation strategies may be associated with permissive hypercapnia, which has been shown by ex vivo and in vivo studies to have protective effects. We hypothesized that hypercapnic acidosis may be synergistic with low V(T) ventilation; therefore, we studied the effects of hypercapnia and V(T) on unstimulated and lipopolysaccharide-stimulated isolated perfused lungs. Isolated perfused rat lungs were ventilated for 2 hours with low (7 mL/kg) or moderately high (20 mL/kg) V(T) and 5% or 20% CO(2), with lipopolysaccharide or saline added to the perfusate. Hypercapnia resulted in reduced pulmonary edema, lung stiffness, tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) in the lavage and perfusate. The moderately high V(T) did not cause lung injury but increased lavage IL-6 and perfusate IL-6 as well as TNF-alpha. Pulmonary edema and respiratory mechanics improved, possibly as a result of a stretch-induced increase in surfactant turnover. Lipopolysaccharide did not induce significant lung injury. We conclude that hypercapnia exerts a protective effect by modulating inflammation, lung mechanics, and edema. The moderately high V(T) used in this study stimulated inflammation but paradoxically improved edema and lung mechanics with an associated increase in surfactant release.

Pre- and postoperative ventilation-perfusion scan findings in patients undergoing total hip replacement or knee arthroplasty

International Nuclear Information System (INIS)

Kim, S.M.; Park, C.H.; Intenzo, C.M.

1988-01-01

Venous thrombolembolism is one of the major postoperative complications in patients undergoing total hip replacement (THR) or knee anthroplasty (TKA). The reported incidence of pulmonary embolism in this group is as high as 20%. The purpose of this report was to evaluate the value of preoperative and 7th-day postpoperative ventilation-perfusion (V/Q) lung scans in the management of patients undergoing elective reconstructive surgery of the hips or knees. Routine preoperative and 7th-day postoperative V/Q lung scans were obtained in 34 patients who underwent THR (17 patients) or TKA (17 patients). There were 15 male and 19 female patients, with an age distribution ranging from 56 to 80 years. Chest radiographs were obtained within 1 day of the pre- or postoperative lungs scan. Lung scans were interpreted by two experienced nuclear physicians

Reverse ventilation--perfusion mismatch

International Nuclear Information System (INIS)

Palmaz, J.C.; Barnett, C.A.; Reich, S.B.; Krumpe, P.E.; Farrer, P.A.

1984-01-01

Patients having lobar airway obstruction or consolidation usually have decreases of both ventilation and perfusion on lung scans. We report three patients in whom hypoxic vasoconstriction was apparently incomplete, resulting in a ''reversed'' ventilation-perfusion mismatch. Perfusion of the hypoxic lobe on the radionuclide scan was associated with metabolic alkalosis, pulmonary venous and pulmonary arterial hypertension in these patients

Ventilation-perfusion lung imaging in diaphragmatic paralysis

International Nuclear Information System (INIS)

Chopra, S.K.; Taplin, G.V.

1977-01-01

Clinical, radiological, physiological, and lung imaging findings from a patient with paralysis of the diaphragm are described. Dyspnea, hypoxemia and hypercapnia increased when the patient changed from the upright to the supine positions. Ventilation (V) and perfusion (P) images of the right lung appeared to be relatively normal and remained nearly the same in the upright and supine positions. In contrast, V/P images of the left lung were smaller than those of the right lung in the upright position and decreased further in the supine position. In addition, the size of the ventilation image was much smaller than that of the perfusion

Role of combined perfusion/ventilation scanning in diagnosis of pulmonary embolism

Energy Technology Data Exchange (ETDEWEB)

Moustafa, H; Elhaddad, SH; Wageeh, SH; Samy, A; Abdo, S [Nuclear medicine and radiology department, faculty of medicine and Cairo university, Cairo, (Egypt)

1995-10-01

This study was conducted on 200 patients with suspected pulmonary embolism. Their age ranged 9-74 years with a mean age of 41.9+14.6 years.The commonest symptoms were dyspnea; chest pain and haemoptysis in 67.5%,49.5% and 14.5% respectively, whereas the main signs were tachycardia in 64.5% followed by rales and oedema of lower limbs in 28.5% and 14% respectively. Cardiac diseases were presenting the main risk factors in 47% followed by DVT, surgery, COLD in 24%,10% and 9.5% respectively. perfusion lung scan was normal in 27.5%, whereas low, intermediate and high probability scans were seen in 7%,23.5% and 42% respectively. The addition of ventilation scan, change probability of perfusion defects into 18.5%,19% and 31.5% in low, intermediate and high probability scans respectively. In addition 3.5% of patient diagnosed as non- embolic disease. There was significant correlation with increase number of symptoms and signs in relation to scan probability in both whole group and high probability group. Also, the incidence of pulmonary embolism appear to be additive with increase number of risk factors in the group of high probability scans. 3 figs., 3 tabs.

Role of combined perfusion/ventilation scanning in diagnosis of pulmonary embolism

International Nuclear Information System (INIS)

Moustafa, H.; Elhaddad, SH.; Wageeh, SH.; Samy, A.; Abdo, S.

1995-01-01

This study was conducted on 200 patients with suspected pulmonary embolism. Their age ranged 9-74 years with a mean age of 41.9+14.6 years.The commonest symptoms were dyspnea; chest pain and haemoptysis in 67.5%,49.5% and 14.5% respectively, whereas the main signs were tachycardia in 64.5% followed by rales and oedema of lower limbs in 28.5% and 14% respectively. Cardiac diseases were presenting the main risk factors in 47% followed by DVT, surgery, COLD in 24%,10% and 9.5% respectively. perfusion lung scan was normal in 27.5%, whereas low, intermediate and high probability scans were seen in 7%,23.5% and 42% respectively. The addition of ventilation scan, change probability of perfusion defects into 18.5%,19% and 31.5% in low, intermediate and high probability scans respectively. In addition 3.5% of patient diagnosed as non- embolic disease. There was significant correlation with increase number of symptoms and signs in relation to scan probability in both whole group and high probability group. Also, the incidence of pulmonary embolism appear to be additive with increase number of risk factors in the group of high probability scans. 3 figs., 3 tabs

Ventilation and perfusion imaging by electrical impedance tomography: a comparison with radionuclide scanning.

Science.gov (United States)

Kunst, P W; Vonk Noordegraaf, A; Hoekstra, O S; Postmus, P E; de Vries, P M

1998-11-01

Electrical impedance tomography (EIT) is a technique that makes it possible to measure ventilation and pulmonary perfusion in a volume that approximates to a 2D plane. The possibility of using EIT for measuring the left-right division of ventilation and perfusion was compared with that of radionuclide imaging. Following routine ventilation (81mKr) and perfusion scanning (99mTc-MAA), EIT measurements were performed at the third and the sixth intercostal level in 14 patients with lung cancer. A correlation (r = 0.98, p RC) was calculated for estimating the left-right division with EIT. The RC for the ventilation measurements was 94% and 96% for the perfusion measurements. The correlation analysis for reproducibility of the EIT measurements was 0.95 (p < 0.001) for the ventilation and 0.93 (p < 0.001) for the perfusion measurements. In conclusion, EIT can be regarded as a promising technique to estimate the left-right division of pulmonary perfusion and ventilation.

Pulmonary Perfusion Changes as Assessed by Contrast-Enhanced Dual-Energy Computed Tomography after Endoscopic Lung Volume Reduction by Coils.

Science.gov (United States)

Lador, Frédéric; Hachulla, Anne-Lise; Hohn, Olivia; Plojoux, Jérôme; Ronot, Maxime; Montet, Xavier; Soccal, Paola M

2016-01-01

Endoscopic lung volume reduction by coils (LVRC) is a recent treatment approach for severe emphysema. Furthermore, dual-energy computed tomography (DECT) now offers a combined assessment of lung morphology and pulmonary perfusion. The aim of our study was to assess the impact of LVRC on pulmonary perfusion with DECT. Seventeen patients (64.8 ± 6.7 years) underwent LVRC. DECT was performed prior to and after LVRC. For each patient, lung volumes and emphysema quantification were automatically calculated. Then, 6 regions of interest (ROIs) on the iodine perfusion map were drawn in the anterior, mid, and posterior right and left lungs at 4 defined levels. The ROI values were averaged to obtain lung perfusion as assessed by the lung's iodine concentration (CLung, μg·cm-3). The CLung values were normalized using the left atrial iodine concentration (CLA) to take into account differences between successive DECT scans. The 6-min walk distance (6MWD) improved significantly after the procedure (p = 0.0002). No lung volume changes were observed between successive DECT scans for any of the patients (p = 0.32), attesting the same suspended inspiration. After LVRC, the emphysema index was significantly reduced in the treated lung (p = 0.0014). Lung perfusion increased significantly adjacent to the treated areas (CLung/CLA from 3.4 ± 1.7 to 5.6 ± 2.2, p < 0.001) and in the ipsilateral untreated areas (from 4.1 ± 1.4 to 6.6 ± 1.7, p < 0.001), corresponding to a mean 65 and 61% increase in perfusion, respectively. No significant difference was observed in the contralateral upper and lower areas (from 4.4 ± 1.9 to 4.8 ± 2.1, p = 0.273, and from 4.9 ± 2.0 to 5.2 ± 1.7, p = 0.412, respectively). A significant correlation between increased 6MWD and increased perfusion was found (p = 0.0027, R2 = 0.3850). Quantitative analysis based on DECT acquisition revealed that LVRC results in a significant increase in perfusion in the coil-free areas adjacent to the treated ones, as

Pulmonary embolic disease: roles of angiography and lung scanning in diagnosis

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Jackson, D C; Tyson, J W; Johnsrude, I S; Wilkinson, Jr, R H

1975-06-01

The definitive diagnosis of pulmonary embolism remains difficult despite recent advances in nuclear medicine and angiography. In 10% of a selected series of 145 patients a negative chest x-ray and a positive lung scan was associated with no arteriographic evidence of pulmonary emboli. A normal perfusion lung scan excludes significant pulmonary embolism. When pulmonary arteriography is necessary, a biplane selective pulmonary angiogram should be performed and subselective injections may be required. Pulmonary arteriography is less of a threat to a patient suspected of having pulmonary embolic disease than inappropriate treatment.

Reversible ventilation and perfusion abnormalities in unilateral obstructed lung

International Nuclear Information System (INIS)

Ward, H.E.; Jones, R.L.; King, E.G.; Sproule, B.J.; Fortune, R.L.

1982-01-01

An intraluminal carcinoid tumor obstructing the left mainstem bronchus produced hypoxemia through alteration in ventilation/perfusion matching. Studies of regional lung function using 133-xenon (/sup 133/Xe) and a multiprobe computerized instrumentation system documented a reduction of perfusion to 22 percent and ventilation to 6 percent of the total. There was negligible washout of intravenously injected /sup 133/Xe from the left lung consistent with air trapping. Four days after left mainstem bronchial sleeve resection, perfusion, ventilation and washout of injected xenon had significantly improved and by four months postresection, all measurements were virtually normal, although complete restoration of perfusion in relation to ventilation was delayed. Regional lung function studied with a multiprobe system in this patient provided a clinical model for the study of ventilation and perfusion inter-relationships in large airway obstruction and demonstrated that a prolonged time may be required for return of perfusion to normal

Studies in radioaerosol lung scanning in urban health survey subjects

International Nuclear Information System (INIS)

Doshi, V.B.; Gregat, I.K.; Kamat, S.R.; Papewar, V.N.; Raikar, U.R.; Sharma, S.M.; Ganatra, R.D.

1984-01-01

As a part of health survey in relation to air pollution, 16 smokers(11 from 'high' and 5 from 'low' zone) were studied with extensive serial lung functions, chest radiography and radioaerosol lung scanning. The clinical diagnosis were chronic bronchitis(COPD) in 9 subjects; but others (4 'High' and 3 'Low') were considered normal. The values of FVC, FEV were normal in most of these three groups, but FEV 1 /FVC percent values were lower in subjects from 'high' zone.The functional declines were higher in normals of 'high' zone. Radioaerosol (ventilation) scans (with technetium 99 ) showed a normal picture in 2 COPD and 3 normal subjects; in 3 COPD and 1 normal subjects the abnormalities were definite. For perfusion scans, 2 COPD and 3 normal subjects showed a normal pattern while definite abnormalities were seen in 1 COPD and 1 normal subjects. Lung scans may pick up abnormalities in normal smokers at an early stage. (author)

Value of the ventilation/perfusion scan in acute pulmonary embolism: Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED)

International Nuclear Information System (INIS)

Anon.

1990-01-01

To determine the sensitivities and specificities of ventilation/perfusion lung scans for acute pulmonary embolism, a random sample of 933 of 1,493 patients was studied prospectively. Nine hundred thirty-one underwent scintigraphy and 755 underwent pulmonary angiography; 251 (33%) of 755 demonstrated pulmonary embolism. Almost all patients with pulmonary embolism had abnormal scans of high, intermediate, or low probability, but so did most without pulmonary embolism. Of 116 patients with high-probability scans and definitive angiograms, 102 (88%) had pulmonary embolism, but only a minority with pulmonary embolism had high-probability scans. Of 322 with intermediate-probability scans and definitive angiograms, 105 (33%) had pulmonary embolism. Follow-up and angiography together suggest pulmonary embolism occurred among 12% of patients with low-probability scans. Clinical assessment combined with the ventilation/perfusion scan established the diagnosis or exclusion of pulmonary embolism only for a minority of patients--those with clear and concordant clinical and ventilation/perfusion scan findings

Ventilation/Perfusion Positron Emission Tomography—Based Assessment of Radiation Injury to Lung

International Nuclear Information System (INIS)

Siva, Shankar; Hardcastle, Nicholas; Kron, Tomas; Bressel, Mathias; Callahan, Jason; MacManus, Michael P.; Shaw, Mark; Plumridge, Nikki; Hicks, Rodney J.; Steinfort, Daniel; Ball, David L.; Hofman, Michael S.

2015-01-01

Purpose: To investigate 68 Ga-ventilation/perfusion (V/Q) positron emission tomography (PET)/computed tomography (CT) as a novel imaging modality for assessment of perfusion, ventilation, and lung density changes in the context of radiation therapy (RT). Methods and Materials: In a prospective clinical trial, 20 patients underwent 4-dimensional (4D)-V/Q PET/CT before, midway through, and 3 months after definitive lung RT. Eligible patients were prescribed 60 Gy in 30 fractions with or without concurrent chemotherapy. Functional images were registered to the RT planning 4D-CT, and isodose volumes were averaged into 10-Gy bins. Within each dose bin, relative loss in standardized uptake value (SUV) was recorded for ventilation and perfusion, and loss in air-filled fraction was recorded to assess RT-induced lung fibrosis. A dose-effect relationship was described using both linear and 2-parameter logistic fit models, and goodness of fit was assessed with Akaike Information Criterion (AIC). Results: A total of 179 imaging datasets were available for analysis (1 scan was unrecoverable). An almost perfectly linear negative dose-response relationship was observed for perfusion and air-filled fraction (r 2 =0.99, P<.01), with ventilation strongly negatively linear (r 2 =0.95, P<.01). Logistic models did not provide a better fit as evaluated by AIC. Perfusion, ventilation, and the air-filled fraction decreased 0.75 ± 0.03%, 0.71 ± 0.06%, and 0.49 ± 0.02%/Gy, respectively. Within high-dose regions, higher baseline perfusion SUV was associated with greater rate of loss. At 50 Gy and 60 Gy, the rate of loss was 1.35% (P=.07) and 1.73% (P=.05) per SUV, respectively. Of 8/20 patients with peritumoral reperfusion/reventilation during treatment, 7/8 did not sustain this effect after treatment. Conclusions: Radiation-induced regional lung functional deficits occur in a dose-dependent manner and can be estimated by simple linear models with 4D-V/Q PET/CT imaging. These

Ventilation/Perfusion Positron Emission Tomography—Based Assessment of Radiation Injury to Lung

Energy Technology Data Exchange (ETDEWEB)

Siva, Shankar, E-mail: shankar.siva@petermac.org [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville (Australia); Hardcastle, Nicholas [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Kron, Tomas [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Bressel, Mathias [Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne (Australia); Callahan, Jason [Centre for Molecular Imaging, Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); MacManus, Michael P.; Shaw, Mark; Plumridge, Nikki [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Hicks, Rodney J. [Centre for Molecular Imaging, Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Medicine, University of Melbourne, Parkville (Australia); Steinfort, Daniel [Department of Medicine, University of Melbourne, Parkville (Australia); Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne (Australia); Ball, David L. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Hofman, Michael S. [Centre for Molecular Imaging, Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Medicine, University of Melbourne, Parkville (Australia)

2015-10-01

Purpose: To investigate {sup 68}Ga-ventilation/perfusion (V/Q) positron emission tomography (PET)/computed tomography (CT) as a novel imaging modality for assessment of perfusion, ventilation, and lung density changes in the context of radiation therapy (RT). Methods and Materials: In a prospective clinical trial, 20 patients underwent 4-dimensional (4D)-V/Q PET/CT before, midway through, and 3 months after definitive lung RT. Eligible patients were prescribed 60 Gy in 30 fractions with or without concurrent chemotherapy. Functional images were registered to the RT planning 4D-CT, and isodose volumes were averaged into 10-Gy bins. Within each dose bin, relative loss in standardized uptake value (SUV) was recorded for ventilation and perfusion, and loss in air-filled fraction was recorded to assess RT-induced lung fibrosis. A dose-effect relationship was described using both linear and 2-parameter logistic fit models, and goodness of fit was assessed with Akaike Information Criterion (AIC). Results: A total of 179 imaging datasets were available for analysis (1 scan was unrecoverable). An almost perfectly linear negative dose-response relationship was observed for perfusion and air-filled fraction (r{sup 2}=0.99, P<.01), with ventilation strongly negatively linear (r{sup 2}=0.95, P<.01). Logistic models did not provide a better fit as evaluated by AIC. Perfusion, ventilation, and the air-filled fraction decreased 0.75 ± 0.03%, 0.71 ± 0.06%, and 0.49 ± 0.02%/Gy, respectively. Within high-dose regions, higher baseline perfusion SUV was associated with greater rate of loss. At 50 Gy and 60 Gy, the rate of loss was 1.35% (P=.07) and 1.73% (P=.05) per SUV, respectively. Of 8/20 patients with peritumoral reperfusion/reventilation during treatment, 7/8 did not sustain this effect after treatment. Conclusions: Radiation-induced regional lung functional deficits occur in a dose-dependent manner and can be estimated by simple linear models with 4D-V/Q PET

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer.

Science.gov (United States)

Chen, Xiaoliang; Xu, Yanyan; Duan, Jianghui; Li, Chuandong; Sun, Hongliang; Wang, Wu

2017-07-01

To investigate the potential relationship between perfusion parameters from first-pass dual-input perfusion computed tomography (DI-PCT) and iodine uptake levels estimated from dual-energy CT (DE-CT).The pre-experimental part of this study included a dynamic DE-CT protocol in 15 patients to evaluate peak arterial enhancement of lung cancer based on time-attenuation curves, and the scan time of DE-CT was determined. In the prospective part of the study, 28 lung cancer patients underwent whole-volume perfusion CT and single-source DE-CT using 320-row CT. Pulmonary flow (PF, mL/min/100 mL), aortic flow (AF, mL/min/100 mL), and a perfusion index (PI = PF/[PF + AF]) were automatically generated by in-house commercial software using the dual-input maximum slope method for DI-PCT. For the dual-energy CT data, iodine uptake was estimated by the difference (λ) and the slope (λHU). λ was defined as the difference of CT values between 40 and 70 KeV monochromatic images in lung lesions. λHU was calculated by the following equation: λHU = |λ/(70 - 40)|. The DI-PCT and DE-CT parameters were analyzed by Pearson/Spearman correlation analysis, respectively.All subjects were pathologically proved as lung cancer patients (including 16 squamous cell carcinoma, 8 adenocarcinoma, and 4 small cell lung cancer) by surgery or CT-guided biopsy. Interobserver reproducibility in DI-PCT (PF, AF, PI) and DE-CT (λ, λHU) were relatively good to excellent (intraclass correlation coefficient [ICC]Inter = 0.8726-0.9255, ICCInter = 0.8179-0.8842; ICCInter = 0.8881-0.9177, ICCInter = 0.9820-0.9970, ICCInter = 0.9780-0.9971, respectively). Correlation coefficient between λ and AF, and PF were as follows: 0.589 (P input CT perfusion analysis method can be applied to assess blood supply of lung cancer patients. Preliminary results demonstrated that the iodine uptake relevant parameters derived from DE-CT significantly correlated with perfusion

Pulmonary ventilation/perfusion scan

Science.gov (United States)

... to stop eating (fast), be on a special diet, or take any medicines before the test. A chest x-ray is usually done before or after a ventilation and perfusion scan. You wear a hospital gown or comfortable clothing that does not have ...

The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer

International Nuclear Information System (INIS)

Christian, Judith A.; Partridge, Mike; Nioutsikou, Elena; Cook, Gary; McNair, Helen A.; Cronin, Bernadette; Courbon, Frederic; Bedford, James L.; Brada, Michael

2005-01-01

Background and purpose: Patients with non-small cell lung cancer (NSCLC) often have inhomogeneous lung perfusion. Radiotherapy planning computed tomography (CT) scans have been accurately co-registered with lung perfusion single photon emission computed tomography (SPECT) scans to design radiotherapy treatments which limit dose to healthy 'perfused' lung. Patients and methods: Patients with localised NSCLC had CT and SPECT scans accurately co-registered in the planning system. The SPECT images were used to define a volume of perfused 'functioning' lung (FL). Inverse planning software was used to create 3D-conformal plans, the planning objective being either to minimise the dose to whole lungs (WL) or to minimise the dose to FL. Results: Four plans were created for each of six patients. The mean difference in volume between WL and FL was 1011.7 cm 3 (range 596.2-1581.1 cm 3 ). One patient with bilateral upper lobe perfusion deficits had a 16% reduction in FLV 2 (the percentage volume of functioning lung receiving ≥20 Gy). The remaining patients had inhomogeneous perfusion deficits such that inverse planning was not able to sufficiently optimise beam angles to avoid functioning lung. Conclusion: SPECT perfusion images can be accurately co-registered with radiotherapy planning CT scans and may be helpful in creating treatment plans for patients with large perfusion deficits

Lung perfusion and emphysema distribution affect the outcome of endobronchial valve therapy

Directory of Open Access Journals (Sweden)

Thomsen C

2016-06-01

Full Text Available Christian Thomsen,1 Dorothea Theilig,2 Dominik Herzog,1 Alexander Poellinger,2 Felix Doellinger,2 Nils Schreiter,3 Vera Schreiter,2 Dirk Schürmann,1 Bettina Temmesfeld-Wollbrueck,1 Stefan Hippenstiel,1 Norbert Suttorp,1 Ralf-Harto Hubner1 1Department of Internal Medicine/Infectious Diseases and Respiratory Medicine, 2Institute of Radiology, 3Institute of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany Abstract: The exclusion of collateral ventilation (CV and other factors affect the clinical success of endoscopic lung volume reduction (ELVR. However, despite its benefits, the outcome of ELVR remains difficult to predict. We investigated whether clinical success could be predicted by emphysema distribution assessed by computed tomography scan and baseline perfusion assessed by perfusion scintigraphy. Data from 57 patients with no CV in the target lobe (TL were retrospectively analyzed after ELVR with valves. Pulmonary function tests (PFT, St George’s Respiratory Questionnaire (SGRQ, and 6-minute walk tests (6MWT were performed on patients at baseline. The sample was grouped into high and low levels at the median of TL perfusion, ipsilateral nontarget lobe (INL perfusion, and heterogeneity index (HI. These groups were analyzed for association with changes in outcome parameters from baseline to 3 months follow-up. Compared to baseline, patients showed significant improvements in PFT, SGRQ, and 6MWT (all P≤0.001. TL perfusion was not associated with changes in the outcome. High INL perfusion was significantly associated with increases in 6MWT (P=0.014, and high HI was associated with increases in forced expiratory volume in 1 second (FEV1, (P=0.012. Likewise, there were significant correlations for INL perfusion and improvement of 6MWT (r=0.35, P=0.03 and for HI and improvement in FEV1 (r=0.45, P=0.001. This study reveals new attributes that associate with positive outcomes for patient selection prior to ELVR

Ventilation perfusion radionuclide imaging in cryptogenic fibrosing alveolitis

International Nuclear Information System (INIS)

Bourke, S.J.; Hawkins, T.; Keavey, P.M.; Gascoigne, A.D.; Corris, P.A.

1993-01-01

There is increasing interest in ventilation perfusion (V/Q) imaging in cryptogenic fibrosing alveolitis because of the data these scans provide on the dynamic V/Q relationships in such patients undergoing single lung transplantation. We analysed the V/Q scans of 45 consecutive patients with advanced cryptogenic fibrosing alveolitis being considered for single lung transplantation. Scans were classified according to the presence, severity and degree of matching of defects in ventilation and perfusion images and the results were compared with the data obtained from lung function tests. Ventilation images showed defects in 13 (29%) and ''washout delay'' in 15 (33%) patients; 10 (22%) patients had asymmetric distribution of ventilation with one lung receiving >60% of total ventilation. Perfusion images showed normal perfusion in 8 (18%), mild defects in 18 (40%) and major defects in 19 (42%) patients. The distribution of perfusion between lungs was significantly asymmetric in 20 (45%) patients. V/Q images were matched in 15 (33%), mildly mismatched in 15 (33%) and severely mismatched in 15 (33%) patients, but the degree of V/Q mismatch did not show a relationship to KCO, PaO 2 or A-aO 2 gradient. The appearances were atypical of pulmonary embolism in eight patients. (Author)

Influence of perfusion and ventilation scans on therapeutic decision making and outcome in cases of possible embolism

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Mercandetti, A.J.; Kipper, M.S.; Moser, K.M.

1985-01-01

The authors examined the influence of perfusion (Q) and ventilation (V) scans on therapeutic decision making and outcome among 229 patients referred for lung scans because embolism was suggested and found that specific V/Q scan patterns strongly influenced postscan decisions regarding initiation, maintenance or cessation of heparin therapy. These therapeutic decisions bore a relationship to outcome (recurrences and death) and disclosed decision-making deficits that need remedy by future investigational and educational efforts. 25 references, 5 tables

Quantitative study on lung volume and lung perfusion using SPECT and CT in thoracal tumors

International Nuclear Information System (INIS)

Beyer-Enke, S.A.; Goerich, J.; Strauss, L.G.

1988-01-01

22 patients with space occupying lesions in the thoracal region were investigated by computer tomography and by perfusion scintigraphy using SPECT. In order to evaluate the CT images quantitatively, the lung volume was determined using approximation method and compared with the perfusion in the SPECT study. For this, anatomically equivalent transaxial SPECT slices had been coordinated to the CT slices. Between the determined lung volumes and the activity in the ocrresponding layers, a statistically significant correlation was found. It could be shown that the stronger perfusion, frequently observed at the right side of the healthy lung, may be explained by an higher volume of the right pulmonary lobe. Whereas in benign displacing processes the relation activity to volume was similar to the one of the healthy lung, a strongly reduced perfusion together with inconspicuous lung volumes became apparent with malignant tumors. In addition to the great morphological evidence of CT and SPECT studies, additional informations regarding the dignity of displacing processes may be derived from the quantitative evaluation of both methods. (orig.) [de

Lung perfusion SPECT in predicting postoperative pulmonary function in lung cancer

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Hirose, Yoshiaki; Imaeda, Takeyoshi; Doi, Hidetaka; Kokubo, Mitsuharu; Sakai, Satoshi; Hirose, Hajime

1993-01-01

The aim of this prospective study is to evaluate the availability of preoperative perfusion SPECT in predicting postoperative pulmonary function following resection. Twenty-three patients with lung cancer who were candidates for lobectomy were investigated preoperatively with spirometry, x-ray computed tomography and 99m Tc-macroaggregated albumin SPECT. Their postoperative pulmonary functions were predicted with these examinations. The forced vital capacity and the forced expiratory volume in one second were selected as parameters for overall pulmonary function. The postoperative pulmonary function was predicted by the following formula: Predicted postoperative value=observed preoperative value x precent perfusion of the lung not to be resected. The patients were reinvestigated with spirometry at 3 months and 6 months after lobectomy, and the values obtained were statistically compared with the predicted values. Close relationships were found between predicted and observed forced vital capacity (r=0.87, p<0.001), and predicted and observed forced expiratory volume in one second (r=0.90, p<0.001). The accurate prediction of pulmonary function after lobectomy could be achieved by means of lung perfusion SPECT. (author)

Effective avoidance of a functional spect-perfused lung using intensity modulated radiotherapy (IMRT) for non-small cell lung cancer (NSCLC): An update of a planning study

International Nuclear Information System (INIS)

Lavrenkov, Konstantin; Singh, Shalini; Christian, Judith A.; Partridge, Mike; Nioutsikou, Elena; Cook, Gary; Bedford, James L.; Brada, Michael

2009-01-01

IMRT and 3-dimensional conformal radiotherapy (3-DCRT) plans of 25 patients with non-small cell lung (NSCLC) were compared in terms of planning target volume (PTV) coverage and sparing of functional lung (FL) defined by a SPECT perfusion scan. IMRT resulted in significant reduction of functional V 20 and mean lung dose in stage III patients with inhomogeneous hypoperfusion. If the dose to FL is shown to be the determinant of lung toxicity, IMRT would allow for effective dose escalation by specific avoidance of functional lung.

Improved visualization of delayed perfusion in lung MRI

International Nuclear Information System (INIS)

Risse, Frank; Eichinger, Monika; Kauczor, Hans-Ulrich; Semmler, Wolfhard; Puderbach, Michael

2011-01-01

Introduction: The investigation of pulmonary perfusion by three-dimensional (3D) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was proposed recently. Subtraction images are generated for clinical evaluation, but temporal information is lost and perfusion defects might therefore be masked in this process. The aim of this study is to demonstrate a simple analysis strategy and classification for 3D-DCE-MRI perfusion datasets in the lung without omitting the temporal information. Materials and methods: Pulmonary perfusion measurements were performed in patients with different lung diseases using a 1.5 T MR-scanner with a time-resolved 3D-GRE pulse sequence. 25 3D-volumes were acquired after iv-injection of 0.1 mmol/kg KG Gadolinium-DTPA. Three parameters were determined for each pixel: (1) peak enhancement S n,max normalized to the arterial input function to detect regions of reduced perfusion; (2) time between arterial peak enhancement in the large pulmonary artery and tissue peak enhancement τ to visualize regions with delayed bolus onset; and (3) ratio R = S n,max /τ was calculated to visualize impaired perfusion, irrespectively of whether related to reduced or delayed perfusion. Results: A manual selection of peak perfusion images is not required. Five different types of perfusion can be found: (1) normal perfusion; (2) delayed non-reduced perfusion; (3) reduced non-delayed perfusion; (4) reduced and delayed perfusion; and (5) no perfusion. Types II and IV could not be seen in subtraction images since the temporal information is necessary for this purpose. Conclusions: The analysis strategy in this study allows for a simple and observer-independent visualization and classification of impaired perfusion in dynamic contrast-enhanced pulmonary perfusion MRI by using the temporal information of the datasets.

Lung perfusion scanning studies on pulmonary radiolesions after /sup 60/Co teletherapy of operated cancer of the breast and on polycythaemia vera following radiophosphorus therapy

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Herzog, M

1973-01-01

When X-ray and scintigraphic control examinations were carried out on 75 patients with cancer of the breast, the X-ray examinations showed pulmonary radiolesions in 37.3% (28 patients) at an average of 12 weeks after radiotherapy with tele /sup 60/Co. The scintigraphic examination, on the other hand, showed a reduced activity concentration - a sign of disturbed blood flow through the lungs - in only 13.0% (9 patients). A reactive increase in blood flow in the form of a higher particle concentration in the irradiated lobe of the lung immediately after irradiation was scintigraphically detected in 21.3% (16 patients). In 15 patients with polycythaemia vera who had been treated with /sup 32/P, the lung perfusion scan detected 4 cases of stopped blood supply without correlative X-ray findings or episodes of embolism in clinical anamnesis.

Assessing tumor treatment response and prognosis in non-small cell lung cancer with perfusion CT

International Nuclear Information System (INIS)

Wang Jianwei; Wu Ning; Song Ying

2010-01-01

Objective: To prospectively investigate whether any of the perfusion parameters would predict early tumor response to chemotherapy and/or radiotherapy and prognosis in non-small cell lung cancer (NSCLC). Methods: In a prospective series, Perfusion CT were performed in 152 patients suspected lung cancer with 16-slice or 8-slice multislice CT. Contrast medium (50 ml) was injected at a rate of 4 ml/s with a power injector. The scanning delay was 10 seconds and the scanning time was 50 seconds. Among 152 patients, 123 patients were proved lung cancer by pathology. With the perfusion 3.0 software, the parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and capillary permeability surface area product (PS) were calculated. The perfusion image quality was evaluated on a 4-1eveal scale. The treatment response after chemotherapy and (or) radiotherapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST), and then the relationship between perfusion parameters with early tumor response to chemotherapy and (or) radiotherapy was evaluated. Student t test and Kaplan-Meier estimates were used for data analysis. Results: In 84 patients (68.3%), the perfusion image quality was staged level 2 (moderate) and level 3 (good). Among them, 35 patients with NSCLC were assessed with RECIST after chemotherapy and (or) radiotherapy. In these 35 patients, The BF of responders and nonresponders was (81.0 ± 33.6)and (56.3 ± 23.1) ml · min -1 ·100 g -1 , respectively, which was significantly different(t=2.393, P=0.023). The median PFS of low-BF group (BF ≤ 80 ml · min -1 · 100 g -1 ) and high-BF group (BF>80 ml · min -1 · 100 g -1 ) was 11.8 and 8.0 months respectively (P>0.05), and the median PFS of low-BV group (BF ≤ 6 ml/100 g -1 ) and high-BV group (BF>6 ml/100 g -1 ) was 9.2 and 8.0 months respectively(P>0.05), both of them were not significantly different. Conclusion: NSCLC in high perfusion are relatively sensitive to chemotherapy

Unsuccessful lung scan due to major right-to-left shunt through a sinus venosus septal defect

International Nuclear Information System (INIS)

Brendel, A.J.; Larnaudie, B.; Lambert, B.; Leccia, F.; Barat, J.L.; Ducassou, D.; Fontan, F.

1985-01-01

In a patient with a prior history of cerebral abscess and cerebral ischemia, an unsuccessful perfusion lung scan led to a radionuclide angiocardiogram using an arm vein injection. This showed a total right-to-left (R-L) shunt from the superior vena cava (SVC) to the left atrium. Repeat radionuclide study, through a leg vein, demonstrated a moderate R-L shunt and an interpretable lung scan could be obtained. Catheterization and contrast cineangiogram did not provide the exact diagnosis, the preoperative conclusion being anomalous drainage of the SVC into the left atrium, with atrial septal defect (ASD) and partial anomalous pulmonary venous connection to the SVC. The operative diagnosis was high atrial (sinus venosus) septal defect. This example of major but clinically unsuspected R-L shunt emphasizes the value of performing a perfusion lung scan, preferably in conjunction with radionuclide angiocardiography in patients with a prior history of unexplained cerebral abscess or systemic ischemia. Implications of the site of an ASD on quantitation of L-R shunts by radionuclide methods are also discussed

Pulmonary vein stenosis after RF ablation diagnosed on a V/Q lung scan - a case study

International Nuclear Information System (INIS)

Edwards, Russell G.

2009-01-01

Full text: A 26-year-old female presented to the emergency department with pleuritic chest pain, acute SOB and raised D-dimer. A PE was suspected and a V/Q lung scan was performed. The initial V/Q lung scan displayed normal ventilation images but reduced perfusion throughout the left lung. Further evaluation was required and a CTPA and repeat perfusion scan were performed. After review of these imaging procedures it was discovered the patient had poor opacification of her left upper pulmonary vein compared to the left lower and right pulmonary veins. Further investigation into the patient's medical history revealed she had undergone radiofrequency ablation for atrial fibrillation 12 months prior. This was significant as it is well documented that a delayed complication of radiofrequency ablation is pulmonary vein stenosis. Although it is rare for the stenosis to be severe enough to cause symptomatic complications from this treatment for atrial fibrillation, it is becoming more widely used and therefore cases are becoming more prevalent. The patient subsequently had a stent inserted into her stenosed pulmonary vein with symptomatic relief.

Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs.

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Halsøy, Kathrine; Kondratiev, Timofey; Tveita, Torkjel; Bjertnaes, Lars J

2016-01-01

Victims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic-isolated blood-perfused rat lungs whether perfusion at constant pressure influences fluid filtration differently from perfusion at constant flow. Isolated blood-perfused rat lungs were hanging freely in a weight transducer for measuring weight changes (ΔW). Fluid filtration coefficient (Kfc), was determined by transiently elevating left atrial pressure (Pla) by 5.8 mmHg two times each during normothermia (37°C) and during hypothermia (15°C). The lung preparations were randomized to two groups. One group was perfused with constant flow (Constant flow group) and the other group with constant pulmonary artery pressure (Constant PPA group). Microvascular pressure (Pmv) was determined before and during elevation of Pla (ΔPmv) by means of the double occlusion technique. Kfc was calculated with the formula Kfc = ΔW/ΔPmv/min. All Kfc values were normalized to predicted lung weight (P LW ), which was based on body weight (BW) according to the formula: P LW  = 0.0053 BW - 0.48 and presented as Kfc PLW in mg/min/mmHg/g. At cessation, bronchoalveolar lavage (BAL) fluid/perfusate protein concentration (B/P) ratio was determined photometrically. Data were analyzed with parametric or non-parametric tests as appropriate. p  Kfc PLW and B/P ratio increased significantly by more than 10-fold during hypothermia concerted by visible signs of edema in the trachea. Hemoglobin and hematocrit increased within the Constant flow group and between the groups at cessation of the experiments. In hypothermic rat lungs perfused at constant flow, fluid filtration coefficient per gram P LW and B/P ratio increased more than 10-fold concerted by increased

Structural and perfusion magnetic resonance imaging of the lung in cystic fibrosis

International Nuclear Information System (INIS)

Amaxopoulou, Christina; Gnannt, Ralph; Kellenberger, Christian J.; Higashigaito, Kai; Jung, Andreas

2018-01-01

Because of its absence of ionising radiation and possibility for obtaining functional information, MRI is promising for assessing lung disease in children who require repetitive imaging for long-term follow-up. To describe MRI findings in children with cystic fibrosis and evaluate semi-quantitative dynamic contrast-enhanced lung perfusion. We retrospectively compared lung MRI in 25 children and young adults with cystic fibrosis (median age 3.7 years) to 12 children (median age 2 years) imaged for other pathologies. MRI at 1.5 T included respiratory-gated sequences and contrast-enhanced lung perfusion imaging. We described and graded any morphologic change. Signal enhancement and time to peak values of perfusion abnormalities were compared to those of normally enhancing lung parenchyma. Frequent findings in patients with cystic fibrosis were bronchial wall thickening (24/25, 96%), areas of consolidation (22/25, 88%), enlarged lymph nodes (20/25, 80%), bronchiectasis (5/25, 20%) and mucus plugging (3/25, 12%). Compared to normally enhancing lung, perfusion defects (21/25, 84%), characterised by decreased enhancement, showed prolonged time to peak. Areas of consolidation showed increased enhancement. While time to peak of procedure-related atelectasis was not significantly different from that of normal lung, disease-related consolidation showed prolonged time to peak (P=0.01). Lung MRI demonstrates structural and perfusion abnormalities in children and young people with cystic fibrosis. Semi-quantitative assessment of dynamic contrast-enhanced perfusion imaging might allow differentiation between procedure-related atelectasis and disease-related consolidation. (orig.)

Structural and perfusion magnetic resonance imaging of the lung in cystic fibrosis

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Amaxopoulou, Christina; Gnannt, Ralph; Kellenberger, Christian J. [University Children' s Hospital Zuerich, Department of Diagnostic Imaging, Zuerich, CH (Switzerland); University Children' s Hospital Zuerich, Children' s Research Center, Zuerich (Switzerland); Higashigaito, Kai [University Hospital Zuerich, Institute of Diagnostic and Interventional Radiology, Zuerich (Switzerland); Jung, Andreas [University Children' s Hospital Zuerich, Children' s Research Center, Zuerich (Switzerland); University Children' s Hospital Zuerich, Division of Pneumology, Zuerich (Switzerland)

2018-02-15

Because of its absence of ionising radiation and possibility for obtaining functional information, MRI is promising for assessing lung disease in children who require repetitive imaging for long-term follow-up. To describe MRI findings in children with cystic fibrosis and evaluate semi-quantitative dynamic contrast-enhanced lung perfusion. We retrospectively compared lung MRI in 25 children and young adults with cystic fibrosis (median age 3.7 years) to 12 children (median age 2 years) imaged for other pathologies. MRI at 1.5 T included respiratory-gated sequences and contrast-enhanced lung perfusion imaging. We described and graded any morphologic change. Signal enhancement and time to peak values of perfusion abnormalities were compared to those of normally enhancing lung parenchyma. Frequent findings in patients with cystic fibrosis were bronchial wall thickening (24/25, 96%), areas of consolidation (22/25, 88%), enlarged lymph nodes (20/25, 80%), bronchiectasis (5/25, 20%) and mucus plugging (3/25, 12%). Compared to normally enhancing lung, perfusion defects (21/25, 84%), characterised by decreased enhancement, showed prolonged time to peak. Areas of consolidation showed increased enhancement. While time to peak of procedure-related atelectasis was not significantly different from that of normal lung, disease-related consolidation showed prolonged time to peak (P=0.01). Lung MRI demonstrates structural and perfusion abnormalities in children and young people with cystic fibrosis. Semi-quantitative assessment of dynamic contrast-enhanced perfusion imaging might allow differentiation between procedure-related atelectasis and disease-related consolidation. (orig.)

Ex vivo lung perfusion with adenosine A2A receptor agonist allows prolonged cold preservation of lungs donated after cardiac death.

Science.gov (United States)

Wagner, Cynthia E; Pope, Nicolas H; Charles, Eric J; Huerter, Mary E; Sharma, Ashish K; Salmon, Morgan D; Carter, Benjamin T; Stoler, Mark H; Lau, Christine L; Laubach, Victor E; Kron, Irving L

2016-02-01

Ex vivo lung perfusion has been successful in the assessment of marginal donor lungs, including donation after cardiac death (DCD) donor lungs. Ex vivo lung perfusion also represents a unique platform for targeted drug delivery. We sought to determine whether ischemia-reperfusion injury would be decreased after transplantation of DCD donor lungs subjected to prolonged cold preservation and treated with an adenosine A2A receptor agonist during ex vivo lung perfusion. Porcine DCD donor lungs were preserved at 4°C for 12 hours and underwent ex vivo lung perfusion for 4 hours. Left lungs were then transplanted and reperfused for 4 hours. Three groups (n = 4/group) were randomized according to treatment with the adenosine A2A receptor agonist ATL-1223 or the dimethyl sulfoxide vehicle: Infusion of dimethyl sulfoxide during ex vivo lung perfusion and reperfusion (DMSO), infusion of ATL-1223 during ex vivo lung perfusion and dimethyl sulfoxide during reperfusion (ATL-E), and infusion of ATL-1223 during ex vivo lung perfusion and reperfusion (ATL-E/R). Final Pao2/Fio2 ratios (arterial oxygen partial pressure/fraction of inspired oxygen) were determined from samples obtained from the left superior and inferior pulmonary veins. Final Pao2/Fio2 ratios in the ATL-E/R group (430.1 ± 26.4 mm Hg) were similar to final Pao2/Fio2 ratios in the ATL-E group (413.6 ± 18.8 mm Hg), but both treated groups had significantly higher final Pao2/Fio2 ratios compared with the dimethyl sulfoxide group (84.8 ± 17.7 mm Hg). Low oxygenation gradients during ex vivo lung perfusion did not preclude superior oxygenation capacity during reperfusion. After prolonged cold preservation, treatment of DCD donor lungs with an adenosine A2A receptor agonist during ex vivo lung perfusion enabled Pao2/Fio2 ratios greater than 400 mm Hg after transplantation in a preclinical porcine model. Pulmonary function during ex vivo lung perfusion was not predictive of outcomes after transplantation. Copyright �

Magnetic Resonance Imaging of Ventilation and Perfusion in the Lung

Science.gov (United States)

Prisk, Gordon Kim (Inventor); Hopkins, Susan Roberta (Inventor); Buxton, Richard Bruce (Inventor); Pereira De Sa, Rui Carlos (Inventor); Theilmann, Rebecca Jean (Inventor); Cronin, Matthew Vincent (Inventor)

2017-01-01

Methods, devices, and systems are disclosed for implementing a fully quantitative non-injectable contrast proton MRI technique to measure spatial ventilation-perfusion (VA/Q) matching and spatial distribution of ventilation and perfusion. In one aspect, a method using MRI to characterize ventilation and perfusion in a lung includes acquiring an MR image of the lung having MR data in a voxel and obtaining a breathing frequency parameter, determining a water density value, a specific ventilation value, and a perfusion value in at least one voxel of the MR image based on the MR data and using the water density value to determine an air content value, and determining a ventilation-perfusion ratio value that is the product of the specific ventilation value, the air content value, the inverse of the perfusion value, and the breathing frequency.

Kinetics of reversible-sequestration of leukocytes by the isolated perfused rat lung

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Goliaei, B.

1980-08-01

The kinetics and morphology of sequestration and margination of rat leukocytes were studied using an isolated perfused and ventilated rat lung preparation. Whole rat blood, bone marrow suspension, or leukocyte suspensions, were used to perfuse the isolated rat lung. The lung was also perfused with latex particle suspensions and the passage of particles through the lung capillaries was studied. When a leukocyte suspension was perfused through the lung in the single-pass mode, the rate of sequestration decreased as more cells were perfused. In contrast, latex particles of a size comparable to that of leukocytes were totally stopped by the lung. When the leukocyte suspension was recirculated through the lung, cells were rapidly removed from circulation until a steady state was reached, after which no net removal of cells by the lung occurred. These results indicate that leukocytes are reversibly sequestered from circulation. The sequestered cells marginated and attached to the luminal surface of the endothelium of post-capillary venules and veins. A mathematical model was developed based on the assumption that the attachment and detachment of leukocytes to blood vessel walls follows first-order kinetics. The model correctly predicts the following characteristics of the system: (a) the kinetics of the sequestration of leukocytes by the lung; (b) the existence of a steady state when a suspension of leukocytes is recirculated through the lung; and (c) the independence of the fraction of cells remaining in circulation from the starting concentration for all values of starting concentration. (ERB)

Histogram based analysis of lung perfusion of children after congenital diaphragmatic hernia repair.

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Kassner, Nora; Weis, Meike; Zahn, Katrin; Schaible, Thomas; Schoenberg, Stefan O; Schad, Lothar R; Zöllner, Frank G

2018-05-01

To investigate a histogram based approach to characterize the distribution of perfusion in the whole left and right lung by descriptive statistics and to show how histograms could be used to visually explore perfusion defects in two year old children after Congenital Diaphragmatic Hernia (CDH) repair. 28 children (age of 24.2±1.7months; all left sided hernia; 9 after extracorporeal membrane oxygenation therapy) underwent quantitative DCE-MRI of the lung. Segmentations of left and right lung were manually drawn to mask the calculated pulmonary blood flow maps and then to derive histograms for each lung side. Individual and group wise analysis of histograms of left and right lung was performed. Ipsilateral and contralateral lung show significant difference in shape and descriptive statistics derived from the histogram (Wilcoxon signed-rank test, phistogram derived parameters. Histogram analysis can be a valuable tool to characterize and visualize whole lung perfusion of children after CDH repair. It allows for several possibilities to analyze the data, either describing the perfusion differences between the right and left lung but also to explore and visualize localized perfusion patterns in the 3D lung volume. Subgroup analysis will be possible given sufficient sample sizes. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of isoproterenol on distribution of perfusion in embolized dog lungs

International Nuclear Information System (INIS)

Shepard, J.W. Jr.; Hauer, D.; Sgroi, V.; Moser, K.M.

1979-01-01

In 19 mechanically ventilated, anesthetized dogs, autologous venous thrombi were formed in the inferior vena cava and subsequently released. Serial perfusion lung scintigrams revealed the postembolic distribution of pulmonary blood flow before, during, and after the infusion of isoproterenol at 2.2 μg/min. Isoproterenol failed to restore perfusion to embolically occluded regions. When reperfusion occurred it was attributable to clot resolution. Gas exchange and hemodynamic measurements obtained in seven thromboembolized animals showed no scan evidence of reperfusion during the isoproterenol infusion. After embolization, cardiac output increased from 1.7 to 2.6 liter/min (p 2 from 38.0 to 45.3 mm Hg (p 2 to 50.7 mm Hg, along with a decrease in pulmonary vascular resistance from the postembolic mean of 448 to 246 dynes.sec.cm -5 (p < 0.05). Perfusion defects following acute pulmonary thromboembolization are not altered by the infusion of the potent pulmonary vasodilator, isoproterenol. Infusion of this drug following thromboembolization may have potential therapeutic benefit by reducing pulmonary vascular resistance, increasing cardiac output, and elevating the mixed-venous oxygen tension

Comparison of lung preservation solutions in human lungs using an ex vivo lung perfusion experimental model

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Israel L. Medeiros

2012-09-01

Full Text Available OBJECTIVE: Experimental studies on lung preservation have always been performed using animal models. We present ex vivo lung perfusion as a new model for the study of lung preservation. Using human lungs instead of animal models may bring the results of experimental studies closer to what could be expected in clinical practice. METHOD: Brain-dead donors whose lungs had been declined by transplantation teams were used. The cases were randomized into two groups. In Group 1, Perfadex®was used for pulmonary preservation, and in Group 2, LPDnac, a solution manufactured in Brazil, was used. An ex vivo lung perfusion system was used, and the lungs were ventilated and perfused after 10 hours of cold ischemia. The extent of ischemic-reperfusion injury was measured using functional and histological parameters. RESULTS: After reperfusion, the mean oxygenation capacity was 405.3 mmHg in Group 1 and 406.0 mmHg in Group 2 (p = 0.98. The mean pulmonary vascular resistance values were 697.6 and 378.3 dyn·s·cm-5, respectively (p =0.035. The mean pulmonary compliance was 46.8 cm H20 in Group 1 and 49.3 ml/cm H20 in Group 2 (p =0.816. The mean wet/dry weight ratios were 2.06 and 2.02, respectively (p=0.87. The mean Lung Injury Scores for the biopsy performed after reperfusion were 4.37 and 4.37 in Groups 1 and 2, respectively (p = 1.0, and the apoptotic cell counts were 118.75/mm² and 137.50/mm², respectively (p=0.71. CONCLUSION: The locally produced preservation solution proved to be as good as Perfadex®. The clinical use of LPDnac may reduce costs in our centers. Therefore, it is important to develop new models to study lung preservation.

Role of radio-aerosol and perfusion lung imaging in early detection of chronic obstructive lung disease

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Garg, A; Pande, J N; Guleria, J S; Gopinath, P G

1983-04-01

The efficacy of radio-aerosol and perfusion lung imaging in the early detection of chronic obstructive lung disease was evaluated in 38 subjects. The subjects included 5 non-smokers, 21 smokers with minimal or no respiratory symptoms and 12 patients with chronic obstructive lung disease. Each subject consented to a respiratory questionaire, detailed physical examination, chest X-ray examinations, detailed pulmonary function tests and sup(99m)Tc-radioaerosol-inhalation lung imaging. Perfusion lung imaging with sup(99m)Tc-labelled macroaggregated albumin was performed in 22 subjects. A significant correlation (P<0.001) was observed between the degree of abnormalities on radio-aerosol imaging and pulmonary function tests (PFTs) including forced expiratory volume in 1 s, maximum midexpiratory flow rate and mean transit time analysis. Abnormal radio-aerosol patterns and deranged PFTs were observed in 21 subjects each. Of 21 subjects with abnormal radioaerosol pattern 8 had normal PFTs. Of 21 subjects with abnormal PFTs 8 had normal aerosol images. Aerosol lung images and PFTs were abnormal more frequently than perfusion lung images. The results suggest that radio-aerosol lung imaging is as sensitive an indicator as PFTs for early detection of chronic obstructive lung disease and can be usefully combined with PFTs for early detection of alteration in pulmonary physiology in smokers.

Clinical evaluation of lung rest/stress perfusion scintigraphy in patients with severe emphysema

International Nuclear Information System (INIS)

Hadjikostova, Hr.

1998-01-01

Volume lung reduction surgery (LVRS) improves lung function and physical tolerance for selected patients with severe pulmonary emphysema by making conditions for developing of the vital parenchyma so far compressed by the emphysema blisters. The aim of this study was to establish the comparative functional information obtained from REST/STRESS lung perfusion tomoscintigraphies for identification of non functional lung tissue. Eleven patients (8 males and 3 females at age 41-60) were examined by two lung perfusions SPECT scintigraphies after intravenous application of 222 MBq 99m Tc-MAA: 1. after 30 min. lying rest and 2. 48 hours later after 6 min. walk test. Comparing the two scintigraphies the following changes in perfusion performance have been established at STRESS examination: increased at six patients (significant at three and slight also at three) and decreased at two. There was no difference between REST and STRESS examinations at 3 patients. Comparative REST/STRESS lung perfusion scintigraphy is important method for screening severe pulmonary patients for LVRS. (author)

Assessment of myocardial perfusion using a new scanning agent

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Khalil, M.N

1987-01-01

This work assessed a new compound: Tc-99m tertiary butyl isonitrile (T-BIN) in scanning the normal myocardium in dogs. Experimentally induced myocardial infarcts (M.I.) were detected. The compound cleared significantly from the blood within 15 minutes and from the lungs within an hour after intravenous administration. Liver uptake was high and remained so. Cardiac uptake occurred quickly and continued for 6 hours. Comparable results were obtained in normal humans and patients. Myocardial scanning was best after 60 minutes at rest or 30 minutes after exercise. Liver uptake sometimes obscured the detection of inferior M.I. but this problem was reduced using a 45/sup 0/ left anterior oblique view with a 20/sup 0/ cranial tilt. At rest 9/10 patients with M.I. showed defects corresponding to the infarct sites. In 20 patients with angina pectoris 16 had perfusion defects on exercise. In 15/16 patients reversible ischaemia was demonstrated. The reperfusion scans were best obtained at 4 hours post exercise. Both Tl-201 and T-BIN detected equally the infarcts (3/3) but in patients with angina 8/10 with T-BIN and 6/10 with Tl-201 showed defects. ECG gating of the T-BIN scans was also studied.

Application of CT perfusion imaging in radiotherapy for lung cancer

International Nuclear Information System (INIS)

Xia Guangrong; Liu Guimei; He Wen; Jin Guohua; Xie Ruming; Xu Yongxiang; Li Xiaobo; Li Xuebing

2011-01-01

Objective: To investigate the value of CT perfusion imaging in evaluation of therapeutic effect and prognosis in radiotherapy for lung cancer. Methods: Fifty-one cases of lung cancer who were unable or refused to be operated on, 36 males and 15 females, aged 37-80, underwent CT perfusion imaging, 29 of which only before radiotherapy and 22 before and after radiotherapy twice. The images were collected by cine dynamic scanning (5 mm/4 slices) and input into the GE AW4.0 workstation for data processing. The slice positions of CT imaging were determined according to the largest tumor size in CT scan. Regions of interest of tumor were drawn at the region corresponding to the original images of CT perfusion. Radiotherapy was performed after CT perfusion imaging. Relevant parameters, including blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS) were calculated. The treatment response after radiotherapy was evaluated by RECIST. At 2 -4 weeks after the treatment, CT examination was conducted once more. Results: The tests of the 51 patients showed that the BV was 13.6 ml·100 g -1 , the BF was 129.5 ml·min -1 ·100 g -1 , the MTT was 9.1 s, and the PS was 10.0 ml· min -1 · 100 g -1 before radiotherapy. The tests of the 22 of the 51 patients showed that the values of BV and BF after radiotherapy were 7.6 ml· 100 g -1 and 97.8 ml·min -1 · 100 g -1 , respectively, both lower than those before radiotherapy (11.2 and 108.7 ml·min -1 ·100 g -1 , respectively), however, both not significantly (t=1.28, 0.40, P>0.05); and the values of MTT and PS after radiotherapy were 8.9 s and 7.8 ml·min -1 · 100 g -1 , respectively, both not significantly higher than those before radiotherapy (7.2 s and 6.8 ml· min -1 · 100 g -1 , respectively, t=-1.15, -0.57, P>0.05). The mean area of tumor after radiotherapy was 1189.6 mm 2 , significantly less than that before radiotherapy (1920.3 mm 2 , t=3.98, P<0.05). The MTT of the SCLC patients was 12

Estimation of Radiation Exposure of 128-Slice 4D-Perfusion CT for the Assessment of Tumor Vascularity

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Ketelsen, Dominik; Horger, Marius; Buchgeister, Markus; Fenchel, Michael; Thomas, Christoph; Boehringer, Nadine; Schulze, Maximilian; Tsiflikas, Ilias; Claussen, Claus D.; Heuschmid, Martin [University Hospital Tuebingen, Tuebingen (Germany)

2010-10-15

We aimed to estimate the effective dose of 4D-Perfusion-CT protocols of the lung, liver, and pelvis for the assessment of tumor vascularity. An Alderson-Rando phantom equipped with thermoluminescent dosimeters was used to determine the effective dose values of 4D Perfusion-CT. Phantom measurements were performed on a 128-slice single source scanner in adaptive 4D-spiral-mode with bidirectional table movement and a total scan range of 69 mm over a time period of nearly 120 seconds (26 scans). Perfusion measurements were simulated for the lung, liver, and pelvis under the following conditions: lung (80 kV, 60 mAs), liver (80 kV/80 mAs and 80 kV/120 mAs), pelvis (100 kV/80 mAs and 100 kV/120 mAs). Depending on gender, the evaluated body region and scan protocol, an effective whole-body dose between 2.9-12.2 mSv, was determined. The radiation exposure administered to gender-specific organs like the female breast tissue (lung perfusion) or to the ovaries (pelvic perfusion) led to an increase in the female specific dose by 86% and 100% in perfusion scans of the lung and the pelvis, respectively. Due to a significant radiation dose of 4D-perfusion-CT protocols, the responsible use of this new promising technique is mandatory. Gender- and organ-specific differences should be considered for indication and planning of tumor perfusion scans

Perfusion lung scintigraphy in primary pulmonary hypertension

International Nuclear Information System (INIS)

Ogawa, Y.; Hayashida, K.; Uehara, T.; Shimonagata, T.; Nishimura, T.; Osaka Univ., Suita

1993-01-01

15 cases of primary pulmonary hypertension were classified into two groups by patterns of perfusion lung scintigraphy. Perfusion scintigrams showed multiple, small, ill-defined defects (mottled + ve) pattern in eight cases, and the remaining seven cases had a normal (mottled - ve) pattern. The mean pulmonary arterial pressure in patients with a mottled pattern (54 ± 10 mmHg) was higher than in those with a normal pattern (42 ± 9 mmHg, p < 0.05). There were no significant differences between the two groups in right ventricular ejection fraction, partial pressures of oxygen in the arterial blood or alveolo-arterial oxygen difference. All the patients with a mottled pattern died within 2 years following the lung scintigraphy. There was a significant difference in the survival curves between the two groups. (author)

Accuracy and Utility of Deformable Image Registration in 68Ga 4D PET/CT Assessment of Pulmonary Perfusion Changes During and After Lung Radiation Therapy

International Nuclear Information System (INIS)

Hardcastle, Nicholas; Hofman, Michael S.; Hicks, Rodney J.; Callahan, Jason; Kron, Tomas; MacManus, Michael P.; Ball, David L.; Jackson, Price; Siva, Shankar

2015-01-01

Purpose: Measuring changes in lung perfusion resulting from radiation therapy dose requires registration of the functional imaging to the radiation therapy treatment planning scan. This study investigates registration accuracy and utility for positron emission tomography (PET)/computed tomography (CT) perfusion imaging in radiation therapy for non–small cell lung cancer. Methods: 68 Ga 4-dimensional PET/CT ventilation-perfusion imaging was performed before, during, and after radiation therapy for 5 patients. Rigid registration and deformable image registration (DIR) using B-splines and Demons algorithms was performed with the CT data to obtain a deformation map between the functional images and planning CT. Contour propagation accuracy and correspondence of anatomic features were used to assess registration accuracy. Wilcoxon signed-rank test was used to determine statistical significance. Changes in lung perfusion resulting from radiation therapy dose were calculated for each registration method for each patient and averaged over all patients. Results: With B-splines/Demons DIR, median distance to agreement between lung contours reduced modestly by 0.9/1.1 mm, 1.3/1.6 mm, and 1.3/1.6 mm for pretreatment, midtreatment, and posttreatment (P<.01 for all), and median Dice score between lung contours improved by 0.04/0.04, 0.05/0.05, and 0.05/0.05 for pretreatment, midtreatment, and posttreatment (P<.001 for all). Distance between anatomic features reduced with DIR by median 2.5 mm and 2.8 for pretreatment and midtreatment time points, respectively (P=.001) and 1.4 mm for posttreatment (P>.2). Poorer posttreatment results were likely caused by posttreatment pneumonitis and tumor regression. Up to 80% standardized uptake value loss in perfusion scans was observed. There was limited change in the loss in lung perfusion between registration methods; however, Demons resulted in larger interpatient variation compared with rigid and B-splines registration. Conclusions

Co-registered perfusion SPECT/CT: Utility for prediction of improved postoperative outcome in lung volume reduction surgery candidates

International Nuclear Information System (INIS)

Takenaka, Daisuke; Ohno, Yoshiharu; Koyama, Hisanobu; Nogami, Munenobu; Onishi, Yumiko; Matsumoto, Keiko; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro

2010-01-01

Purpose: To directly compare the capabilities of perfusion scan, SPECT, co-registered SPECT/CT, and quantitatively and qualitatively assessed MDCT (i.e. quantitative CT and qualitative CT) for predicting postoperative clinical outcome for lung volume reduction surgery (LVRS) candidates. Materials and methods: Twenty-five consecutive candidates (19 men and six women, age range: 42-72 years) for LVRS underwent preoperative CT and perfusion scan with SPECT. Clinical outcome of LVRS for all subjects was also assessed by determining the difference between pre- and postoperative forced expiratory volume in 1 s (FEV 1 ) and 6-min walking distance (6MWD). All SPECT examinations were performed on a SPECT scanner, and co-registered to thin-section CT by using commercially available software. On planar imaging, SPECT and SPECT/CT, upper versus lower zone or lobe ratios (U/Ls) were calculated from regional uptakes between upper and lower lung fields in the operated lung. On quantitatively assessed CT, U/L for all subjects was assessed from regional functional lung volumes. On qualitatively assessed CT, planar imaging, SPECT and co-registered SPECT/CT, U/Ls were assessed with a 4-point visual scoring system. To compare capabilities of predicting clinical outcome, each U/L was statistically correlated with the corresponding clinical outcome. Results: Significantly fair or moderate correlations were observed between quantitatively and qualitatively assessed U/Ls obtained with all four methods and clinical outcomes (-0.60 ≤ r ≤ -0.42, p < 0.05). Conclusion: Co-registered perfusion SPECT/CT has better correlation with clinical outcome in LVRS candidates than do planar imaging, SPECT or qualitatively assessed CT, and is at least as valid as quantitatively assessed CT.

Co-registered perfusion SPECT/CT: Utility for prediction of improved postoperative outcome in lung volume reduction surgery candidates

Energy Technology Data Exchange (ETDEWEB)

Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.j [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Division of Image-Based Medicine, Institute of Biomedical Research and Innovation, 2-2, Minatojima Minamimachi Chuo-ku, Kobe, Hyogo, 650-0047 (Japan); Onishi, Yumiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Matsumoto, Keiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Department of Radiology, University of Yamanashi, 1110 Shimogato, Chuo, Yamanashi, 409-3898 (Japan); Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan)

2010-06-15

Purpose: To directly compare the capabilities of perfusion scan, SPECT, co-registered SPECT/CT, and quantitatively and qualitatively assessed MDCT (i.e. quantitative CT and qualitative CT) for predicting postoperative clinical outcome for lung volume reduction surgery (LVRS) candidates. Materials and methods: Twenty-five consecutive candidates (19 men and six women, age range: 42-72 years) for LVRS underwent preoperative CT and perfusion scan with SPECT. Clinical outcome of LVRS for all subjects was also assessed by determining the difference between pre- and postoperative forced expiratory volume in 1 s (FEV{sub 1}) and 6-min walking distance (6MWD). All SPECT examinations were performed on a SPECT scanner, and co-registered to thin-section CT by using commercially available software. On planar imaging, SPECT and SPECT/CT, upper versus lower zone or lobe ratios (U/Ls) were calculated from regional uptakes between upper and lower lung fields in the operated lung. On quantitatively assessed CT, U/L for all subjects was assessed from regional functional lung volumes. On qualitatively assessed CT, planar imaging, SPECT and co-registered SPECT/CT, U/Ls were assessed with a 4-point visual scoring system. To compare capabilities of predicting clinical outcome, each U/L was statistically correlated with the corresponding clinical outcome. Results: Significantly fair or moderate correlations were observed between quantitatively and qualitatively assessed U/Ls obtained with all four methods and clinical outcomes (-0.60 {<=} r {<=} -0.42, p < 0.05). Conclusion: Co-registered perfusion SPECT/CT has better correlation with clinical outcome in LVRS candidates than do planar imaging, SPECT or qualitatively assessed CT, and is at least as valid as quantitatively assessed CT.

Estimation of Radiation Exposure of 128-Slice 4D-Perfusion CT for the Assessment of Tumor Vascularity

Science.gov (United States)

Horger, Marius; Buchgeister, Markus; Fenchel, Michael; Thomas, Christoph; Boehringer, Nadine; Schulze, Maximilian; Tsiflikas, Ilias; Claussen, Claus D.; Heuschmid, Martin

2010-01-01

Objective We aimed to estimate the effective dose of 4D-Perfusion-CT protocols of the lung, liver, and pelvis for the assessment of tumor vascularity. Materials and Methods An Alderson-Rando phantom equipped with thermoluminescent dosimeters was used to determine the effective dose values of 4D-Perfusion-CT. Phantom measurements were performed on a 128-slice single-source scanner in adaptive 4D-spiral-mode with bidirectional table movement and a total scan range of 69 mm over a time period of nearly 120 seconds (26 scans). Perfusion measurements were simulated for the lung, liver, and pelvis under the following conditions: lung (80 kV, 60 mAs), liver (80 kV/80 mAs and 80 kV/120 mAs), pelvis (100 kV/80 mAs and 100 kV/120 mAs). Results Depending on gender, the evaluated body region and scan protocol, an effective whole-body dose between 2.9-12.2 mSv, was determined. The radiation exposure administered to gender-specific organs like the female breast tissue (lung perfusion) or to the ovaries (pelvic perfusion) led to an increase in the female specific dose by 86% and 100% in perfusion scans of the lung and the pelvis, respectively. Conclusion Due to a significant radiation dose of 4D-perfusion-CT protocols, the responsible use of this new promising technique is mandatory. Gender- and organ-specific differences should be considered for indication and planning of tumor perfusion scans. PMID:20808699

Contrast-enhanced 3D MRI of lung perfusion in children with cystic fibrosis - initial results

International Nuclear Information System (INIS)

Eichinger, Monika; Puderbach, Michael; Zuna, Ivan; Kauczor, Hans-Ulrich; Fink, Christian; Gahr, Julie; Mueller, Frank-Michael; Ley, Sebastian; Plathow, Christian; Tuengerthal, Siegfried

2006-01-01

This paper is a feasibility study of magnetic resonance imaging (MRI) of lung perfusion in children with cystic fibrosis (CF) using contrast-enhanced 3D MRI. Correlation assessment of perfusion changes with structural abnormalities. Eleven CF patients (9 f, 2 m; median age 16 years) were examined at 1.5 T. Morphology: HASTE coronal, transversal (TR/TE/α/ST: 600 ms/28 ms/180 /6 mm), breath-hold 18 s. Perfusion: Time-resolved 3D GRE pulse sequence (FLASH, TE/TR/α: 0.8/1.9 ms/40 ), parallel imaging (GRAPPA, PAT 2). Twenty-five data sets were acquired after intravenous injection of 0.1 mmol/kg body weight of gadodiamide, 3-5 ml/s. A total of 198 lung segments were analyzed by two radiologists in consensus and scored for morphological and perfusion changes. Statistical analysis was performed by Mantel-Haenszel chi-square test. Results showed that perfusion defects were observed in all patients and present in 80% of upper, and 39% of lower lobes. Normal lung parenchyma showed homogeneous perfusion (86%, P<0.0001). Severe morphological changes led to perfusion defects (97%, P<0.0001). Segments with moderate morphological changes showed normal (53%) or impaired perfusion (47%). In conclusion, pulmonary perfusion is easy to judge in segments with normal parenchyma or severe changes. In moderately damaged segments, MRI of lung perfusion may help to better assess actual functional impairment. Contrast-enhanced 3D MRI of lung perfusion has the potential for early vascular functional assessment and therapy control in CF patients. (orig.)

A potential to reduce pulmonary toxicity: The use of perfusion SPECT with IMRT for functional lung avoidance in radiotherapy of non-small cell lung cancer

International Nuclear Information System (INIS)

Lavrenkov, Konstantin; Christian, Judith A.; Partridge, Mike; Niotsikou, Elena; Cook, Gary; Parker, Michelle; Bedford, James L.; Brada, Michael

2007-01-01

Background and purpose: The study aimed to examine specific avoidance of functional lung (FL) defined by a single photon emission computerized tomography (SPECT) lung perfusion scan, using intensity modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3-DCRT) in patients with non-small cell lung cancer (NSCLC). Materials and methods: Patients with NSCLC underwent planning computerized tomography (CT) and lung perfusion SPECT scan in the treatment position using fiducial markers to allow co-registration in the treatment planning system. Radiotherapy (RT) volumes were delineated on the CT scan. FL was defined using co-registered SPECT images. Two inverse coplanar RT plans were generated for each patient: 4-field 3-DCRT and 5-field step-and-shoot IMRT. 3-DCRT plans were created using automated AutoPlan optimisation software, and IMRT plans were generated employing Pinnacle 3 treatment planning system (Philips Radiation Oncology Systems). All plans were prescribed to 64 Gy in 32 fractions using data for the 6 MV beam from an Elekta linear accelerator. The objectives for both plans were to minimize the volume of FL irradiated to 20 Gy (fV 20 ) and dose variation within the planning target volume (PTV). A spinal cord dose was constrained to 46 Gy. Volume of PTV receiving 90% of the prescribed dose (PTV 90 ), fV 20 , and functional mean lung dose (fMLD) were recorded. The PTV 90 /fV 20 ratio was used to account for variations in both measures, where a higher value represented a better plan. Results: Thirty-four RT plans of 17 patients with stage I-IIIB NSCLC suitable for radical RT were analysed. In 6 patients with stage I-II disease there was no improvement in PTV 90 , fV 20 , PTV/fV 20 ratio and fMLD using IMRT compared to 3-DCRT. In 11 patients with stage IIIA-B disease, the PTV was equally well covered with IMRT and 3-DCRT plans, with IMRT producing better PTV 90 /fV 20 ratio (mean ratio - 7.2 vs. 5.3, respectively, p = 0.001) and reduced f

Accuracy and Utility of Deformable Image Registration in {sup 68}Ga 4D PET/CT Assessment of Pulmonary Perfusion Changes During and After Lung Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Hardcastle, Nicholas, E-mail: nick.hardcastle@gmail.com [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Hofman, Michael S. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Hicks, Rodney J. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Department of Medicine, University of Melbourne, Melbourne (Australia); Callahan, Jason [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Kron, Tomas [Department of Medical Imaging and Radiation Sciences, Monash University, Clayton (Australia); The Sir Peter MacCallum Department of Oncology, Melbourne University, Victoria (Australia); MacManus, Michael P.; Ball, David L. [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne (Australia); Jackson, Price [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Siva, Shankar [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia)

2015-09-01

Purpose: Measuring changes in lung perfusion resulting from radiation therapy dose requires registration of the functional imaging to the radiation therapy treatment planning scan. This study investigates registration accuracy and utility for positron emission tomography (PET)/computed tomography (CT) perfusion imaging in radiation therapy for non–small cell lung cancer. Methods: {sup 68}Ga 4-dimensional PET/CT ventilation-perfusion imaging was performed before, during, and after radiation therapy for 5 patients. Rigid registration and deformable image registration (DIR) using B-splines and Demons algorithms was performed with the CT data to obtain a deformation map between the functional images and planning CT. Contour propagation accuracy and correspondence of anatomic features were used to assess registration accuracy. Wilcoxon signed-rank test was used to determine statistical significance. Changes in lung perfusion resulting from radiation therapy dose were calculated for each registration method for each patient and averaged over all patients. Results: With B-splines/Demons DIR, median distance to agreement between lung contours reduced modestly by 0.9/1.1 mm, 1.3/1.6 mm, and 1.3/1.6 mm for pretreatment, midtreatment, and posttreatment (P<.01 for all), and median Dice score between lung contours improved by 0.04/0.04, 0.05/0.05, and 0.05/0.05 for pretreatment, midtreatment, and posttreatment (P<.001 for all). Distance between anatomic features reduced with DIR by median 2.5 mm and 2.8 for pretreatment and midtreatment time points, respectively (P=.001) and 1.4 mm for posttreatment (P>.2). Poorer posttreatment results were likely caused by posttreatment pneumonitis and tumor regression. Up to 80% standardized uptake value loss in perfusion scans was observed. There was limited change in the loss in lung perfusion between registration methods; however, Demons resulted in larger interpatient variation compared with rigid and B-splines registration

Clinical indications for Thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.J.; Kelly, D.T.

1982-01-01

Thallium-201 myocardial perfusion scanning can assess regional myocardial perfusion non-invasively. As it is both time-consuming and expensive its use should be restricted to specific diagnostic problems. The clinical indications in known or suspected coronary artery disease are reviewed. In suspected coronary artery disease thallium scanning is most useful in patients with chest pain when the exercise ECG is uninterpretable, in men with probable angina but a negative exercise ECG, or conversely a positive exercise ECG without typical angina, and in women with probable angina and either a positive or a negative exercise ECG. In known coronary artery disease, thallium scanning may help determine the functional significance of a coronary obstruction found at angiography and may determine the site of myocardial ischaemia when multiple obstructions are present

Graft downsizing during ex vivo lung perfusion: case report and technical notes.

Science.gov (United States)

Nosotti, M; Rosso, L; Mendogni, P; Tosi, D; Palleschi, A; Righi, I; Froio, S; Valenza, F; Santambrogio, L

2014-09-01

Among patients with respiratory insufficiency awaiting lung transplantation, small adult patients have a lower opportunity of receiving size-matched pulmonary grafts, because of the shortage of donors, particularly those of small size. Reducing the size of an oversized graft is one of the methods to increase the donor pool; similarly, ex vivo lung perfusion is an emerging technique aimed toward the same purpose. We describe how we combined the 2 techniques (lobar transplantation plus contralateral nonanatomic graft reduction during ex vivo lung perfusion) to overcome graft shortage in a clinical case. For the 1st time, this case report demonstrates that surgical manipulation during ex vivo lung perfusion does not affect the functional improvement in a lung previously judged to be not suitable for transplantation. The 6-month follow-up results are similar to those of standard bilateral lung transplantation. Copyright © 2014 Elsevier Inc. All rights reserved.

The uptake and metabolism of cystamine and taurine by isolated, ventilated and perfused rat and rabbit lungs

International Nuclear Information System (INIS)

Sharma, R.; Kodavanti, U.P.; Smith, L.L.; Mehendale, H.M.

1991-01-01

Cystamine has been reported to be taken up by the lung slices and metabolized to taurine via hypotaurine through enzymatic processes. The objective of these studies was to determine whether intact isolated, ventilated and perfused rat and rabbit lungs also posses similar characteristics. The lungs were isolated from male New Zealand white rabbits and S-D rats and perfused with 20 μM [ 14 C] cystamine (Sp. Act., 16.4 mCi/mmol) for 60 min and 30 min, respectively. Cystamine and its metabolites in lung as well as in perfusate were separated by TLC and quantitated using scintillation spectrometry. Similar experiments were also conducted with 20 μM taurine to investigate its fate in perfused lungs. Significant pulmonary uptake of cystamine and taurine occurred during perfusion. Cystamine was metabolized to [ 14 C] hypotaurine and [ 14 C] taurine. No further metabolism of taurine was evident in rat or rabbit lungs. Inclusion of 1 nM GSH did not significantly alter the ability of lungs to sequester cystamine, but the metabolism of hypotaurine to taurine was decreased. It was evident that cystamine was metabolized to taurine by perfused lungs in the same way as in lung slices

Concentration of (+/-)-propranolol in isolated, perfused lungs of rat.

Science.gov (United States)

Dollery, C T; Junod, A F

1976-01-01

1 The metabolism and the accumulation of (+/-)-propranolol have been studied in isolated lungs of the rat, perfused with an artificial medium. 2 Little or no metabolism took place during the perfusion periods (up to 10 minutes). 3 Accumulation was observed with high tissue/medium ratios for substrate concentrations of 0.2 muM to 1 mM; there was evidence for saturability, but no real plateau could be seen. The presence of two binding sites with different affinities was established. 4 Cold greatly inhibited the accumulation process at low substrate concentrations, but had no effect at 1 mM propranolol. 5 Inhibition of accumulation was measured in the presence of imipramine, desmethylimipramine, nortryptiline, chlorpromazine and of Na+-free medium. Cocaine, 5-hydroxytryptamine and noradrenaline had no effect. Lidocaine enhanced the accumulation process. Release of previously bound propranolol was accelerated in the presence of propranolol and imipramine, unaffected by a Na+-free medium and decreased by cold and by lidocaine. 6 Experiments on lung tissue slices yielded qualitatively similar results to those obtained with perfused lungs. Ouabain and KCN had no or little effect on propranolol accumulation. PMID:1276542

Regional distribution of perfusion and ventilation in hamartoangiomyomatosis of the lung

Energy Technology Data Exchange (ETDEWEB)

Tominaga, Shigeru; Ohsaka, Tomohisa; Nanbu, Masashi; Toyoda, Keiko; Mori, Yutaka; Kawakami, Kenji; Inatomi, Keiko; Kira, Shiro

1989-01-01

We investigated regional distribution of perfusion and ventilation in three cases of hamartoangiomyomatosis (HAM) by /sup 133/Xe gas and /sup 99m/Tc-MAA. In two cases, /sup 133/Xe washout were dominantly delayed in middle lung field and in the third case, it was delayed in upper lung field. This distribution was different from the result in the other chronic obstructive pulmonary disease (COPD). In most cases of COPD, /sup 133/Xe washout was prominently delayed in the lower lung field. Distribution of pulmonary perfusion in HAM were consistent with that of ventilation as in COPD.

Preserving Functional Lung Using Perfusion Imaging and Intensity-Modulated Radiation Therapy for Advanced-Stage Non-Small Cell Lung Cancer

International Nuclear Information System (INIS)

Shioyama, Yoshiyuki; Jang, Si Young; Liu, H. Helen; Guerrero, Thomas; Wang, Xuanmin; Gayed, Isis W.; Erwin, William D.; Liao, Zhongxing; Chang, Joe Y.; Jeter, Melenda; Yaremko, Brian P.; Borghero, Yerko O.; Cox, James D.; Komaki, Ritsuko; Mohan, Radhe

2007-01-01

Purpose: To assess quantitatively the impact of incorporating functional lung imaging into intensity-modulated radiation therapy planning for locally advanced non-small cell lung cancer (NSCLC). Methods and Materials: Sixteen patients with advanced-stage NSCLC who underwent radiotherapy were included in this study. Before radiotherapy, each patient underwent lung perfusion imaging with single-photon-emission computed tomography and X-ray computed tomography (SPECT-CT). The SPECT-CT was registered with simulation CT and was used to segment the 50- and 90-percentile hyperperfusion lung (F50 lung and F90 lung). Two IMRT plans were designed and compared in each patient: an anatomic plan using simulation CT alone and a functional plan using SPECT-CT in addition to the simulation CT. Dosimetric parameters of the two types of plans were compared in terms of tumor coverage and avoidance of normal tissues. Results: In incorporating perfusion information in IMRT planning, the median reductions in the mean doses to the F50 and F90 lung in the functional plan were 2.2 and 4.2 Gy, respectively, compared with those in the anatomic plans. The median reductions in the percentage of volume irradiated with >5 Gy, >10 Gy, and >20 Gy in the functional plans were 7.1%, 6.0%, and 5.1%, respectively, for F50 lung, and 11.7%, 12.0%, and 6.8%, respectively, for F90 lung. A greater degree of sparing of the functional lung was achieved for patients with large perfusion defects compared with those with relatively uniform perfusion distribution. Conclusion: Function-guided IMRT planning appears to be effective in preserving functional lung in locally advanced-stage NSCLC patients

Lung PET scan

Science.gov (United States)

... Chest PET scan; Lung positron emission tomography; PET - chest; PET - lung; PET - tumor imaging; ... Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging . 6th ed. Philadelphia, ...

Utilization of the organ care system as ex-vivo lung perfusion after cold storage transportation.

Science.gov (United States)

Mohite, P N; Maunz, O; Popov, A-F; Zych, B; Patil, N P; Simon, A R

2015-11-01

The Organ Care System (OCS) allows perfusion and ventilation of the donor lungs under physiological conditions. Ongoing trials to compare preservation with OCS Lung with standard cold storage do not include donor lungs with suboptimal gas exchange and donor lungs treated with OCS following cold storage transportation. We present a case of a 48-yr-old man who received such lungs after cold storage transportation treated with ex-vivo lung perfusion utilizing OCS. © The Author(s) 2015.

Effects of smoking on lung uptake of 201Tl during exercise myocardial perfusion imaging

International Nuclear Information System (INIS)

Ouyang Wei; He Guorong; Liu Jinhua

2004-01-01

Objective: To investigate the influence of smoking on lung uptake of 201 Tl during myocardial perfusion imaging. Methods: Ninety-two healthy subjects, with normal 201 Tl myocardial perfusion imaging findings but no evidence of left ventricular hypertrophy and pulmonary disease, were divided into three groups, smoker, nonsmoker and quitted smoker groups. Exercise/delay 201 Tl myocardial perfusion imaging was performed on all subjects included. Lung/heart ratio was defined on the anterior planar image obtained during exercise tomography. Results: Both the lung/heart ratios during exercise in smoker (0.40 ± 0.07, F=10.635, P 201 Tl lung/heart ratios in smokers are higher than in nonsmokers and this must be kept in mind when 201 Tl lung/heart ratios are used clinically, even in quitted smokers

The value of lung scintigraphy in the diagnosis of pulmonary embolism

NARCIS (Netherlands)

van Beek, E. J.; Tiel-van Buul, M. M.; Büller, H. R.; van Royen, E. A.; ten Cate, J. W.

1993-01-01

The role of lung scintigraphy in the diagnostic management of patients with clinically suspected pulmonary embolism is reviewed. Evidence is provided that a normal perfusion scan excludes clinically relevant pulmonary embolism, and that a high probability lung scan, defined as a segmental perfusion

CT perfusion scanning of the brain in stroke and beyond

International Nuclear Information System (INIS)

Riedel, Christian

2011-01-01

CT perfusion scanning (CTP) allows for quantitative analysis of cerebral blood flow (CBF) and cerebral blood volume (CBV). Until recently, it was only possible to study brain perfusion parameters in a small stack of CT-slices close to the skull base. With the introduction of multidetector CT scanners with 64 and more detector rows it has become possible to assess perfusion of the entire brain. An optimal choice of scanning parameters like the new 'shuttle'-technique combined with a well adapted regimen for contrast administration is required to guarantee reliable perfusion measurements while still keeping the X-ray dose absorbed by the patient at a minimum. With these techniques, CTP is not only an important modality in the work-up of patients suffering from acute ischemic stroke but can also be valuable in other emergency situations such as in prolonged epileptic seizures or to monitor patients with subacute subarachnoid hemorrhage. (orig.)

An evaluation of the feasibility of assessment of volume perfusion for the whole lung by 128-slice spiral CT

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Sun, Haitao [Imaging Center of Taian Central Hospital, Taian, Shandong (China); Gao, Fei; Li, Ning; Liu, Cheng [Shandong Univ., Shandong Medical Imaging Research Inst., CT Room, Shandong (China)], e-mail: liucheng491025@sina.com

2013-10-15

Background: Lung perfusion based on dynamic scanning cannot provide a quantitative assessment of the whole lung because of the limited coverage of the current computed tomography (CT) detector designs. Purpose: To evaluate the feasibility of dynamic volume perfusion CT (VPCT) of the whole lung using a 128-slice CT for the quantitative assessment and visualization of pulmonary perfusion. Material and Methods: Imaging was performed in a control group of 17 subjects who had no signs of disturbance of pulmonary function or diffuse lung disease, and 15 patients (five patients with acute pulmonary embolism and 10 with emphysema) who constituted the abnormal lung group. Dynamic VPCT was performed in all subjects, and pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT) were calculated from dynamic contrast images with a coverage of 20.7 cm. Regional and volumetric PBF, PBV, and MTT were statistically evaluated and comparisons were made between the normal and abnormal lung groups. Results: Regional PBF (94.2{+-}36.5, 161.8 {+-}29.6, 185.7 {+-}38.1 and 125.5 {+-}46.1, 161.9 {+-}31.4, 169.3 {+-}51.7), PBV (6.7 {+-}2.8, 10.9 {+-}3.0, 12.9 {+-}4.5 and 9.9 {+-}4.6, 10.3 {+-}2.9, 11.9 {+-}4.5), and MTT (5.8 {+-}2.4, 4.5 {+-}1.3, 4.7 {+-}2.1 and 5.6 {+-}2.3, 4.3 {+-}1.5, 4.9 {+-}1.5) demonstrated significant differences in the gravitational and isogravitational directions in the normal lung group (P < 0.05). The PBF (154.2 {+-}30.6 vs. 94.9 {+-}15.9) and PBV (11.1 {+-}4.0 vs. 6.6 {+-}1.7) by dynamic VPCT showed significant differences between normal and abnormal lungs (P < 0.05), notwithstanding the four large lungs that had coverage > 20.7 cm. Conclusion: Dynamic VPCT of the whole lung is feasible for the quantitative assessment of pulmonary perfusion by 128-slice CT, and may in future permit the evaluation of both morphological and functional features of the whole lung in a single examination.

Lung perfusion scintigraphy in congenital heart disease

International Nuclear Information System (INIS)

Sugimura, Hiroshi; Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Oonishi, Takashi; Futami, Shigemi; Watanabe, Katsushi

1990-01-01

Lung perfusion scintigrams were reviewed retrospectively in 28 patients with congenital heart disease, whose ages ranged from the first year to 16 years with an average age of 5 years and 6 months. Seventy four MBq (2 mCi), 111 MBq (2 mCi), and 185 MBq (5 mCi) of Tc-99m macroaggregated albumin were iv injected in the age groups of 0-3, 4-11, and more than 11 years, respectively. Five minutes later, images were obtained in six projections. Abnormal findings on lung perfusion scintigrams were observed in 13 patients (46%). Of these patients, 8 (29%) had a partially decreased blood flow and 5 (17%) had a decreased blood flow in the unilateral lung. No significant difference in the occurrence of abnormal findings was observed among the age groups, although they tended to occur in younger patients. Sex, underlying conditions, and hemodynamics were also independent of scintigraphically abnormal findings. Even when classifying the patients as having either cyanotic or non-cyanotic heart disease, no significant difference in hemodynamics was observed between the group of abnormal findings and the group of normal findings. Pulmonary arteriography available in all patients failed to reveal abnormal findings, with the exception of pulmonary artery stenosis in 2 patients that corresponded to a decreased blood flow in the unilateral lung. Pulmonary artery stenosis seemed to be responsible for abnormal pulmonary blood flow, although other causes remained uncertain. (N.K.)

Lung perfusion and ventilation scintigraphy in pre- and postoperative diagnostics

International Nuclear Information System (INIS)

Sandrock, D.; Munz, D.L.

1998-01-01

Lung perfusion (Tc-99m labeled albumin particles) and ventilation (Xe-133 gas) are used prior to thoracic surgery in order to evaluate changes in perfusion and ventilation due to the underlying diseases. Furthermore, perfusion scintigraphy allows combined with spirometry the prediction of the postinterventional vital capacity and the forced expiratory volume in 1 s. The correlation coefficient for this procedure compared with values measured postoperatively are in the range of 0.8. The method allows the assessment of operability in terms of postinterventional function. (orig.) [de

Diagnostic value of static and dynamic scintigraphy in diagnosis of acute respiratory distress syndrome in the course of sepsis. Part 1. Lung perfusion scintigraphy

International Nuclear Information System (INIS)

Jurgilewicz, D.; Rogowski, F.; Malinowska, L.

1997-01-01

One of the most important complication of sepsis is acute respiratory distress syndrome (ARDS). Diagnosis of the illness is mainly based on chest radiography and gasometric parameters of the blood. The aim of the study was to estimate the diagnostic usefulness of lung perfusion scintigraphy in early detection of blood flow and gas-exchange abnormalities in patients with ARDS in the course of sepsis. Scintigraphic studies of 12 patients in critical condition were performed, using Hungarian planar gamma camera type MB9200 and human albumin microspheres labelled with 99m Tc. Perfusion scans of patients with ARDS demonstrated blurring outlines and abundant diffuse foci of lack of radioactivity in both lungs and quantitative analysis indicated relative increase of Tc99m-MSA accumulation in upper zones of both lungs. Scans of suffering from sepsis were similar to control one. The course of the studies showed that scintigraphic methods could be safely use in patients with sepsis and ARDS and may be helpful in the early diagnosis of ARDS in the septic patients. (author)

Radiographic and radionuclide lung perfusion imaging in healthy calves and calves naturally infected with bovine respiratory syncytial virus

International Nuclear Information System (INIS)

Verhoeff, J.; Brom, W.E. van den; Ingh, T.S.G.A.M. van den

1992-01-01

Nine calves between three and 18 weeks old with serologically confirmed natural bovine respiratory syncytial virus infection were examined clinically, radiographically and by radionuclide lung perfusion imaging. The results were compared with those from seven healthy calves. The diseased calves were euthanased and examined pathologically, virologically and bacteriologically. The clinical signs indicated that the disease was in an acute stage. Radiography of the diseased animals revealed cysts, corresponding morphologically with bullous emphysema, and infiltrations roughly corresponding in distribution with atelectatic and, or, pneumonic areas. Radionuclide lung perfusion imaging revealed no perfusion shifts between the left and right lungs and a normal perfusion pattern in five of the nine diseased calves. The abnormalities in the perfusion patterns of three calves were probably caused by anatomical disorders such as cysts and pleural adhesions, but no cause of the abnormality could be found in one calf. These findings suggest that in calves infected with bovine respiratory syncytial virus, the normal perfusion pattern is maintained until anatomical disorders occur. The pathological examination and radiography revealed that the cranioventral lung fields were particularly poorly ventilated. This finding and the normal perfusion pattern indicate that these parts of the lungs are probably the sites where shuntings and perfusion-ventilation mismatchings occur

First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

DEFF Research Database (Denmark)

Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold

2014-01-01

INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its...... introduction. MATERIAL AND METHODS: The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were...... otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died...

Low pulmonary artery flush perfusion pressure combined with high positive end-expiratory pressure reduces oedema formation in isolated porcine lungs

International Nuclear Information System (INIS)

Schumann, Stefan; Schließmann, Stephan J; Wagner, Giskard; Goebel, Ulrich; Priebe, Hans-Joachim; Guttmann, Josef; Kirschbaum, Andreas

2010-01-01

Flush perfusion of the pulmonary artery with organ protection solution is a standard procedure before lung explantation. However, rapid flush perfusion may cause pulmonary oedema which is deleterious in the lung transplantation setting. In this study we tested the hypotheses that high pulmonary perfusion pressure contributes to the development of pulmonary oedema and positive end-expiratory pressure (PEEP) counteracts oedema formation. We expected oedema formation to increase weight and decrease compliance of the lungs on the basis of a decrease in alveolar volume as fluid replaces alveolar air spaces. The pulmonary artery of 28 isolated porcine lungs was perfused with a low-potassium dextrane solution at low (mean 27 mmHg) or high (mean 40 mmHg) pulmonary artery pressure (PAP) during mechanical ventilation at low (4 cmH 2 O) or high (8 cmH 2 O) PEEP, respectively. Following perfusion and storage, relative increases in lung weight were smaller (p < 0.05) during perfusion at low PAP (62 ± 32% and 42 ± 26%, respectively) compared to perfusion at high PAP (133 ± 54% and 87 ± 30%, respectively). Compared to all other PAP–PEEP combinations, increases in lung weight were smallest (44 ± 9% and 27 ± 12%, respectively), nonlinear intratidal lung compliance was largest (46% and 17% respectively, both p < 0.05) and lung histology showed least infiltration of mononuclear cells in the alveolar septa, and least alveolar destruction during the combination of low perfusion pressure and high PEEP. The findings suggest that oedema formation during pulmonary artery flush perfusion in isolated and ventilated lungs can be reduced by choosing low perfusion pressure and high PEEP. PAP–PEEP titration to minimize pulmonary oedema should be based on lung mechanics and PAP monitoring

Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

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Kleinman, B.; Henkin, R.E.; Glisson, S.N.; el-Etr, A.A.; Bakhos, M.; Sullivan, H.J.; Montoya, A.; Pifarre, R.

1986-02-01

Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques.

Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

International Nuclear Information System (INIS)

Kleinman, B.; Henkin, R.E.; Glisson, S.N.; el-Etr, A.A.; Bakhos, M.; Sullivan, H.J.; Montoya, A.; Pifarre, R.

1986-01-01

Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques

[Significance and mechanism of MSCT perfusion scan on differentiation of NSCLC].

Science.gov (United States)

Liu, Jin-Kang; Hu, Cheng-Ping; Zhou, Mo-Ling; Zhou, Hui; Xiong, Zeng; Xia, Yu; Chen, Wei

2009-06-01

To determine the significance of MSCT perfusion scan on differentiation of NSCLC and to investigate its possible mechanisms. Forty four NSCLC patients underwent CT perfusion scan by MSCT. Among them, 22 cases were selected to detected the two-dimensional tumor microvascular architecture phenotype (2D-TMAP), the relationships between CT perfusion parameters (BF, BV, PEI, TIP), and the differentiation of NSCLC were analysed by using the correlation analysis and trend test. Spearman correlation analysis was used to study the relationships between CT perfusion parameters, differentiation, and 2D-TMAP. The total BF, BV and PEI decreased with decreasing differentiation of NSCLC (P<0.05). The total PEI showed a positive correlation with the total MVD (P<0.05). There were negative correlations between the surrounding area BF, the total BF, BV, and PEI, the uncomplete lumen of the surrounding area MVD, and expression of PCNA, respectively (P<0.05). There were positive correlations between degree of differentiation and the uncomplete lumen of the surrounding area MVD (P<0.05). It was the same as degree of differentiation and expression of PCNA, VEGF, respectively. There were positive correlations between the uncomplete lumen of the surrounding area MVD and expression of VEGF, ephrinB2, EphB4, and PCNA, respectively (P<0.05). Perfusion parameters reflect the difference of density of vassels with mature functional lumen. Careful evaluation of the differences of blood flow pattern in pulmonary space-occupying lesions by MSCT perfusion scan can be used to identify the degree of NSCLC differentiation.

Single-energy computed tomography-based pulmonary perfusion imaging: Proof-of-principle in a canine model

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Yamamoto, Tokihiro, E-mail: toyamamoto@ucdavis.edu [Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, California 95817 (United States); Kent, Michael S.; Wisner, Erik R. [Department of Surgical and Radiological Sciences, University of California Davis School of Veterinary Medicine, Davis, California 95616 (United States); Johnson, Lynelle R.; Stern, Joshua A. [Department of Medicine and Epidemiology, University of California Davis School of Veterinary Medicine, Davis, California 95616 (United States); Qi, Lihong [Department of Public Health Sciences, University of California Davis, Davis, California 95616 (United States); Fujita, Yukio [Department of Radiation Oncology, Tokai University, Isehara, Kanagawa 259-1193 (Japan); Boone, John M. [Department of Radiology, University of California Davis School of Medicine, Sacramento, California 95817 (United States)

2016-07-15

Purpose: Radiotherapy (RT) that selectively avoids irradiating highly functional lung regions may reduce pulmonary toxicity, which is substantial in lung cancer RT. Single-energy computed tomography (CT) pulmonary perfusion imaging has several advantages (e.g., higher resolution) over other modalities and has great potential for widespread clinical implementation, particularly in RT. The purpose of this study was to establish proof-of-principle for single-energy CT perfusion imaging. Methods: Single-energy CT perfusion imaging is based on the following: (1) acquisition of end-inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast agents, (2) deformable image registration (DIR) for spatial mapping of those two CT image data sets, and (3) subtraction of the precontrast image data set from the postcontrast image data set, yielding a map of regional Hounsfield unit (HU) enhancement, a surrogate for regional perfusion. In a protocol approved by the institutional animal care and use committee, the authors acquired CT scans in the prone position for a total of 14 anesthetized canines (seven canines with normal lungs and seven canines with diseased lungs). The elastix algorithm was used for DIR. The accuracy of DIR was evaluated based on the target registration error (TRE) of 50 anatomic pulmonary landmarks per subject for 10 randomly selected subjects as well as on singularities (i.e., regions where the displacement vector field is not bijective). Prior to perfusion computation, HUs of the precontrast end-inspiratory image were corrected for variation in the lung inflation level between the precontrast and postcontrast end-inspiratory CT scans, using a model built from two additional precontrast CT scans at end-expiration and midinspiration. The authors also assessed spatial heterogeneity and gravitationally directed gradients of regional perfusion for normal lung subjects and diseased lung subjects using a two-sample two-tailed t

Single-energy computed tomography-based pulmonary perfusion imaging: Proof-of-principle in a canine model.

Science.gov (United States)

Yamamoto, Tokihiro; Kent, Michael S; Wisner, Erik R; Johnson, Lynelle R; Stern, Joshua A; Qi, Lihong; Fujita, Yukio; Boone, John M

2016-07-01

Radiotherapy (RT) that selectively avoids irradiating highly functional lung regions may reduce pulmonary toxicity, which is substantial in lung cancer RT. Single-energy computed tomography (CT) pulmonary perfusion imaging has several advantages (e.g., higher resolution) over other modalities and has great potential for widespread clinical implementation, particularly in RT. The purpose of this study was to establish proof-of-principle for single-energy CT perfusion imaging. Single-energy CT perfusion imaging is based on the following: (1) acquisition of end-inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast agents, (2) deformable image registration (DIR) for spatial mapping of those two CT image data sets, and (3) subtraction of the precontrast image data set from the postcontrast image data set, yielding a map of regional Hounsfield unit (HU) enhancement, a surrogate for regional perfusion. In a protocol approved by the institutional animal care and use committee, the authors acquired CT scans in the prone position for a total of 14 anesthetized canines (seven canines with normal lungs and seven canines with diseased lungs). The elastix algorithm was used for DIR. The accuracy of DIR was evaluated based on the target registration error (TRE) of 50 anatomic pulmonary landmarks per subject for 10 randomly selected subjects as well as on singularities (i.e., regions where the displacement vector field is not bijective). Prior to perfusion computation, HUs of the precontrast end-inspiratory image were corrected for variation in the lung inflation level between the precontrast and postcontrast end-inspiratory CT scans, using a model built from two additional precontrast CT scans at end-expiration and midinspiration. The authors also assessed spatial heterogeneity and gravitationally directed gradients of regional perfusion for normal lung subjects and diseased lung subjects using a two-sample two-tailed t-test. The mean TRE

Single-energy computed tomography-based pulmonary perfusion imaging: Proof-of-principle in a canine model

International Nuclear Information System (INIS)

Yamamoto, Tokihiro; Kent, Michael S.; Wisner, Erik R.; Johnson, Lynelle R.; Stern, Joshua A.; Qi, Lihong; Fujita, Yukio; Boone, John M.

2016-01-01

Purpose: Radiotherapy (RT) that selectively avoids irradiating highly functional lung regions may reduce pulmonary toxicity, which is substantial in lung cancer RT. Single-energy computed tomography (CT) pulmonary perfusion imaging has several advantages (e.g., higher resolution) over other modalities and has great potential for widespread clinical implementation, particularly in RT. The purpose of this study was to establish proof-of-principle for single-energy CT perfusion imaging. Methods: Single-energy CT perfusion imaging is based on the following: (1) acquisition of end-inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast agents, (2) deformable image registration (DIR) for spatial mapping of those two CT image data sets, and (3) subtraction of the precontrast image data set from the postcontrast image data set, yielding a map of regional Hounsfield unit (HU) enhancement, a surrogate for regional perfusion. In a protocol approved by the institutional animal care and use committee, the authors acquired CT scans in the prone position for a total of 14 anesthetized canines (seven canines with normal lungs and seven canines with diseased lungs). The elastix algorithm was used for DIR. The accuracy of DIR was evaluated based on the target registration error (TRE) of 50 anatomic pulmonary landmarks per subject for 10 randomly selected subjects as well as on singularities (i.e., regions where the displacement vector field is not bijective). Prior to perfusion computation, HUs of the precontrast end-inspiratory image were corrected for variation in the lung inflation level between the precontrast and postcontrast end-inspiratory CT scans, using a model built from two additional precontrast CT scans at end-expiration and midinspiration. The authors also assessed spatial heterogeneity and gravitationally directed gradients of regional perfusion for normal lung subjects and diseased lung subjects using a two-sample two-tailed t

Evaluation of Tl-201 lung uptake and impairment of pulmonary perfusion on scintigraphies in pulmonary tuberculosis

International Nuclear Information System (INIS)

Fujii, Tadashige; Tanaka, Masao; Koizumi, Tomonori; Kubo, Keishi

2000-01-01

Tl-201 lung uptake in 74 patients (85 lesions) and pulmonary perfusion in 105 patients were studied to evaluate clinical usefulness of Tl-201 lung uptake and perfusion lung scintigraphy in pulmonary tuberculosis, using a scintillation camera with a mini-computer system. As indices of Tl-201 lung uptake, lung (lesion) to upper mediastinum uptake ratio (L/M) and visual grading were used. L/M in pulmonary tuberculosis was 1.96±0.66, which was significantly larger than 1.04±0.24 in healthy controls and lower than that in heart diseases with left heart failure and idiopathic interstitial pneumonia, and showed no significant differences with that in acute pneumonia, pyothorax, primary lung cancer and malignant mediastinal tumor. L/M in pulmonary tuberculosis did not correlate with CRP, erythrocyte sedimentation rate, Gaffky number of sputum and body temperature. It correlated with the type of pulmonary tuberculosis according to the Gakken Classification reflecting the disease activity. It was larger in the exudative type, caseo-infiltrative one, disseminated one, one with cavity in infiltrative lesion than the fibro-caseous one. On perfusion lung scintigram, impairment of pulmonary perfusion larger than area of the entire unilateral lung was observed in 68 cases (64.8%). Area of hypoperfused lung field, which correlated with % vital capacity (r=0.60, p=0.0002) and PaO 2 (r=0.39,p=0.0024), was significantly larger in patients with silicosis and those with bilateral pleural involvements such as pleural callosity than in those with type III according to the Gakkai Classification. Most of the patients showed decreased pulmonary perfusion and Tl-201 accumulation of which grade reflects the disease activity in active tuberculous lesion. Patients with miliary tuberculosis and those with silicotuberculosis showed diffuse Tl-201 accumulation in the both lungs. Tl-201 lung scintigraphy seems to be useful for visualizing active tuberculous lesions, particularly the ones that

Single photon emission computed tomography study of human pulmonary perfusion: preliminary findings

Energy Technology Data Exchange (ETDEWEB)

Carratu, L; Sofia, M [Naples Univ. (Italy). Facolta di Medicina e Chirurgia; Salvatore, M; Muto, P; Ariemma, G [Istituto Nazionale per la Prevenzione, Lo Studio e La Cura dei Tumori Fondazione Pascale, Naples (Italy); Lopez-Majano, V [Cook County Hospital, Chicago, IL (USA). Nuclear Medicine Div.

1984-02-01

Single photon emission computed tomography (SPECT) was performed with /sup 99/Tcsup(m)-albumin macroaggregates to study human pulmonary perfusion in healthy subjects and patients with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and lung neoplasms. The reconstructed SPECT data was displayed in coronal, transverse, sagittal plane sections and compared to conventional perfusion scans. The SPECT data gave more complicated anatomical information about the extent of damage and morphology of the pulmonary vascular bed. In healthy subjects and COPD patients, qualitative and quantitative assessment of pulmonary perfusion could be obtained from serial SPECT scans with respect to distribution and relative concentration of the injected radiopharmaceutical. Furthermore, SPECT of pulmonary perfusion has been useful in detecting the extent of damage to the pulmonary circulation. This is useful for the preoperative evaluation and staging of lung cancer.

Measurement of ventilation- and perfusion-mediated cooling during laser ablation in ex vivo human lung tumors

Energy Technology Data Exchange (ETDEWEB)

Vietze, Andrea, E-mail: anvie@gmx.de [Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-Universitaet Greifswald, Sauerbruchstrasse, 17487 Greifswald (Germany); Koch, Franziska, E-mail: franzi_koch@hotmail.com [Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-Universitaet Greifswald, Sauerbruchstrasse, 17487 Greifswald (Germany); Laskowski, Ulrich, E-mail: ulrich.laskowski@klinikum-luedenscheid.de [Department of Vascular and Thoracic Surgery, Klinikum Luedenscheid, Paulmannshoeher Strasse 14, 58515 Luedenscheid (Germany); Linder, Albert, E-mail: albert.linder@klinikum-bremen-ost.de [Department of Thoracic Surgery, Klinikum Bremen-Ost, Zuericher Strasse 40, 28325 Bremen (Germany); Hosten, Norbert, E-mail: hosten@uni-greifswald.de [Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-Universitaet Greifswald, Sauerbruchstrasse, 17487 Greifswald (Germany)

2011-11-15

Purpose: Perfusion-mediated tissue cooling has often been described in the literature for thermal ablation therapies of liver tumors. The objective of this study was to investigate the cooling effects of both perfusion and ventilation during laser ablation of lung malignancies. Materials and methods: An ex vivo lung model was used to maintain near physiological conditions for the specimens. Fourteen human lung lobes containing only primary lung tumors (non-small cell lung cancer) were used. Laser ablation was carried out using a Nd:YAG laser with a wavelength of 1064 nm and laser fibers with 30 mm diffusing tips. Continuous invasive temperature measurement in 10 mm distance from the laser fiber was performed. Laser power was increased at 2 W increments starting at 10 W up to a maximum power of 12-20 W until a temperature plateau around 60 deg. C was reached at one sensor. Ventilation and perfusion were discontinued for 6 min each to assess their effects on temperature development. Results: The experiments lead to 25 usable temperature profiles. A significant temperature increase was observed for both discontinued ventilation and perfusion. In 6 min without perfusion, the temperature rose about 5.5 deg. C (mean value, P < 0.05); without ventilation it increased about 7.0 deg. C (mean value, P < 0.05). Conclusion: Ventilation- and perfusion-mediated tissue cooling are significant influencing factors on temperature development during thermal ablation. They should be taken into account during the planning and preparation of minimally invasive lung tumor treatment in order to achieve complete ablation.

Follow-up of pulmonary perfusion recovery after embolism

International Nuclear Information System (INIS)

Palla, A.; Donnamaria, V.; Petruzzelli, S.; Giuntini, C.

1986-01-01

Blood flow recovery in a group of 69 patients with pulmonary embolism was followed by serial lung scans over a six month period. Each patient underwent perfusion lung scan at diagnosis then 7, 30 and 180 days later; i.v. heparin was systematically administered for one week after diagnosis, followed by oral warfarin for six months. Blood flow impairment was evaluated by assessing the total number of unperfused lung segments (ULS), as calculated on both lateral views at each scan. The number of ULS was significantly reduced at each interval (P<0.001), ranging from 8.4±3.3 at diagnosis to 3.6±2.7 six months later; most of the recovery (79%) occurred within the first month. No patient had complete restoration of pulmonary blood flow during the whole follow-up period. No difference was found between the number of ULS in right lung versus that in left lung at each interval. Recovery of blood flow was heavily affected by coexisting cardiac or pulmonary disease. In fact, those patients with underlying cardiopulmonary disease (49.2% of the total) showed significantly smaller perfusion improvement after six months (P<0.001). Eight patients (6 with and 2 without cardiopulmonary disease) had clinical and scintigraphic evidence of recurrent embolism during the follow-up period

Estimation of pulmonary hypertension in lung and valvular heart diseases by perfusion lung scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Fujii, Tadashige [Shinshu Univ., Matsumoto, Nagano (Japan). School of Allied Medical Sciences; Tanaka, Masao; Yazaki, Yoshikazu; Kitabayashi, Hirosi; Koizumi, Tomonori; Kubo, Keisi; Sekiguchi, Morie; Yano, Kesato

1999-06-01

To estimate pulmonary hypertension, we measured postural differences in pulmonary blood flow for the lateral decubitus positions on perfusion lung scintigrams with Tc-99 m macro-aggregated albumin, applying the method devised by Tanaka et al (Eur J Nucl Med 17: 320-326, 1990). Utilizing a scintillation camera coupled to a minicomputer system, changes in the distribution of pulmonary blood flow caused by gravitational effects, namely, changes in the total count ratios for the right lung versus the left lung in the right and left lateral decubitus positions (R/L), were obtained for 44 patients with lung disease, 95 patients with valvular heart disease, and 23 normal subjects. Mean standard deviation in the R/L ratios was 3.09{+-}1.28 for the normal subjects, 1.97{+-}0.89 for the patients with lung disease, and 1.59{+-}0.59 for the patients with valvular heart disease. The R/L ratios correlated with mean pulmonary arterial pressure and cardio-thoracic ratios in the lung disease and valvular heart disease groups, with pulmonary arteriolar resistance in the former, and with pulmonary capillary wedge pressure in the latter. Defining pulmonary hypertension (>20 mmHg) as an R/L ratio of less than 1.81, which is the mean-1 standard deviation for normal subjects, the sensitivity and the specificity of the R/L ratio for the diagnosis of pulmonary hypertension were 62.9% and 76.2%, respectively, for the lung disease patients, and 80.3% and 61.8%, respectively, for the valvular heart disease patients. This method seems to be useful for the pathophysiologic evaluation of pulmonary perfusion in cases of lung disease and valvular heart disease. (author)

Estimation of pulmonary hypertension in lung and valvular heart diseases by perfusion lung scintigraphy

International Nuclear Information System (INIS)

Fujii, Tadashige; Tanaka, Masao; Yazaki, Yoshikazu; Kitabayashi, Hirosi; Koizumi, Tomonori; Kubo, Keisi; Sekiguchi, Morie; Yano, Kesato

1999-01-01

To estimate pulmonary hypertension, we measured postural differences in pulmonary blood flow for the lateral decubitus positions on perfusion lung scintigrams with Tc-99 m macro-aggregated albumin, applying the method devised by Tanaka et al (Eur J Nucl Med 17: 320-326, 1990). Utilizing a scintillation camera coupled to a minicomputer system, changes in the distribution of pulmonary blood flow caused by gravitational effects, namely, changes in the total count ratios for the right lung versus the left lung in the right and left lateral decubitus positions (R/L), were obtained for 44 patients with lung disease, 95 patients with valvular heart disease, and 23 normal subjects. Mean standard deviation in the R/L ratios was 3.09±1.28 for the normal subjects, 1.97±0.89 for the patients with lung disease, and 1.59±0.59 for the patients with valvular heart disease. The R/L ratios correlated with mean pulmonary arterial pressure and cardio-thoracic ratios in the lung disease and valvular heart disease groups, with pulmonary arteriolar resistance in the former, and with pulmonary capillary wedge pressure in the latter. Defining pulmonary hypertension (>20 mmHg) as an R/L ratio of less than 1.81, which is the mean-1 standard deviation for normal subjects, the sensitivity and the specificity of the R/L ratio for the diagnosis of pulmonary hypertension were 62.9% and 76.2%, respectively, for the lung disease patients, and 80.3% and 61.8%, respectively, for the valvular heart disease patients. This method seems to be useful for the pathophysiologic evaluation of pulmonary perfusion in cases of lung disease and valvular heart disease. (author)

Beware Cold Agglutinins in Organ Donors! Ex Vivo Lung Perfusion From an Uncontrolled Donation After Circulatory-Determination-of-Death Donor With a Cold Agglutinin: A Case Report.

Science.gov (United States)

Venkataraman, A; Blackwell, J W; Funkhouser, W K; Birchard, K R; Beamer, S E; Simmons, W T; Randell, S H; Egan, T M

2017-09-01

We began to recover lungs from uncontrolled donation after circulatory determination of death to assess for transplant suitability by means of ex vivo lung perfusion (EVLP) and computerized tomographic (CT) scan. Our first case had a cold agglutinin with an interesting outcome. A 60-year-old man collapsed at home and was pronounced dead by Emergency Medical Services personnel. Next-of-kin consented to lung retrieval, and the decedent was ventilated and transported. Lungs were flushed with cold Perfadex, removed, and stored cold. The lungs did not flush well. Medical history revealed a recent hemolytic anemia and a known cold agglutinin. Warm nonventilated ischemia time was 51 minutes. O 2 -ventilated ischemia time was 141 minutes. Total cold ischemia time was 6.5 hours. At cannulation for EVLP, established clots were retrieved from both pulmonary arteries. At initiation of EVLP with Steen solution, tiny red aggregates were observed initially. With warming, the aggregates disappeared and the perfusate became red. After 1 hour, EVLP was stopped because of florid pulmonary edema. The lungs were cooled to 20°C; tiny red aggregates formed again in the perfusate. Ex vivo CT scan showed areas of pulmonary edema and a pyramidal right middle lobe opacity. Dissection showed multiple pulmonary emboli-the likely cause of death. However, histology showed agglutinated red blood cells in the microvasculature in pre- and post-EVLP biopsies, which may have contributed to inadequate parenchymal preservation. Organ donors with cold agglutinins may not be suitable owing to the impact of hypothermic preservation. Copyright © 2017 Elsevier Inc. All rights reserved.

Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

Energy Technology Data Exchange (ETDEWEB)

Dowdle, S.C.; Human, D.G.; Mann, M.D. (Univ. of Cape Town (South Africa))

1990-08-01

Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis.

Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

International Nuclear Information System (INIS)

Dowdle, S.C.; Human, D.G.; Mann, M.D.

1990-01-01

Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis

Accuracy and feasibility of dynamic contrast-enhanced 3D MR imaging in the assessment of lung perfusion: comparison with Tc-99 MAA perfusion scintigraphy

International Nuclear Information System (INIS)

Yilmaz, E.; Akkoclu, A.; Degirmenci, B.; Cooper, R.A.; Sengun, B.; Gulcu, A.; Osma, E.; Ucan, E.S.

2005-01-01

AIM: The aim of this study was to correlate findings of perfusion magnetic resonance imaging (MRI) and perfusion scintigraphy in cases where there was a suspicion of abnormal pulmonary vasculature, and to evaluate the usefulness of MRI in the detection of perfusion deficits of the lung. METHODS: In all, 17 patients with suspected abnormality of the pulmonary vasculature underwent dynamic contrast-enhanced MRI. T1-weighted 3D fast-field echo pulse sequences were obtained (TR/TE 3.3/1.58 ms; flip angle 30 deg ; slice thickness 12 to 15 mm). The dynamic study was acquired in the coronal plane following administration of 0.1 mmol/kg gadopentetate dimeglumine. A total of 8 to 10 sections repeated 20 to 25 times at intervals of 1 s were performed. Perfusion lung scintigraphy was carried out a maximum of 48 h before the MR examination in all cases. Two radiologists, who were blinded to the clinical data and results of other imaging methods, reviewed all coronal sections. MR perfusion images were independently assessed in terms of segmental or lobar perfusion defects in the 85 lobes of the 17 individuals, and the findings were compared with the results of scintigraphy. RESULTS: Of the 17 patients, 8 were found to have pulmonary emboli, 2 chronic obstructive pulmonary disease with emphysema, 2 bullous emphysema, 2 Takayasu arteritis and 1 had a hypoplastic pulmonary artery. Pulmonary perfusion was completely normal in 2 cases. In 35 lobes, perfusion defects were detected using both methods, in 4 with MR alone and in 9 only with scintigraphy. There was good agreement between MRI and scintigraphy findings (kappa=0.695). CONCLUSION: Pulmonary perfusion MRI is a new alternative to scintigraphy in the evaluation of pulmonary perfusion for various lung disorders. In addition, this technique allows measurement and quantification of pulmonary perfusion abnormalities

Ex vivo lung perfusion in clinical lung transplantation--state of the art.

Science.gov (United States)

Andreasson, Anders S I; Dark, John H; Fisher, Andrew J

2014-11-01

Ex vivo lung perfusion (EVLP) has emerged as a new technique for assessing and potentially reconditioning human donor lungs previously unacceptable for clinical transplantation with the potential to dramatically push the limits of organ acceptability. With the recent introduction of portable EVLP, a new era in lung preservation may be upon us with the opportunity to also limit organ ischaemic times and potentially improve the outcome of donor lungs already deemed acceptable for transplantation. It took over half a century for the technique to evolve from basic theory to semi-automated circuits fit for clinical use that are now rapidly being adopted in transplant centres across the globe. With this field in constant evolution and many unanswered questions remaining, our review serves as an update on the state of the art of EVLP in clinical lung transplantation. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Propofol attenuates oxidant-induced acute lung injury in an isolated perfused rabbit-lung model.

Science.gov (United States)

Yumoto, Masato; Nishida, Osamu; Nakamura, Fujio; Katsuya, Hirotada

2005-01-01

Reactive oxygen species have been strongly implicated in the pathogenesis of acute lung injury (ALI). Some animal studies suggest that free radical scavengers inhibit the onset of oxidant-induced ALI. Propofol (2,6-diisopropylphenol) is chemically similar to phenol-based free radical scavengers such as the endogenous antioxidant vitamin E. Both in vivo and in vitro studies have suggested that propofol has antioxidant potential. We hypothesized that propofol may attenuate ALI by acting as a free-radical scavenger. We investigated the effects of propofol on oxidant-induced ALI induced by purine and xanthine oxidase (XO), in isolated perfused rabbit lung, in two series of experiments. In series 1, we examined the relationship between the severity of ALI and the presence of hydrogen peroxide (H2O2). In series 2, we evaluated the effects of propofol on attenuating ALI and the dose dependence of these effects. The lungs were perfused for 90 min, and we evaluated the effects on the severity of ALI by monitoring the pulmonary capillary filtration coefficient (Kfc), pulmonary arterial pressure (Ppa), and the pulmonary capillary hydrostatic pressure (Ppc). In series 1, treatment with catalase (an H2O2 scavenger) prior to the addition of purine and XO resulted in complete prevention of ALI, suggesting that H2O2 may be involved closely in the pathogenesis of ALI. In series 2, pretreatment with propofol at concentrations in excess of 0.5 mM significantly inhibited the increases in the Kfc values, and that in excess of 0.75 mM significantly inhibited the increase in the Ppa values. Propofol attenuates oxidant-induced ALI in an isolated perfused rabbit lung model, probably due to its antioxidant action.

Studies on the correlation between pre-and post-operative perfusion scintigraphy and differential spirometry in operated lungs

International Nuclear Information System (INIS)

Kaseda, Shizuka; Ikeda, Takaaki; Sakai, Tadaaki; Tomaru, Hiroko; Ishihara, Tsuneo; Kikuchi, Keiichi.

1982-01-01

For the purpose of clarifying the relationship between the percentage of perfusion and that of vital capacity or oxygen uptake on the affected lung, perfusion scintigraphy using sup(99m)Tc-MAA and differential spirometry were performed in twenty patients including sixteen patients with lung cancer. Both examinations were performed before and after the operation. The results are as follows: (1) There is a significant correlation between the percentage of perfusion and that of vital capacity or oxygen uptake of the affected lung before and after the operation. (2) The estimation of the percentage of vital capacity or oxygen uptake of the affected lung is possible by combining the spirometry and sup(99m)Tc-MAA pulmonary scintigraphy. (author)

The evaluation of the degree of impairment of pulmonary perfusion in lung cancer patients treated by radiotherapy by the quantification of nonuniform distribution of lung perfusion scintigraphy SPECT

International Nuclear Information System (INIS)

Mitomo, Osamu; Tsunoda, Takashi; Kuwabara, Hidemasa

2004-01-01

By means of quantifying the nonuniform distribution of pulmonary perfusion in Lung Perfusion Scintigraphy SPECT (single photon emission tomography), which is called ''SPECT'' for short, we evaluated the degree of functional impairment of pulmonary perfusion in non-operated lung cancer patients treated by the radiotherapy. Sixty-eight patients with non-operated lung cancer treated with radiotherapy, and who either received or did not receive chemotherapy, from February, 1996 to August, 2002, were examined using SPECT within 6 weeks prior to, or within 2 weeks following radiotherapy. This group was called ''irradiated lung cancer patients''. Twenty-six patients, who were called ''follow-up irradiated lung cancer patients'', were reexamined within four weeks after radiotherapy. On the other hand, 323 patients without lung cancer, who were subdivided into four groups; pulmonary, cardiac, cardio-pulmonary, and non-cardiopulmonary. The SPECT was examined in the supine position after infusing Tc-99m-MAA, 185 MBq in a bolus, mainly into an antecubital vein with the patient's arm elevated. From reconstructed SPECT images, the volume of lung as a whole calculated at 10% of thresholds was assumed to be the ''Baseline Lung Perfusion Volume'' (BPV), and the functional volume rates were calculated in 10% threshold widths from 10% to 100% of the threshold. Assuming the total absolute differences in functional volume rate between each subject and the control to be the distribution index of the lung as a whole (D index), we quantified the degree of nonuniform distribution of the lung as a whole in each subject. In the same way, the distribution index of the left or right lung respectively was calculated as D l or D r index assuming the volume of left or right lung were calculated at 10% of the threshold as left or right BPV and calculating the functional volume rates of each lung in 10% threshold widths from 10% to 100% of the threshold. The D index of irradiated lung cancer

Active Oxygen Metabolites and Thromboxane in Phorbol Myristate Acetate Toxicity to the Isolated, Perfused Rat Lung.

Science.gov (United States)

Carpenter, Laurie Jean

When administered intravenously or intratracheally to rats, rabbits and sheep, phorbol myristate acetate (PMA) produces changes in lung morphology and function are similar to those seen in humans with the adult respiratory distress syndrome (ARDS). Therefore, it is thought that information about the mechanism of ARDS development can be gained from experiments using PMA-treated animals. Currently, the mechanisms by which PMA causes pneumotoxicity are unknown. Results from other studies in rabbits and in isolated, perfused rabbit lungs suggest that PMA-induced lung injury is mediated by active oxygen species from neutrophils (PMN), whereas studies in sheep and rats suggest that PMN are not required for the toxic response. The role of PMN, active oxygen metabolites and thromboxane (TxA_2) in PMA-induced injury to isolated, perfused rat lungs (IPLs) was examined in this thesis. To determine whether PMN were required for PMA to produce toxicity to the IPL, lungs were perfused for 30 min with buffer containing various concentrations of PMA (in the presence or absence of PMN). When concentrations >=q57 ng/ml were added to medium devoid of added PMN, perfusion pressure and lung weight increased. When a concentration of PMA (14-28 ng/ml) that did not by itself cause lungs to accumulate fluid was added to the perfusion medium containing PMN (1 x 10 ^8), perfusion pressure increased, and lungs accumulated fluid. These results indicate that high concentrations of PMA produce lung injury which is independent of PMN, whereas injury induced by lower concentrations is PMN-dependent. To examine whether active oxygen species were involved in mediating lung injury induced by PMA and PMN, lungs were coperfused with the oxygen radical scavengers SOD and/or catalase. Coperfusion with either or both of these enzymes totally protected lungs against injury caused by PMN and PMA. These results suggest that active oxygen species (the hydroxyl radical in particular), mediate lung injury in

Demonstration of pulmonary perfusion heterogeneity induced by gravity and lung inflation using arterial spin labeling

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Fan Li [Department of Radiology, ChangZheng Hospital, Second Military Medical University, Shanghai 200003 (China)], E-mail: fanli0930@163.com; Liu Shiyuan [Department of Radiology, ChangZheng Hospital, Second Military Medical University, Shanghai 200003 (China)], E-mail: fanli7938@chinaren.com; Xiao Xiangsheng [Department of Radiology, ChangZheng Hospital, Second Military Medical University, Shanghai 200003 (China)], E-mail: lizhaobin79@163.com; Sun Fei [GE Healthcare (China)], E-mail: Fei.sun@med.ge.com

2010-02-15

Objective: To evaluate the effect of gravity and lung inflation on pulmonary perfusion heterogeneity in human lung using an arterial spin labeling (ASL) sequence called flow sensitive alternating inversion recovery (FAIR). Materials and methods: Magnetic resonance imaging of lung perfusion using arterial spin labeling sequence was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner (GE Healthcare). Five coronal slices at an interval of 3 cm from dorsal to ventral (labeled as P3, P6, P9, P12, P15, sequently) were obtained when the volunteers performed breath holding on end expiration and the relative pulmonary blood flow (rPBF) was measured. Then, another coronal perfusion-weighted image of P3 slice was obtained on end inspiration. Tagging efficiency of pulmonary parenchyma with IR ({delta}SI), rPBF and area of the P3 slice were analyzed. Results: (1) Along the direction of gravity, a gradient was visually perceived as a vertical increase in rPBF. There were significant statistic differences in rPBF between any two coronal planes except that between P12 and P15. In supine position, regression coefficients of right and left lung were -4.98 and -5.16, respectively. This means that rPBF decreased 4.98 (right) and 5.16 (left) for each centimeter above the dorsal. No statistical difference was seen between ROIs placed along iso-gravitational plane. (2) For a same slice, there were significant statistic differences in {delta}SI, rPBF and area at different respiratory phases (P < 0.05). Greater {delta}SI and more perfusion were observed on end expiration than on end inspiration. The area was larger on end inspiration than on end expiration. Conclusion: Both gravity and respiratory phase are important determinants of pulmonary perfusion heterogeneity. FAIR is sensitive to demonstrate gravity- and respiratory phase-dependent differences in lung perfusion. Positioning the patient so that the area of interest is down-gravity and asking patient

First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

DEFF Research Database (Denmark)

Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold

2014-01-01

INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its...... otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died......% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. CONCLUSION: In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted...

Significance of single ventilation/perfusion mismatches in krypton-81m/technetium-99m lung scintigraphy

International Nuclear Information System (INIS)

Rosen, J.M.; Palestro, C.J.; Markowitz, D.; Alderson, P.O.

1986-01-01

The significance of a single area of ventilation/perfusion (V/P) mismatch in lung scans performed on patients suspected of pulmonary embolism (PE) was evaluated. Ten of 20 patients with this scan finding were found to have PE. An intermediate probability of PE was found with segmental (71%) or subsegmental (45%) single V/P mismatches. Seven of 16 patients with a single V/P mismatch and without a matching radiographic opacity had PE. Three of the four patients who had a V/P mismatch and a matching radiographic opacity were found to have PE. Multiview ventilation imaging with 81mKr was found to have advantages for the evaluation of single V/P mismatches. Based on the data available at this time, a single V/P mismatch suggests an intermediate probability of PE

High-resolution pulmonary ventilation and perfusion PET/CT allows for functionally adapted intensity modulated radiotherapy in lung cancer

International Nuclear Information System (INIS)

Siva, Shankar; Thomas, Roshini; Callahan, Jason; Hardcastle, Nicholas; Pham, Daniel; Kron, Tomas; Hicks, Rodney J.; MacManus, Michael P.; Ball, David L.; Hofman, Michael S.

2015-01-01

Background and purpose: To assess the utility of functional lung avoidance using IMRT informed by four-dimensional (4D) ventilation/perfusion (V/Q) PET/CT. Materials and methods: In a prospective clinical trial, patients with non-small cell lung cancer (NSCLC) underwent 4D-V/Q PET/CT scanning before 60 Gy of definitive chemoradiation. Both “highly perfused” (HPLung) and “highly ventilated” (HVLung) lung volumes were delineated using a 70th centile SUV threshold, and a “ventilated lung volume” (VLung) was created using a 50th centile SUV threshold. For each patient four IMRT plans were created, optimised to the anatomical lung, HPLung, HVLung and VLung volumes, respectively. Improvements in functional dose volumetrics when optimising to functional volumes were assessed using mean lung dose (MLD), V5, V10, V20, V30, V40, V50 and V60 parameters. Results: The study cohort consisted of 20 patients with 80 IMRT plans. Plans optimised to HPLung resulted in a significant reduction of functional MLD by a mean of 13.0% (1.7 Gy), p = 0.02. Functional V5, V10 and V20 were improved by 13.2%, 7.3% and 3.8% respectively (p-values < 0.04). There was no significant sparing of dose to functional lung when adapting to VLung or HVLung. Plan quality was highly consistent with a mean PTV D95 and D5 ranging from 60.8 Gy to 61.0 Gy and 63.4 Gy to 64.5 Gy, respectively, and mean conformity and heterogeneity index ranging from 1.11 to 1.17 and 0.94 to 0.95, respectively. Conclusion: IMRT plans adapted to perfused but not ventilated lung on 4D-V/Q PET/CT allowed for reduced dose to functional lung whilst maintaining consistent plan quality

Pulmonary vascular volume ratio measured by cardiac computed tomography in children and young adults with congenital heart disease: comparison with lung perfusion scintigraphy

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Goo, Hyun Woo; Park, Sang Hyub [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

2017-11-15

Lung perfusion scintigraphy is regarded as the gold standard for evaluating differential lung perfusion ratio in congenital heart disease. To compare cardiac CT with lung perfusion scintigraphy for estimated pulmonary vascular volume ratio in patients with congenital heart disease. We included 52 children and young adults (median age 4 years, range 2 months to 28 years; 31 males) with congenital heart disease who underwent cardiac CT and lung perfusion scintigraphy without an interim surgical or transcatheter intervention and within 1 year. We calculated the right and left pulmonary vascular volumes using threshold-based CT volumetry. Then we compared right pulmonary vascular volume percentages at cardiac CT with right lung perfusion percentages at lung perfusion scintigraphy by using paired t-test and Bland-Altman analysis. The right pulmonary vascular volume percentages at cardiac CT (66.3 ± 14.0%) were significantly smaller than the right lung perfusion percentages at lung perfusion scintigraphy (69.1 ± 15.0%; P=0.001). Bland-Altman analysis showed a mean difference of -2.8 ± 5.8% and 95% limits of agreement (-14.1%, 8.5%) between these two variables. Cardiac CT, in a single examination, can offer pulmonary vascular volume ratio in addition to pulmonary artery anatomy essential for evaluating peripheral pulmonary artery stenosis in patients with congenital heart disease. However there is a wide range of agreement between cardiac CT and lung perfusion scintigraphy. (orig.)

Pulmonary vascular volume ratio measured by cardiac computed tomography in children and young adults with congenital heart disease: comparison with lung perfusion scintigraphy

International Nuclear Information System (INIS)

Goo, Hyun Woo; Park, Sang Hyub

2017-01-01

Lung perfusion scintigraphy is regarded as the gold standard for evaluating differential lung perfusion ratio in congenital heart disease. To compare cardiac CT with lung perfusion scintigraphy for estimated pulmonary vascular volume ratio in patients with congenital heart disease. We included 52 children and young adults (median age 4 years, range 2 months to 28 years; 31 males) with congenital heart disease who underwent cardiac CT and lung perfusion scintigraphy without an interim surgical or transcatheter intervention and within 1 year. We calculated the right and left pulmonary vascular volumes using threshold-based CT volumetry. Then we compared right pulmonary vascular volume percentages at cardiac CT with right lung perfusion percentages at lung perfusion scintigraphy by using paired t-test and Bland-Altman analysis. The right pulmonary vascular volume percentages at cardiac CT (66.3 ± 14.0%) were significantly smaller than the right lung perfusion percentages at lung perfusion scintigraphy (69.1 ± 15.0%; P=0.001). Bland-Altman analysis showed a mean difference of -2.8 ± 5.8% and 95% limits of agreement (-14.1%, 8.5%) between these two variables. Cardiac CT, in a single examination, can offer pulmonary vascular volume ratio in addition to pulmonary artery anatomy essential for evaluating peripheral pulmonary artery stenosis in patients with congenital heart disease. However there is a wide range of agreement between cardiac CT and lung perfusion scintigraphy. (orig.)

Pulmonary vascular volume ratio measured by cardiac computed tomography in children and young adults with congenital heart disease: comparison with lung perfusion scintigraphy.

Science.gov (United States)

Goo, Hyun Woo; Park, Sang Hyub

2017-11-01

Lung perfusion scintigraphy is regarded as the gold standard for evaluating differential lung perfusion ratio in congenital heart disease. To compare cardiac CT with lung perfusion scintigraphy for estimated pulmonary vascular volume ratio in patients with congenital heart disease. We included 52 children and young adults (median age 4 years, range 2 months to 28 years; 31 males) with congenital heart disease who underwent cardiac CT and lung perfusion scintigraphy without an interim surgical or transcatheter intervention and within 1 year. We calculated the right and left pulmonary vascular volumes using threshold-based CT volumetry. Then we compared right pulmonary vascular volume percentages at cardiac CT with right lung perfusion percentages at lung perfusion scintigraphy by using paired t-test and Bland-Altman analysis. The right pulmonary vascular volume percentages at cardiac CT (66.3 ± 14.0%) were significantly smaller than the right lung perfusion percentages at lung perfusion scintigraphy (69.1 ± 15.0%; P=0.001). Bland-Altman analysis showed a mean difference of -2.8 ± 5.8% and 95% limits of agreement (-14.1%, 8.5%) between these two variables. Cardiac CT, in a single examination, can offer pulmonary vascular volume ratio in addition to pulmonary artery anatomy essential for evaluating peripheral pulmonary artery stenosis in patients with congenital heart disease. However there is a wide range of agreement between cardiac CT and lung perfusion scintigraphy.

Effect of Garlic on Perfusion Scintigraphy of Rabbit's Lungs ...

African Journals Online (AJOL)

Purpose: To study of the effect of garlic on rabbit's lungs, with the aid of perfusion scintigraphy, after experimentally-induced pulmonary embolism. Methods: Twelve adult rabbits were anesthetized. Prepared macroaggregated albumin- technetium 99m (99mTc-MAA) radiopharmaceutical was injected into the ear vein at a ...

Reproducibility of Lobar Perfusion and Ventilation Quantification Using SPECT/CT Segmentation Software in Lung Cancer Patients.

Science.gov (United States)

Provost, Karine; Leblond, Antoine; Gauthier-Lemire, Annie; Filion, Édith; Bahig, Houda; Lord, Martin

2017-09-01

Planar perfusion scintigraphy with 99m Tc-labeled macroaggregated albumin is often used for pretherapy quantification of regional lung perfusion in lung cancer patients, particularly those with poor respiratory function. However, subdividing lung parenchyma into rectangular regions of interest, as done on planar images, is a poor reflection of true lobar anatomy. New tridimensional methods using SPECT and SPECT/CT have been introduced, including semiautomatic lung segmentation software. The present study evaluated inter- and intraobserver agreement on quantification using SPECT/CT software and compared the results for regional lung contribution obtained with SPECT/CT and planar scintigraphy. Methods: Thirty lung cancer patients underwent ventilation-perfusion scintigraphy with 99m Tc-macroaggregated albumin and 99m Tc-Technegas. The regional lung contribution to perfusion and ventilation was measured on both planar scintigraphy and SPECT/CT using semiautomatic lung segmentation software by 2 observers. Interobserver and intraobserver agreement for the SPECT/CT software was assessed using the intraclass correlation coefficient, Bland-Altman plots, and absolute differences in measurements. Measurements from planar and tridimensional methods were compared using the paired-sample t test and mean absolute differences. Results: Intraclass correlation coefficients were in the excellent range (above 0.9) for both interobserver and intraobserver agreement using the SPECT/CT software. Bland-Altman analyses showed very narrow limits of agreement. Absolute differences were below 2.0% in 96% of both interobserver and intraobserver measurements. There was a statistically significant difference between planar and SPECT/CT methods ( P software is highly reproducible. This tridimensional method yields statistically significant differences in measurements for right lung lobes when compared with planar scintigraphy. We recommend that SPECT/CT-based quantification be used for all lung

A porcine ex vivo lung perfusion model with maximal argon exposure to attenuate ischemia-reperfusion injury

Directory of Open Access Journals (Sweden)

An Martens

2017-01-01

Full Text Available Argon (Ar is a noble gas with known organoprotective effects in rodents and in vitro models. In a previous study we failed to find a postconditioning effect of Ar during ex vivo lung perfusion (EVLP on warm-ischemic injury in a porcine model. In this study, we further investigated a prolonged exposure to Ar to decrease cold ischemia-reperfusion injury after lung transplantation in a porcine model with EVLP assessment. Domestic pigs (n = 6/group were pre-conditioned for 6 hours with 21% O 2 and 79% N 2 (CONTR or 79% Ar (ARG. Subsequently, lungs were cold flushed and stored inflated on ice for 18 hours inflated with the same gas mixtures. Next, lungs were perfused for 4 hours on EVLP (acellular while ventilated with 12% O 2 and 88% N 2 (CONTR group or 88% Ar (ARG group. The perfusate was saturated with the same gas mixture but with the addition of CO 2 to an end-tidal CO 2 of 35-45 mmHg. The saturated perfusate was drained and lungs were perfused with whole blood for an additional 2 hours on EVLP. Evaluation at the end of EVLP did not show significant effects on physiologic parameters by prolonged exposure to Ar. Also wet-to-dry weight ratio did not improve in the ARG group. Although in other organ systems protective effects of Ar have been shown, we did not detect beneficial effects of a high concentration of Ar on cold pulmonary ischemia-reperfusion injury in a porcine lung model after prolonged exposure to Ar in this porcine model with EVLP assessment.

A new application of Bull's eye analysis to lung perfusion scintigraphy

International Nuclear Information System (INIS)

Yasui, Kotaro; Kohno, Yoshihiro; Akaki, Shiro; Hasegawa, Mari; Nakagawa, Tomio; Simizu, Mitsuharu; Takeda, Yoshihiro; Hiraki, Yoshio; Nagaya, Isao.

1990-01-01

Technetium-99m macroaggregated albumin lung perfusion scintigraphy was performed and evaluated semiquantitatively by Bull's eye analysis in 24, including 7 with central pulmonary carcinoma, 3 with hypersensitivity pneumonitis (HP), 3 with diffuse panbronchiolitis (DPB) and 11 normal subjects. First, whole lung field was divided into three regions by three concentric circles. And then radial axes were projected from the center to define 36 sectors, 10 degree each. The counts of each sector was calculated and Bull's eye image and circumferential profile curve were displayed. The patient's map was compared with the lower limit of normal (mean-2 SD), and the extent score (ES) and the severity score (SS) were calculated. The ES was 0.25±0.12 in pulmonary carcinoma (n=7), 0.08±0.07 in HP (n=3), 0.06±0.04 in DPB (n=3). The SS was 26.39±15.17 in pulmonary carcinoma, 4.75±5.57 in HP, 4.29±3.67 in DPB. In one case of central pulmonary carcinoma, segmental perfusion defect was evaluated semiquantitatively by Bull's eye image and circumferential profile curve. And in one case of HP, the change of regional pulmonary blood flow could be followed easily using extent and severity map. This new application of Bull's eye analysis to lung perfusion scintigraphy might be useful to evaluate regional pulmonary blood flow. (author)

Assessment of smoking-induced impairment of pulmonary perfusion using three-dimensional SPECT images

Energy Technology Data Exchange (ETDEWEB)

Miyasaka, Takashi [Toho Univ., Tokyo (Japan). School of Medicine

1997-09-01

The effects of smoking on ventilation-perfusion lung scintigrams were investigated. The subjects comprised 40 healthy males (28 smokers and 12 nonsmokers) without a history of cardiopulmonary disease and with normal chest radiographs. After acquisition of planar images of ventilation lung scintigrams with 370 MBq of {sup 133}Xe gas, planar images and SPECT images of pulmonary perfusion flow were obtained using 185 MBq of {sup 99m}Tc-MAA. Planar imaging showed perfusion defects in only 5 smokers. In contrast, 16 subjects were found to have perfusion defects on SPECT images (p<0.05), indicating the usefulness of SPECT images in detecting minor vascular damage of the lung. Although perfusion defects were common in the smokers (p<0.05), their relationship to the BRINKMAN index was uncertain. The perfusion defects found in the smokers were nonsegmental and commonly involved the right upper lobe. Ventilation scans revealed only delayed washout of {sup 133}Xe in 4 smokers, suggesting that smoking-induced abnormal perfusion on SPECT appears earlier than impaired ventilation on scintigrams. (author)

TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

NARCIS (Netherlands)

A. Mendrik (Adrienne); E.J.P.A. Vonken; B.T.J. van Ginneken (Berbke); J.R. Riordan (John ); H.W.A.M. de Jong (Hugo); T. van Seeters (Tom); E.J. Smit (Ewoud); M.A. Viergever (Max); M. Prokop (Mathias)

2011-01-01

textabstractCerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of

Region of interest-based versus whole-lung segmentation-based approach for MR lung perfusion quantification in 2-year-old children after congenital diaphragmatic hernia repair

International Nuclear Information System (INIS)

Weis, M.; Sommer, V.; Hagelstein, C.; Schoenberg, S.O.; Neff, K.W.; Zoellner, F.G.; Zahn, K.; Schaible, T.

2016-01-01

With a region of interest (ROI)-based approach 2-year-old children after congenital diaphragmatic hernia (CDH) show reduced MR lung perfusion values on the ipsilateral side compared to the contralateral. This study evaluates whether results can be reproduced by segmentation of whole-lung and whether there are differences between the ROI-based and whole-lung measurements. Using dynamic contrast-enhanced (DCE) MRI, pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) were quantified in 30 children after CDH repair. Quantification results of an ROI-based (six cylindrical ROIs generated of five adjacent slices per lung-side) and a whole-lung segmentation approach were compared. In both approaches PBF and PBV were significantly reduced on the ipsilateral side (p always <0.0001). In ipsilateral lungs, PBF of the ROI-based and the whole-lung segmentation-based approach was equal (p=0.50). In contralateral lungs, the ROI-based approach significantly overestimated PBF in comparison to the whole-lung segmentation approach by approximately 9.5 % (p=0.0013). MR lung perfusion in 2-year-old children after CDH is significantly reduced ipsilaterally. In the contralateral lung, the ROI-based approach significantly overestimates perfusion, which can be explained by exclusion of the most ventral parts of the lung. Therefore whole-lung segmentation should be preferred. (orig.)

Region of interest-based versus whole-lung segmentation-based approach for MR lung perfusion quantification in 2-year-old children after congenital diaphragmatic hernia repair

Energy Technology Data Exchange (ETDEWEB)

Weis, M.; Sommer, V.; Hagelstein, C.; Schoenberg, S.O.; Neff, K.W. [Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Zoellner, F.G. [Heidelberg University, Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Mannheim (Germany); Zahn, K. [University of Heidelberg, Department of Paediatric Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Schaible, T. [Heidelberg University, Department of Paediatrics, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany)

2016-12-15

With a region of interest (ROI)-based approach 2-year-old children after congenital diaphragmatic hernia (CDH) show reduced MR lung perfusion values on the ipsilateral side compared to the contralateral. This study evaluates whether results can be reproduced by segmentation of whole-lung and whether there are differences between the ROI-based and whole-lung measurements. Using dynamic contrast-enhanced (DCE) MRI, pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) were quantified in 30 children after CDH repair. Quantification results of an ROI-based (six cylindrical ROIs generated of five adjacent slices per lung-side) and a whole-lung segmentation approach were compared. In both approaches PBF and PBV were significantly reduced on the ipsilateral side (p always <0.0001). In ipsilateral lungs, PBF of the ROI-based and the whole-lung segmentation-based approach was equal (p=0.50). In contralateral lungs, the ROI-based approach significantly overestimated PBF in comparison to the whole-lung segmentation approach by approximately 9.5 % (p=0.0013). MR lung perfusion in 2-year-old children after CDH is significantly reduced ipsilaterally. In the contralateral lung, the ROI-based approach significantly overestimates perfusion, which can be explained by exclusion of the most ventral parts of the lung. Therefore whole-lung segmentation should be preferred. (orig.)

Time and dose-related changes in lung perfusion after definitive radiotherapy for NSCLC

DEFF Research Database (Denmark)

Farr, Katherina P; Khalil, Azza A; Møller, Ditte S

2018-01-01

BACKGROUND AND PURPOSE: To examine radiation-induced changes in regional lung perfusion per dose level in 58 non-small-cell lung cancer (NSCLC) patients treated with intensity-modulated radiotherapy (IMRT). MATERIAL AND METHODS: NSCLC patients receiving chemo-radiotherapy (RT) of minimum 60 Gy we...

Arterio-venous anastomoses in isolated, perfused rat lungs.

Science.gov (United States)

Conhaim, Robert L; Segal, Gilad S; Watson, Kal E

2016-11-01

Several studies have suggested that large-diameter (>25 μm) arterio-venous shunt pathways exist in the lungs of rats, dogs, and humans. We investigated the nature of these pathways by infusing specific-diameter fluorescent latex particles (4, 7, 15, 30, or 50 μm) into isolated, ventilated rat lungs perfused at constant pressure. All lungs received the same mass of latex (5 mg), which resulted in infused particle numbers that ranged from 1.7 × 10 7 4 μm particles to 7.5 × 10 4 50 μm particles. Particles were infused over 2 min. We used a flow cytometer to count particle appearances in venous effluent samples collected every 0.5 min for 12 min from the start of particle infusion. Cumulative percentages of infused particles that appeared in the samples averaged 3.17 ± 2.46% for 4 μm diameter particles, but ranged from 0.01% to 0.17% for larger particles. Appearances of 4 μm particles followed a rapid upslope beginning at 30 sec followed by a more gradual downslope that lasted for up to 12 min. All other particle diameters also began to appear at 30 sec, but followed highly irregular time courses. Infusion of 7 and 15 μm particles caused transient but significant perfusate flow reductions, while infusion of all other diameters caused insignificant reductions in flow. We conclude that small numbers of bypass vessels exist that can accommodate particle diameters of 7-to-50 μm. We further conclude that our 4 μm particle data are consistent with a well-developed network of serial and parallel perfusion pathways at the acinar level. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Organotypic lung culture: A new model for studying ischemia and ex vivo perfusion in lung transplantation.

Science.gov (United States)

Baste, Jean-Marc; Gay, Arnaud; Smail, Hassiba; Noël, Romain; Bubenheim, Michael; Begueret, Hugues; Morin, Jean-Paul; Litzler, Pierre-Yves

2015-01-01

Donors after cardiac death (DCD) in lung transplantation is considered as a solution for organ shortage. However, it is characterized by warm ischemic period, which could be involved in severe Ischemia-Reperfusion lesion (IR) with early graft dysfunction. We describe a new hybrid model combining in vivo ischemia followed by in vitro reoxygenation using organ-specific culture. A hybrid model using in vivo ischemic period followed by in vitro lung slice reoxygenation was set up in rat to mimic DCD in lung transplantation with in vitro perfusion. Different markers (bioenergetics, oxidant stress assays, and histology) were measured to evaluate the viability of lung tissue after different ischemic times (I-0, I-1, I-2, I-4, I-15 hours) and reoxygenation times (R-0, R-1, R-4, R-24 hours). No differences were found in cell viability, ATP concentrations, extracellular LDH assays or histology, demonstrating extensive viability of up to 4 hours in lung tissue warm ischemia. We found oxidative stress mainly during the ischemic period with no burst at reoxygenation. Cytosolic anti-oxidant system was involved first (I-0,I-1,I-2) followed by mitochondrial anti-oxidant system for extensive ischemia (I-4). Histological features showed differences in this model of ischemia-reoxygenation between bronchial epithelium and lung parenchymal cells, with epithelium regeneration after 2 hours of warm ischemia and 24 hours of perfusion. The results of our hybrid model experiment suggest extensive lung viability of up to 4 hours ischemia. Our model could be an interesting tool to evaluate ex vivo reconditioning techniques after different in vivo lung insults.

Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer

Energy Technology Data Exchange (ETDEWEB)

Farr, Katherina P.; Khalil, Azza A.; Grau, Cai [Aarhus University Hospital, Department of Oncology, Aarhus C (Denmark); Kramer, Stine; Morsing, Anni [Aarhus University Hospital, Department of Nuclear Medicine and PET Centre, Aarhus C (Denmark)

2015-07-15

The purpose of the study was to evaluate the ability of baseline perfusion defect score (DS) on SPECT to predict the development of severe symptomatic radiation pneumonitis (RP) and to evaluate changes in perfusion on SPECT as a method of lung perfusion function assessment after curative radiotherapy (RT) for non-small-cell lung cancer (NSCLC). Patients with NSCLC undergoing curative RT were included prospectively. Perfusion SPECT/CT and global pulmonary function tests (PFT) were performed before RT and four times during follow-up. Functional activity on SPECT was measured using a semiquantitative perfusion DS. Pulmonary morbidity was graded by the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4 for pneumonitis. Patients were divided into two groups according to the severity of RP. A total of 71 consecutive patients were included in the study. Baseline DS was associated with chronic obstructive pulmonary disease. A significant inverse correlation was found between baseline DS and forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide. Patients with severe RP had significantly higher baseline total lung DS (mean 5.43) than those with no or mild symptoms (mean DS 3.96, p < 0.01). PFT results were not different between these two groups. The odds ratio for total lung DS was 7.8 (95 % CI 1.9 - 31) demonstrating the ability of this parameter to predict severe RP. Adjustment for other potential confounders known to be associated with increased risk of RP was performed and did not change the odds ratio. The median follow-up time after RT was 8.4 months. The largest DS increase of 13.3 % was associated with severe RP at 3 months of follow-up (p < 0.01). The development of severe RP during follow-up was not associated with changes in PFT results. Perfusion SPECT is a valuable method for predicting severe RP and for assessing changes in regional functional perfusion after curative RT comparable with

Relation between lung perfusion defects and intravascular clots in acute pulmonary thromboembolism: assessment with breath-hold SPECT-CT pulmonary angiography fusion images.

Science.gov (United States)

Suga, Kazuyoshi; Yasuhiko, Kawakami; Iwanaga, Hideyuki; Tokuda, Osamu; Matsunaga, Naofumi

2008-09-01

The relation between lung perfusion defects and intravascular clots in acute pulmonary thromboembolism (PTE) was comprehensively assessed on deep-inspiratory breath-hold (DIBrH) perfusion SPECT-computed tomographic pulmonary angiography (CTPA) fusion images. Subjects were 34 acute PTE patients, who had successfully performed DIBrH perfusion SPECT using a dual-headed SPECT and a respiratory tracking system. Automated DIBrH SPECT-CTPA fusion images were used to assess the relation between lung perfusion defects and intravascular clots detected by CTPA. DIBrH SPECT visualized 175 lobar/segmental or subsegmental defects in 34 patients, and CTPA visualized 61 intravascular clots at variable locations in 30 (88%) patients, but no clots in four (12%) patients. In 30 patients with clots, the fusion images confirmed that 69 (41%) perfusion defects (20 segmental, 45 subsegmental and 4 lobar defects) of total 166 defects were located in lung territories without clots, although the remaining 97 (58%) defects were located in lung territories with clots. Perfusion defect was absent in lung territories with clots (one lobar branch and three segmental branches) in four (12%) of these patients. In four patients without clots, nine perfusion defects including four segmental ones were present. Because of unexpected dissociation between intravascular clots and lung perfusion defects, the present fusion images will be a useful adjunct to CTPA in the diagnosis of acute PTE.

Estimation of pulmonary hypertension of congenital heart diseases in children by lung perfusion scintigraphy

International Nuclear Information System (INIS)

Zheng Jinghao; Zhang Shantong; Zeng Jiye; Jia Hongli; Ji Zhiying; Chen Siyi

1993-01-01

The authors report that changes in the distribution of pulmonary perfusion caused by gravitation effect, namely, changes in the total count ratios of the right against the left lung between right and left lateral decubitus positions (rt/lt) could estimate pulmonary hypertension using lung perfusion scintigraphy with 99m Tc-labelled macroaggregated albumin. The results showed: rt/lt was inversely related to mean pulmonary arterial pressure. It is concluded that the method is simple, safe, reproducible, unaffected by cardiac structural abnormality and valuable as a noninvasive approach for the estimation of pulmonary hypertension

The role of three dimensional functional lung imaging in radiation treatment planning: the functional dose-volume histogram

International Nuclear Information System (INIS)

Marks, Lawrence B.; Spencer, David P.; Sherouse, George W.; Bentel, Gunilla; Clough, Robert; Vann, Karen; Jaszczak, Ronald; Coleman, R. Edward; Prosnitz, Leonard R.

1995-01-01

Purpose: During thoracic irradiation (XRT), treatment fields are usually designed to minimize the volume of nontumor-containing lung included. Generally, functional heterogeneities within the lung are not considered. The three dimensional (3D) functional information provided by single photon emission computed tomography (SPECT) lung perfusion scans might be useful in designing beams that minimize incidental irradiation of functioning lung tissue. We herein review the pretreatment SPECT scans in 86 patients (56 with lung cancer) to determine which are likely to benefit from this technology. Methods and Materials: Prior to thoracic XRT, SPECT lung perfusion scans were obtained following the intravenous injection of ∼4 mCi of 99m Tc-labeled macro-aggregated albumin. The presence of areas of decreased perfusion, their location relative to the tumor, and the potential clinical usefulness of their recognition, were scored. Patients were grouped and compared (two-tailed chi-square) based on clinical factors. Conventional dose-volume histograms (DVHs) and functional DVHs (DV F Hs) are calculated based on the dose distribution throughout the computed tomography (CT)-defined lung and SPECT-defined perfused lung, respectively. Results: Among 56 lung cancer patients, decreases in perfusion were observed at the tumor, adjacent to the tumor, and separate from the tumor in 94%, 74%, and 42% of patients, respectively. Perfusion defects adjacent to the tumor were often large with centrally placed tumors. Hypoperfusion in regions separate from the tumor were statistically most common in patients with relatively poor pulmonary function and chronic obstructive pulmonary disease (COPD). Considering all SPECT defects adjacent to and separate from the tumor, corresponding CT abnormalities were seen in only ∼50% and 20% of patients, respectively, and were generally not as impressive. Following XRT, hypoperfusion at and separate from the tumor persisted, while defects adjacent to the

Ventilation/perfusion scintigraphy in children with post-infectious bronchiolitis obliterans: a pilot study.

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Bo-Qia Xie

Full Text Available PURPOSE: Childhood post-infectious bronchiolitis obliterans (BO is an infrequent lung disease leading to narrowing and/or complete obliteration of small airways. Ventilation and perfusion (V/Q scan can provide both regional and global pulmonary information. However, only few retrospective researches investigating post-infectious BO involved V/Q scan, the clinical value of this method is unknown. This preliminary prospective study was aimed to evaluate the correlation of V/Q scan with disease severity, pulmonary function test results, and prognosis in children with post-infectious BO. METHODS: Twenty-five post-infectious BO children (18 boys and 7 girls; mean age, 41 months underwent V/Q scan and pulmonary function tests. Patients were followed after their inclusion. Ventilation index and perfusion index obtained from V/Q scan were used to measure pulmonary abnormalities. Spearman's rank correlation test of ventilation index and perfusion index on disease severity, lung function tests indices, and follow-up results were performed. RESULTS: The median follow-up period was 4.6 years (range, 2.2 to 5.0 years. Ventilation index and perfusion index were both correlated with disease severity (r = 0.72, p<0.01 and r = 0.73, p<0.01, but only ventilation index was related to pulmonary function tests results (all p<0.05. In addition, Spearman test yielded significant correlations between perfusion index and prognosis (r = 0.77, p<0.01, and ventilation index and prognosis (r = 0.63, p = 0.01. CONCLUSIONS: For children with post-infectious BO, the present study preliminarily indicated that the degree of ventilation and perfusion abnormalities evaluated by V/Q scan may be used to assess disease severity, and may be predictive of patient's outcome.

A database for estimating organ dose for coronary angiography and brain perfusion CT scans for arbitrary spectra and angular tube current modulation

International Nuclear Information System (INIS)

Rupcich, Franco; Badal, Andreu; Kyprianou, Iacovos; Schmidt, Taly Gilat

2012-01-01

Purpose: The purpose of this study was to develop a database for estimating organ dose in a voxelized patient model for coronary angiography and brain perfusion CT acquisitions with any spectra and angular tube current modulation setting. The database enables organ dose estimation for existing and novel acquisition techniques without requiring Monte Carlo simulations. Methods: The study simulated transport of monoenergetic photons between 5 and 150 keV for 1000 projections over 360° through anthropomorphic voxelized female chest and head (0° and 30° tilt) phantoms and standard head and body CTDI dosimetry cylinders. The simulations resulted in tables of normalized dose deposition for several radiosensitive organs quantifying the organ dose per emitted photon for each incident photon energy and projection angle for coronary angiography and brain perfusion acquisitions. The values in a table can be multiplied by an incident spectrum and number of photons at each projection angle and then summed across all energies and angles to estimate total organ dose. Scanner-specific organ dose may be approximated by normalizing the database-estimated organ dose by the database-estimated CTDI vol and multiplying by a physical CTDI vol measurement. Two examples are provided demonstrating how to use the tables to estimate relative organ dose. In the first, the change in breast and lung dose during coronary angiography CT scans is calculated for reduced kVp, angular tube current modulation, and partial angle scanning protocols relative to a reference protocol. In the second example, the change in dose to the eye lens is calculated for a brain perfusion CT acquisition in which the gantry is tilted 30° relative to a nontilted scan. Results: Our database provides tables of normalized dose deposition for several radiosensitive organs irradiated during coronary angiography and brain perfusion CT scans. Validation results indicate total organ doses calculated using our database are

A rare combination of cardiopulmonary anomalies demonstrated on ventilation-perfusion scan

International Nuclear Information System (INIS)

Khan, S.; Dunn, J.; Al-Nahhas, A.; Ariff, B.; Juli, C.; Karunanithy, N.; Strickland, N.

2008-01-01

In this case report we describe an unusual appearance seen on a ventilation-perfusion (V/Q) scan in a woman with pulmonary hypertension. Although the pulmonary hypertension was not caused by pulmonary emboli, the V/Q scan suggested several cardiac anomalies which may lead to pulmonary hypertension. Most of the cardiac anomalies, including right-sided aortic arch and right-to-left shunt, can be deduced from careful examination of the V/Q scan. A subsequent cardiac MRI scan confirmed the anomalies. (authors)

Pulmonary perfusion ''without ventilation''

International Nuclear Information System (INIS)

Chapman, C.N.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-01-01

An 88-yr-old man, with prior left upper lobectomy and phrenic nerve injury, had a ventilation/perfusion lung image. Both wash-in and equilibrium ventilation images showed no radioactive gas in the left lung. Nevertheless, the left lung was perfused. A similar result was obtained on a repeat study 8 days later. Delayed images, during washout, showed some radioactive gas in the left lung. Nearly absent ventilation (but continued perfusion) of that lung might have been related to altered gas dynamics brought about by the prior lobectomy, a submucosal bronchial lesion, phrenic nerve damage, and limited motion of the left part of the diaphragm. This case raises the issue of the degree of ventilation (and the phase relationship between the lungs) required for the entry of radioactive gas into a diseased lung, and the production of a ''reversed ventilation/perfusion mismatch.''

Assessment value of quantitative indexes of pancreatic CT perfusion scanning for malignant degree of pancreatic cancer

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Jiang-Xia Lei

2016-10-01

Full Text Available Objective: To analyze the assessment value of the quantitative indexes of pancreatic CT perfusion scanning for malignant degree of pancreatic cancer. Methods: A total of 58 patients with space-occupying pancreatic lesions were divided into 20 patients with pancreatic cancer and 38 patients with benign pancreatic lesions after pancreatic CT perfusion. Patients with pancreatic cancer received palliative surgery, and the cancer tissue and para-carcinoma tissue specimens were collected during operation. The differences in pancreatic CT perfusion scanning parameter values and serum tumor marker levels were compared between patients with pancreatic cancer and patients with benign pancreatic lesions, mRNA expression levels of malignant molecules in pancreatic cancer tissue and para-carcinoma tissue were further determined, and the correlation between pancreatic CT perfusion scanning parameter values and malignant degree of pancreatic cancer was analyzed. Results: CT perfusion scanning BF, BV and Per values of patients with pancreatic cancer were lower than those of patients with benign pancreatic lesions; serum CA19-9, CEA, CA125 and CA242 levels were higher than those of patients with benign pancreatic lesions (P<0.05; mRNA expression levels of Bcl-2, Bcl-xL and survivin in pancreatic cancer tissue samples were higher than those in paracarcinoma tissue samples, and mRNA expression levels of P53 and Bax were lower than those in para-carcinoma tissue samples (P<0.05; CT perfusion scanning parameters BF, BV and Per values of patients with pancreatic cancer were negatively correlated with CA19-9, CEA, CA125 and CA242 levels in serum as well as mRNA expression levels of Bcl-2, Bcl-xL and survivin in pancreatic cancer tissue, and positively correlated with mRNA expression levels of P53 and Bax in pancreatic cancer tissue (P<0.05. Conclusions: Pancreatic CT perfusion scanning is a reliable way to judge the malignant degree of pancreatic cancer and plays a

The utility of the macro-aggregated albumin lung perfusion scan in the diagnosis and prognosis of hepatopulmonary syndrome in cirrhotic patients candidates for liver transplantation

Directory of Open Access Journals (Sweden)

Israel Grilo

Full Text Available Background: The macro-aggregated albumin lung perfusion scan (99mTc-MAA is a diagnostic method for hepatopulmonary syndrome (HPS. Aim: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. Methods: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT were prospectively analyzed. A transthoracic contrast echocardiography and 99mTc-MAA were performed in 85 patients, and 74 patients were diagnosed with HPS. Results: The overall sensitivity of 99mTc-MAA for the diagnosis of HPS was 18.9% (14/74 in all of the HPS cases and 66.7% (4/6 in the severe to very severe cases. In HPS patients who did not have lung disease, the degree of brain uptake of 99mTc-MAA was correlated with the alveolar-arterial oxygen gradient (A-a PO2 (r = 0.32, p < 0.05 and estimated oxygen shunt (r = 0.41, p < 0.05 and inversely correlated with partial pressure of arterial oxygen (PaO2 while breathing 100% O2 (r = -0.43, p < 0.05. The 99mTc-MAA was positive in 20.6% (7/36 of the patients with HPS and lung disease. The brain uptake of 99mTc-MAA was not associated with mortality and normalized in all cases six months after LT. Conclusions: The 99mTc-MAA is a low sensitivity test for the diagnosis of HPS that can be useful in patients who have concomitant lung disease and in severe to very severe cases of HPS. It was not related to mortality, and brain uptake normalized after LT.

Abolished ventilation and perfusion of lung caused by blood clot in the left main bronchus

DEFF Research Database (Denmark)

Afzelius, P; Bergmann, A; Henriksen, J H

2015-01-01

/Q) scintigraphy with single-photon emission CT (SPECT)/CT. V/Q SPECT/CT demonstrated abolished ventilation due to obstruction of the left main bronchus and markedly reduced perfusion of the entire left lung, a condition that was completely reversed after removal of a blood clot. We present the first pictorially......It is generally assumed that the lungs possess arterial autoregulation associated with bronchial obstruction. A patient with pneumonia and congestive heart failure unexpectedly developed frequent haemoptysis. High-resolution CT and diagnostic CT were performed as well as ventilation/perfusion (V...

Preparation and evaluation of (131I)AgI particles: potential lungs perfusion imaging agent

International Nuclear Information System (INIS)

Chattopadhyay, Sankha; Das, Sujata Saha; Sinha, Samarendu; Sarkar, Bharat Ranjan; Ganguly, Shantanu; Chandra, Susmita; De, Kakali; Mishra, Mridula

2010-01-01

Since the discovery of iodine-131 (t 1/2 : 8 d) by Livingood and Seaborg (1938), this, and other radioisotopes of iodine, have found widespread use in nuclear medicine. The purpose of the present work was to formulate Ag 131 I particles and bio-evaluate the same. The Ag 131 I particles were prepared in acidic condition having 100% R.C. Purity. The biological evaluation of Ag 131 1 particles was made by injecting about 111-185 MBq of Ag 131 I particles preparations in female albino rabbits (2-2.5 kg weight) intravenously by femoral vein under urethane anesthesia. Imaging studies were performed under Gamma Camera. The entire amount of the Ag 131 I particles were found to deposit in the lungs and remained there almost unchanged for a certain period of time after the intervenous administration. The images showed excellent, uniform lung uptake with no interference from liver and spleen to the lower regions of right and left lobes. It showed a high accumulation in the rabbits lungs (>99%) and remained constant for at least for 20 min. It is also worthy to study with 123 I/ 124 I labelled AgI for lung imaging study. In conclusion, the synthetic radiopharmaceutical ( 131 I)-Silver iodide colloid can be prepared with a large particle size, in a simple and practical manner, and it has good potential for use as a perfusion imaging agent in lung scans

Evaluation of pN factors in patients with primary lung cancer by using perfusion, inhalation and ventilation studies

International Nuclear Information System (INIS)

Tamai, Toyosato; Tanabe, Masatada; Satoh, Katashi

1987-01-01

The interpretation of scintigraphic patterns and the role of pathophysiological mechanisms in patients with primary lung cancer were investigated. To determine the relative roles of perfusion, inhalation and ventilation scintigraphy, the relationship between the count ratio of the affected side to the healthy side and the post-surgical histological lymph nodes factors were observed in this study. These scintigraphic count ratio's in patients with primary lung cancer did not reflect the pN factors except in the perfusion study in patients with hilar primary lung cancer. (author)

Pulmonary MR angiography and perfusion imaging—A review of methods and applications

Energy Technology Data Exchange (ETDEWEB)

Johns, Christopher S.; Swift, Andrew J.; Hughes, Paul J.C. [University of Sheffield (United Kingdom); Ohno, Yoshiharu [Division of Functional and Diagnostic Imaging Research, Department of Radiology, KobeUniversity Graduate School of Medicine, Kobe, Hyogo (Japan); Schiebler, Mark [UW-Madison School of Medicine and Public Health, Madison, WI (United States); Wild, Jim M., E-mail: j.m.wild@sheffield.ac.uk [University of Sheffield (United Kingdom)

2017-01-15

Highlights: • This article represents an overview of the methodology and clinical applications of pulmonary MRA and perfusion imaging. • Both contrast enhanced and non-contrast enhanced metholodology for MRA and perfusion are covered. • The current clinical uses and future directions of MRA and MR perfusion are discussed. - Abstract: The pulmonary vasculature and its role in perfusion and gas exchange is an important consideration in many conditions of the lung and heart. Currently the mainstay of imaging of the vasculature and perfusion of the lungs lies with CT and nuclear medicine perfusion scans, both of which require ionizing radiation exposure. Improvements in MRI techniques have increased the use of MRI in pulmonary vascular imaging. Here we review MRI methods for imaging the pulmonary vasculature and pulmonary perfusion, both using contrast enhanced and non-contrast enhanced methodology. In many centres pulmonary MR angiography and dynamic contrast enhanced perfusion MRI are now well established in the routine workflow of patients particularly with pulmonary hypertension and thromboembolic disease. However, these imaging modalities offer exciting new directions for future research and clinical use in other respiratory diseases where consideration of pulmonary perfusion and gas exchange can provide insight in to pathophysiology.

Pulmonary MR angiography and perfusion imaging—A review of methods and applications

International Nuclear Information System (INIS)

Johns, Christopher S.; Swift, Andrew J.; Hughes, Paul J.C.; Ohno, Yoshiharu; Schiebler, Mark; Wild, Jim M.

2017-01-01

Highlights: • This article represents an overview of the methodology and clinical applications of pulmonary MRA and perfusion imaging. • Both contrast enhanced and non-contrast enhanced metholodology for MRA and perfusion are covered. • The current clinical uses and future directions of MRA and MR perfusion are discussed. - Abstract: The pulmonary vasculature and its role in perfusion and gas exchange is an important consideration in many conditions of the lung and heart. Currently the mainstay of imaging of the vasculature and perfusion of the lungs lies with CT and nuclear medicine perfusion scans, both of which require ionizing radiation exposure. Improvements in MRI techniques have increased the use of MRI in pulmonary vascular imaging. Here we review MRI methods for imaging the pulmonary vasculature and pulmonary perfusion, both using contrast enhanced and non-contrast enhanced methodology. In many centres pulmonary MR angiography and dynamic contrast enhanced perfusion MRI are now well established in the routine workflow of patients particularly with pulmonary hypertension and thromboembolic disease. However, these imaging modalities offer exciting new directions for future research and clinical use in other respiratory diseases where consideration of pulmonary perfusion and gas exchange can provide insight in to pathophysiology.

Lung Perfusion SPECT: Application in a Patient With Tetralogy of Fallot and Suspected Pulmonary Thromboemboli

International Nuclear Information System (INIS)

Ranji Amjad, Mina; Abbasi, Mehrshad; Farzanehfar, Saeed

2015-01-01

A 22-year-old woman presented with acute left-sided pleuritic chest pain and dyspnea 6 days after surgery for revision of the stenotic central aortopulmonary shunt. She had a history of tetralogy of Fallot (TOF), pulmonary valve stenosis, ventricular septal defect and major aortopulmonary collateral artery. Her Waterston shunt was placed when she was 5 years old and stented and re-dilated after stenosis. Acute pulmonary thromboemboli (PTE) was suspected and pulmonary perfusion scan was performed with 4 mCi 99m Technetium labeled macroaggregated albumin. The left lung was globally hypoperfused with evident uptake in the brain, renal parenchyma and thyroid. SPECT images revealed a segmental wedge-shaped peripheral defect in the posterior segment of the left upper lobe. The scan was interpreted as acute/chronic PTE or vascular abnormality. CT angiography excluded PTE; nevertheless the patient was treated with a therapeutic dose of heparin changed to warfarin and was discharged with improvement of the symptoms. Pulmonary artery angiography was not performed

Changes in perfusion scintigraphy in the first days of heparin therapy in patients with acute pulmonary embolism

NARCIS (Netherlands)

de Groot, M. R.; Oostdijk, A. H.; Engelage, A. H.; van Marwijk Kooy, M.; Büller, H. R.

2000-01-01

Patients with suspected pulmonary embolism often receive heparin therapy for hours to days before ventilation/perfusion scintigraphy is completed. We assessed to what extent the lung scan classification and pulmonary vascular perfusion changed over a period of 2-4 days of full anticoagulant therapy.

Factors affecting the lung perfused blood volume in patients with intrapulmonary clots after anti-coagulation therapy

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Okada, Munemasa, E-mail: radokada@yamaguchi-u.ac.jp [Department of Radiology, Yamaguchi University Graduate School of Medicine 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Masuda, Yu [4th Grade of 6-year Medicine Doctor Program, Department of Medicine, Yamaguchi University Faculty of Medicine and Health Sciences 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Nakashima, Yoshiteru [Department of Radiology, Yamaguchi Grand Medical Center, Oosaki 77, Hofu, Yamaguchi 747-8511 (Japan); Nomura, Takafumi; Nakao, Sei [Department of Radiology, Yamaguchi University Graduate School of Medicine 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Suga, Kazuyoshi [Department of Radiology, St Hills Hospital, Imamurakita 3-7-18, Ube, Yamaguchi 755-0155 (Japan); Kido, Shoji [Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University, Tokiwadai 2-16-1, Ube, Yamaguchi 755-8611 (Japan); Matsunaga, Naofumi [Department of Radiology, Yamaguchi University Graduate School of Medicine 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan)

2015-08-15

Highlights: • Dual-energy CT can provide morphological and functional lung images in the same examination. • The subsequent dual-energy CT demonstrates the increased whole lung perfused blood volume (V{sub 120}) despite the residual intrapulmonary clots after treatment in one examination. • The increased whole lung perfusion (V{sub 120}) and a decreased low perfusion volume (V{sub 5}) result in the improvement in the low perfusion rate (%V{sub 5}) in the patients with acute pulmonary embolism after treatment. - Abstract: Objectives: Factors affecting the improvement in the lung perfused blood volume (LPBV) were evaluated based on the presence of intrapulmonary clots (IPCs) after anti-coagulation therapy using 64-slice dual-energy CT. Materials and methods: 96 patients exhibiting venous thromboembolism underwent initial and repeated LPBV examinations between December 2008 and July 2014. Fifteen patients were excluded due to pulmonary comorbidities, and a total of 81 patients were included in this study. Acute pulmonary embolism (PE) was diagnosed in 46 of the patients (56.7%). LPBV images were three-dimensionally reconstructed with two threshold ranges: 1–120 HU (V{sub 120}) and 1–5 HU (V{sub 5}), and the relative value of V{sub 5} per V{sub 120} expressed as %V{sub 5}. These values were subsequently compared with indicators of the severity of PE, such as the D-dimer level, heart rate and CT measurements. This study was approved by the local ethics committee. Results: In patients with IPCs, the D-dimer, V{sub 5} and %V{sub 5}values were significantly larger (p ≤ 0.01) in the initial LPBV, although these differences disappeared in subsequent LPBV after treatment. The right ventricular (RV) diameter, RV/left ventricular (RV/LV) diameter ratio and %V{sub 5} values were also significantly reduced, whereas the V{sub 5} value did not significantly decrease (p = 0.07), but V{sub 120} value significantly increased (p < 0.001) after treatment. However, in

Detection of reactive oxygen species in isolated, perfused lungs by electron spin resonance spectroscopy

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Schudt Christian

2005-07-01

Full Text Available Abstract Background The sources and measurement of reactive oxygen species (ROS in intact organs are largely unresolved. This may be related to methodological problems associated with the techniques currently employed for ROS detection. Electron spin resonance (ESR with spin trapping is a specific method for ROS detection, and may address some these technical problems. Methods We have established a protocol for the measurement of intravascular ROS release from isolated buffer-perfused and ventilated rabbit and mouse lungs, combining lung perfusion with the spin probe l-hydroxy-3-carboxy-2,2,5,5-tetramethylpyrrolidine (CPH and ESR spectroscopy. We then employed this technique to characterize hypoxia-dependent ROS release, with specific attention paid to NADPH oxidase-dependent superoxide formation as a possible vasoconstrictor pathway. Results While perfusing lungs with CPH over a range of inspired oxygen concentrations (1–21 %, the rate of CP• formation exhibited an oxygen-dependence, with a minimum at 2.5 % O2. Addition of superoxide dismutase (SOD to the buffer fluid illustrated that a minor proportion of this intravascular ROS leak was attributable to superoxide. Stimulation of the lungs by injection of phorbol-12-myristate-13-acetate (PMA into the pulmonary artery caused a rapid increase in CP• formation, concomitant with pulmonary vasoconstriction. Both the PMA-induced CPH oxidation and the vasoconstrictor response were largely suppressed by SOD. When the PMA challenge was performed at different oxygen concentrations, maximum superoxide liberation and pulmonary vasoconstriction occurred at 5 % O2. Using a NADPH oxidase inhibitor and NADPH-oxidase deficient mice, we illustrated that the PMA-induced superoxide release was attributable to the stimulation of NADPH oxidases. Conclusion The perfusion of isolated lungs with CPH is suitable for detection of intravascular ROS release by ESR spectroscopy. We employed this technique to

Partial scan artifact reduction (PSAR) for the assessment of cardiac perfusion in dynamic phase-correlated CT.

Science.gov (United States)

Stenner, Philip; Schmidt, Bernhard; Bruder, Herbert; Allmendinger, Thomas; Haberland, Ulrike; Flohr, Thomas; Kachelriess, Marc

2009-12-01

Cardiac CT achieves its high temporal resolution by lowering the scan range from 2pi to pi plus fan angle (partial scan). This, however, introduces CT-value variations, depending on the angular position of the pi range. These partial scan artifacts are of the order of a few HU and prevent the quantitative evaluation of perfusion measurements. The authors present the new algorithm partial scan artifact reduction (PSAR) that corrects a dynamic phase-correlated scan without a priori information. In general, a full scan does not suffer from partial scan artifacts since all projections in [0, 2pi] contribute to the data. To maintain the optimum temporal resolution and the phase correlation, PSAR creates an artificial full scan pn(AF) by projectionwise averaging a set of neighboring partial scans pn(P) from the same perfusion examination (typically N approximately 30 phase-correlated partial scans distributed over 20 s and n = 1, ..., N). Corresponding to the angular range of each partial scan, the authors extract virtual partial scans pn(V) from the artificial full scan pn(AF). A standard reconstruction yields the corresponding images fn(P), fn(AF), and fn(V). Subtracting the virtual partial scan image fn(V) from the artificial full scan image fn(AF) yields an artifact image that can be used to correct the original partial scan image: fn(C) = fn(P) - fn(V) + fn(AF), where fn(C) is the corrected image. The authors evaluated the effects of scattered radiation on the partial scan artifacts using simulated and measured water phantoms and found a strong correlation. The PSAR algorithm has been validated with a simulated semianthropomorphic heart phantom and with measurements of a dynamic biological perfusion phantom. For the stationary phantoms, real full scans have been performed to provide theoretical reference values. The improvement in the root mean square errors between the full and the partial scans with respect to the errors between the full and the corrected scans is

Partial scan artifact reduction (PSAR) for the assessment of cardiac perfusion in dynamic phase-correlated CT

International Nuclear Information System (INIS)

Stenner, Philip; Schmidt, Bernhard; Bruder, Herbert; Allmendinger, Thomas; Haberland, Ulrike; Flohr, Thomas; Kachelriess, Marc

2009-01-01

Purpose: Cardiac CT achieves its high temporal resolution by lowering the scan range from 2π to π plus fan angle (partial scan). This, however, introduces CT-value variations, depending on the angular position of the π range. These partial scan artifacts are of the order of a few HU and prevent the quantitative evaluation of perfusion measurements. The authors present the new algorithm partial scan artifact reduction (PSAR) that corrects a dynamic phase-correlated scan without a priori information. Methods: In general, a full scan does not suffer from partial scan artifacts since all projections in [0, 2π] contribute to the data. To maintain the optimum temporal resolution and the phase correlation, PSAR creates an artificial full scan p n AF by projectionwise averaging a set of neighboring partial scans p n P from the same perfusion examination (typically N≅30 phase-correlated partial scans distributed over 20 s and n=1,...,N). Corresponding to the angular range of each partial scan, the authors extract virtual partial scans p n V from the artificial full scan p n AF . A standard reconstruction yields the corresponding images f n P , f n AF , and f n V . Subtracting the virtual partial scan image f n V from the artificial full scan image f n AF yields an artifact image that can be used to correct the original partial scan image: f n C =f n P -f n V +f n AF , where f n C is the corrected image. Results: The authors evaluated the effects of scattered radiation on the partial scan artifacts using simulated and measured water phantoms and found a strong correlation. The PSAR algorithm has been validated with a simulated semianthropomorphic heart phantom and with measurements of a dynamic biological perfusion phantom. For the stationary phantoms, real full scans have been performed to provide theoretical reference values. The improvement in the root mean square errors between the full and the partial scans with respect to the errors between the full and the

Do thallium myocardial perfusion scan abnormalities predict survival in sarcoid patients without cardiac symptoms

International Nuclear Information System (INIS)

Kinney, E.L.; Caldwell, J.W.

1990-01-01

Whereas the total mortality rate for sarcoidosis is 0.2 per 100,000, the prognosis, when the heart is involved, is very much worse. The authors used the difference in mortality rate to infer whether thallium 201 myocardial perfusion scan abnormalities correspond to myocardial sarcoid by making the simplifying assumption that if they do, then patients with abnormal scans will be found to have a death rate similar to patients with sarcoid heart disease. The authors therefore analyzed complete survival data on 52 sarcoid patients without cardiac symptoms an average of eighty-nine months after they had been scanned as part of a protocol. By use of survival analysis (the Cox proportional hazards model), the only variable that was significantly associated with survival was age. The patients' scan pattern, treatment status, gender, and race were not significantly related to survival. The authors conclude that thallium myocardial perfusion scans cannot reliably be used to diagnose sarcoid heart disease in sarcoid patients without cardiac symptoms

Lung perfusion in hemorrhagic shock of rats. The effects of resuscitation with whole blood, saline or hes 6%

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Turhanoglu, S.; Kaya, S.; Kararmaz, A.; Turhanoglu, A.D. [Dicle Univ., Diyarbakir (Turkey). Medical School

2001-12-01

This study was undertaken to determine the effects of various resuscitation regimens on lung perfusion following resuscitation from hemorrhagic shock. Fourty male Sprague-Dawley rats (250-300 g) were used. The rats were divided randomly into four groups (n=10 for each) and were sedated with intramuscular ketamine (100 mg/kg). We measured blood pressure, rectal temperature and lung perfusion using radioscintigraphy with a technetium colloid indicator. The systolic blood pressure was decreased 75% by removing blood via v. jugularis in the first three groups and group 4 was accepted as the control group, and blood volume was not diminished. Then the first three groups were resuscitated with autologous blood containing 125 units heparine/ml in group 1, saline in group 2, and hydroxyethyl starch (HES) 6% in group 3. After the correction of hypovolemia, all animals were injected 100 Bg (0.1 cc) technetium 99m macroaggregated albumin ({sup 99m}Tc MAA) via penil vein. After injection of {sup 99m}Tc MAA, 3 minutes fixed images were detected by a {gamma} camera in posterior position at 15 minutes and 5 hours. {sup 99m}Tc MMA ''wash out'' rate in lung was determined quantitatively at 5 hours. Compared to a control group, lung perfusion was decreased significantly in groups resuscitated with saline, and HES 6% while perfusion was restored with autologous blood. We conclude that heparinized autologous blood saved lung capillary circulation in hemorrhagic shock in rats. (author)

Lung perfusion in hemorrhagic shock of rats. The effects of resuscitation with whole blood, saline or hes 6%

International Nuclear Information System (INIS)

Turhanoglu, S.; Kaya, S.; Kararmaz, A.; Turhanoglu, A.D.

2001-01-01

This study was undertaken to determine the effects of various resuscitation regimens on lung perfusion following resuscitation from hemorrhagic shock. Fourty male Sprague-Dawley rats (250-300 g) were used. The rats were divided randomly into four groups (n=10 for each) and were sedated with intramuscular ketamine (100 mg/kg). We measured blood pressure, rectal temperature and lung perfusion using radioscintigraphy with a technetium colloid indicator. The systolic blood pressure was decreased 75% by removing blood via v. jugularis in the first three groups and group 4 was accepted as the control group, and blood volume was not diminished. Then the first three groups were resuscitated with autologous blood containing 125 units heparine/ml in group 1, saline in group 2, and hydroxyethyl starch (HES) 6% in group 3. After the correction of hypovolemia, all animals were injected 100 Bg (0.1 cc) technetium 99m macroaggregated albumin ( 99m Tc MAA) via penil vein. After injection of 99m Tc MAA, 3 minutes fixed images were detected by a γ camera in posterior position at 15 minutes and 5 hours. 99m Tc MMA ''wash out'' rate in lung was determined quantitatively at 5 hours. Compared to a control group, lung perfusion was decreased significantly in groups resuscitated with saline, and HES 6% while perfusion was restored with autologous blood. We conclude that heparinized autologous blood saved lung capillary circulation in hemorrhagic shock in rats. (author)

Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

International Nuclear Information System (INIS)

Suga, K.; Yasuhiko, K.; Iwanaga, H.; Tokuda, O.; Matsunaga, N.

2009-01-01

Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

Energy Technology Data Exchange (ETDEWEB)

Suga, K.; Yasuhiko, K. (Dept. of Radiology, St. Hill Hospital, Ube, Yamaguchi (Japan)); Iwanaga, H.; Tokuda, O.; Matsunaga, N. (Dept. of Radiology, Yamaguchi Univ. School of Medicine, Ube, Yamaguchi (Japan))

2009-01-15

Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

Functional mechanism of lung mosaic CT attenuation: assessment with deep-inspiration breath-hold perfusion SPECT-CT fusion imaging and non-breath-hold Technegas SPECT.

Science.gov (United States)

Suga, K; Yasuhiko, K; Iwanaga, H; Tokuda, O; Matsunaga, N

2009-01-01

The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Although further validation is required, our results indicate that heterogeneous pulmonary arterial

Partial scan artifact reduction (PSAR) for the assessment of cardiac perfusion in dynamic phase-correlated CT

Energy Technology Data Exchange (ETDEWEB)

Stenner, Philip; Schmidt, Bernhard; Bruder, Herbert; Allmendinger, Thomas; Haberland, Ulrike; Flohr, Thomas; Kachelriess, Marc [Institute of Medical Physics, Henkestrasse 91, 91052 Erlangen (Germany); Siemens AG, Healthcare Sector, Siemensstrasse 1, 91301 Forchheim (Germany); Institute of Medical Physics, Henkestrasse. 91, 91052 Erlangen (Germany)

2009-12-15

Purpose: Cardiac CT achieves its high temporal resolution by lowering the scan range from 2{pi} to {pi} plus fan angle (partial scan). This, however, introduces CT-value variations, depending on the angular position of the {pi} range. These partial scan artifacts are of the order of a few HU and prevent the quantitative evaluation of perfusion measurements. The authors present the new algorithm partial scan artifact reduction (PSAR) that corrects a dynamic phase-correlated scan without a priori information. Methods: In general, a full scan does not suffer from partial scan artifacts since all projections in [0, 2{pi}] contribute to the data. To maintain the optimum temporal resolution and the phase correlation, PSAR creates an artificial full scan p{sub n}{sup AF} by projectionwise averaging a set of neighboring partial scans p{sub n}{sup P} from the same perfusion examination (typically N{approx_equal}30 phase-correlated partial scans distributed over 20 s and n=1,...,N). Corresponding to the angular range of each partial scan, the authors extract virtual partial scans p{sub n}{sup V} from the artificial full scan p{sub n}{sup AF}. A standard reconstruction yields the corresponding images f{sub n}{sup P}, f{sub n}{sup AF}, and f{sub n}{sup V}. Subtracting the virtual partial scan image f{sub n}{sup V} from the artificial full scan image f{sub n}{sup AF} yields an artifact image that can be used to correct the original partial scan image: f{sub n}{sup C}=f{sub n}{sup P}-f{sub n}{sup V}+f{sub n}{sup AF}, where f{sub n}{sup C} is the corrected image. Results: The authors evaluated the effects of scattered radiation on the partial scan artifacts using simulated and measured water phantoms and found a strong correlation. The PSAR algorithm has been validated with a simulated semianthropomorphic heart phantom and with measurements of a dynamic biological perfusion phantom. For the stationary phantoms, real full scans have been performed to provide theoretical reference

Assessment of the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level in patients with emphysema

International Nuclear Information System (INIS)

Ley-Zaporozhan, Julia; Ley, Sebastian; Eberhardt, Ralf; Weinheimer, Oliver; Fink, Christian; Puderbach, Michael; Eichinger, Monika; Herth, Felix; Kauczor, Hans-Ulrich

2007-01-01

Purpose: To assess the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level using CT and MRI in patients with emphysema. Material and methods: Forty-five patients with severe emphysema (GOLD III and IV) underwent inspiratory 3D-HRCT and contrast-enhanced MR-perfusion (1.5T; 3.5 mm x 1.9 mm x 4 mm). 3D-HRCT data was analyzed using a software for detection and visualization of emphysema. Emphysema was categorized in four clusters with different volumes and presented as overlay on the CT. CT and lung perfusion were visually analyzed for three lobes on each side using a four-point-score to grade the abnormalities on CT (1: predominantly small emphysema-clusters to 4: >75% large emphysema-clusters) and MRI (1: normal perfusion to 4: no perfusion). Results: A total of 270 lobes were evaluated. At CT, the score was 1 for 9 lobes, 2 for 43, 3 for 77, and 4 for 141 lobes. At MRI, the score was 1 for 13 lobes, 2 for 45, 3 for 92, and 4 for 120 lobes. Matching of lung parenchymal destruction and reduced perfusion was found in 213 lobes (weighted kappa = 0.8). The score was higher on CT in 44, and higher on MRI in 13 lobes. Conclusion: 3D-HRCT and 3D MR-perfusion show a high lobar agreement between parenchymal destruction and reduction of perfusion in patients with severe emphysema

Evaluation of optimal scan duration and end time in cerebral CT perfusion study

International Nuclear Information System (INIS)

Hirata, Masaaki; Sugawara, Yoshifumi; Miki, Hitoshi; Mochizuki, Teruhito; Murase, Kenya

2005-01-01

The purpose of this study was to evaluate the optimal end time of scanning and the influence of varying the number of source images adopted for calculation of the parameter values in computerized tomography (CT) perfusion. Nineteen CT perfusion studies in 14 patients with cerebrovascular disease were retrospectively analyzed. CT perfusion scanning was performed using continuous scans of 1 sec/rotation x 60 sec with 5-mm-thick sections. To determine the appropriate end time of scanning, the time-density curves (TDCs) of the anterior cerebral artery (ACA), superior sagittal sinus (SSS), and basal ganglia were analyzed. The functional maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were retrospectively generated from various numbers (30, 35, 40, 45, 50, 55, and 60) of source images. Defining the values calculated from the number of source images equal to the end time of the first pass as standard values, the percentage difference between the standard values and the values generated from various numbers of sources were evaluated. The TDCs of SSS showed the latest end time of the first pass (mean, 38.6±5.2 sec; range, 32 to 48 sec). Therefore, the values calculated from the number of source images equal to the end time of the first pass of SSS were defined as standard values. Increase and decrease of the number of source images for calculation resulted in increase of the percentage difference in every parameter value. The percentage differences ranged up to 49.6% for CBF, 48.0% for CBV, and 20.0% for MTT. Scanning until the end time of the first pass of SSS is necessary and sufficient for reliable measurement. Variable scan time based on the TDC of the SSS may be of better utility than use of fixed scan time. Further, the radiation dose could be minimized in many cases by reducing the scan time. (author)

First Danish experience with ex vivo lung perfusion of donor lungs before transplantation.

Science.gov (United States)

Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold; Zemtsovski, Mikhail; Nilsson, Jens Christian; Seidelin, Casper Tobias; Perch, Michael; Iversen, Martin; Steinbrüchel, Daniel

2014-03-01

The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction. The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs. no funding was granted for the present paper. not relevant.

Ventilation and Perfusion Lung Scintigraphy of Allergen-Induced Airway Responses in Atopic Asthmatic Subjects

Directory of Open Access Journals (Sweden)

Krishnan Parameswaran

2007-01-01

Full Text Available BACKGROUND: Both ventilation (V and perfusion (Q of the lungs are altered in asthma, but their relationships with allergen-induced airway responses and gas exchange are not well described.

The distribution of lung damage in children with cystic fibrosis and its relationship to colonisation with Pseudomonas aeroginosa

International Nuclear Information System (INIS)

Evans, I.; Hambleton, G.; Mann, N.; Brown, J.

1987-01-01

Ventilation-perfusion lung scans were performed with 81m Kr inhalation and 99m Tc-albumin injection in 33 children with cystic fibrosis. It was found that both ventilation and perfusion scans yielded more information than radiographs of the chest in assessing lung damage. Using a scoring system, it was demonstrated by statistical methods that in the worst affected patients the disease was worse in the upper zones of the lungs, where changes were not detectable on chest radiographs. Pseudomonas was present in the sputum of these patients. (orig.)

Demonstration of cerebral abnormalities in cocaine abusers with SPECT perfusion brain scans

International Nuclear Information System (INIS)

Nagel, J.S.; Tumeh, S.S.; English, R.J.; Moore, M.; Lee, V.W.; Holman, L.B.

1989-01-01

This paper reports I-123 isopropyl iodoamphetamine (IMP) single-photon emission CT (SPECT) brain scans performed on cocaine users to investigate the effects of cocaine on the cerebral perfusion in a manner similar to previous CT, angiographic and positron-emission tomographic (PET) studies. Ten asymptomatic or mildly symptomatic cocaine users, two users with major neurovascular complications, and five normal subjects were studied with IMP SPECT. Rotating-brain images of the cerebral IMP uptake were displayed by using a distance-weighted surface-projection technique and were visually analyzed for focal cortical perfusion deficits. Eleven cocaine users had multiple scattered cortical IMP defects. Frontal lobe defects were most prominent. One user had confluent defects resembling swiss cheese. Concurrent CT scans available in nine patients were negative in seven and showed infarcts in two. No similar focal findings were visible in normals

Ventilation-perfused studies using SPECT

International Nuclear Information System (INIS)

Zwijnenburg, A.

1989-01-01

A method for the quantitative analysis of ventilation-perfusion SPECT studies is decribed and an effort is made to evaluate its usefullness. The technical details of the emthod are described. In the the transaxial reconstructions of the tomographic studies the contour of the lungs is detected and regional values of lung volume, ventilation, perfusion and ventilation-perfusion ratios are calculated. The method is operator independent. The lung volume calculations from the SPECT studies are validated by comparing them with lung volume measurements using the helium dilution technique. A good correlation (r=0.91) was found between the two volumes. SPECT volume was greater than the volume measured with helium dilution, which was attributed to non-gas-containing structures in the. lungs. The use of ventilation-perfusion ratio SPECT is described to evaluate the effect of ionizing radiation on the lungs in patients treated with mantle field irradiation for Hodgkin's disease. Perfusion changes appear as early as 2 months after the start of irradiation. Ventilation changes appear later and relatively minor. No changes are seen outside the radiation portals. The ventilation-perfusion inequality in pulmonary sarcoidosis is treated. It is suggested that the decrease D LCO in these patients may be partly due to an even distribution of ventilation perfusion ratios. An effort is made to establish the properties of a new tracer used for the assessment of the metabolic function of the pulmonary endothelium. The lung uptake of I-123 IMP mimics the distribution of a perfusion tracer and it is suggested that this tracer may be useful for the early detection of pulmonary vascular damage, even when blood flow is still intact. Some aspects of the use of Kr-81m as a ventilation tracer are discussed as well as the effect of noise on Kr-81m SPECT reconstructions. (author). 146 refs.; 39 figs.; 8 tabs

Diagnosis of epidural hematoma by brain scan and perfusion study: case report

International Nuclear Information System (INIS)

Buozas, D.J.; Barrett, I.R.; Mishkin, F.S.

1976-01-01

By using the arterial and venous phases of an anterior cerebral perfusion study, which showed downward displacement of the sagittal sinus, and the finding of a rim on the delayed scans, the specific diagnosis of epidural hematoma was established

Feasibility of perfusion CT technique integrated into conventional {sup 18}FDG/PET-CT studies in lung cancer patients: clinical staging and functional information in a single study

Energy Technology Data Exchange (ETDEWEB)

Ippolito, Davide; Capraro, Cristina; Sironi, Sandro [University of Milano-Bicocca, School of Medicine, Milan (Italy); University of Milano-Bicocca, Department of Diagnostic Radiology, H.S. Gerardo Monza, Via Pergolesi 11, Monza, Milan (Italy); Guerra, Luca [University of Milano-Bicocca, School of Medicine, Milan (Italy); San Gerardo Hospital, Department of Nuclear Medicine and PET Unit - Molecular Bioimaging Centre, Monza (Italy); De Ponti, Elena [University of Milano-Bicocca, School of Medicine, Milan (Italy); San Gerardo Hospital, Department of Medical Physics, Monza (Italy); Messa, Cristina [University of Milano-Bicocca, School of Medicine, Milan (Italy); San Gerardo Hospital, Department of Nuclear Medicine and PET Unit - Molecular Bioimaging Centre, Monza (Italy); Tecnomed Foundation, University of Milano-Bicocca, Institute for Bioimaging and Molecular Physiology, National Research Council, Milan (Italy)

2013-02-15

To assess the additional functional vascular information and the relationship between perfusion measurements and glucose metabolism (SUVmax) obtained by including a perfusion CT study in a whole-body contrast-enhanced PET/CT protocol in primary lung cancer lesions. Enrolled in this prospective study were 34 consecutive patients with a biopsy-proven diagnosis of lung cancer who were referred for contrast-enhanced PET/CT staging. This prospective study was approved by our institutional review board, and informed consent was obtained from all patients. Perfusion CT was performed with the following parameters: 80 kV, 200 mAs, 30 scans during intravenous injection of 50 ml contrast agent, flow rate 5 ml/s. Another bolus of contrast medium (3.5 ml/s, 80 ml, 60-s delay) was administered to ensure a full diagnostic contrast-enhanced CT scan for clinical staging. The perfusion CT data were used to calculate a range of tumour vascularity parameters (blood flow, blood volume and mean transit time), and tumour FDG uptake (SUVmax) was used as a metabolic indicator. Quantitative and functional parameters were compared and in relation to location, histology and tumour size. The nonparametric Kruskal-Wallis rank sum test was used for statistical analysis. A cut-off value of 3 cm was used according to the TNM classification to discriminate between T1 and T2 tumours (i.e. T1b vs. T2a). There were significant perfusion differences (lower blood volumes and higher mean transit time) between tumours with diameter >30 mm and tumours with diameter <30 mm (p < 0.05; blood volume 5.6 vs. 7.1 ml/100 g, mean transit time 8.6 vs. 3.9 s, respectively). Also there was a trend for blood flow to be lower in larger lesions (p < 0.053; blood flow 153.1 vs. 98.3 ml/100 g tissue/min). Significant inverse correlations (linear regression) were found between blood volume and SUVmax in tumours with diameter >30 mm in diameter. Perfusion CT combined with PET/CT is feasible technique that may provide

Liver-lung scan in the diagnosis of right subphrenic abscess

International Nuclear Information System (INIS)

Middleton, H.M. III; Patton, D.D.; Hoyumpa, A.M. Jr.; Schenker, S.

1976-01-01

To assess the value of liver-lung scanning in the diagnosis of right subphrenic abscess, 148 scans were reviewed against corresponding charts. Of 91 scans with adequate clinical data, overall scanning error was 19.3 percent with 14 false positive and 3 false negative scans. Among 49 scans (of the initial group of 91 studies) with presence or absence of actual pathology proved by surgery and/or autopsy, there were 3 true positive, 12 false positive, 29 true negative, and 3 false negative scans. Analysis of data indicated lower accuracy of scan interpretation than generally reported, low specificity for positive scans and high specificity for negative scans, correlation of false interpretations with atypical degrees of liver-lung separation and with scanning defects in liver and lung, and failure of rereading significantly to improve accuracy of interpretation

Unilateral absence of lung perfusion resulting from endarteritis of the pulmonary artery

International Nuclear Information System (INIS)

Calegaro, J.U.M.; Turini, T.L.

This case shows endarteritis of left pulmonary artery in the angiographic study with absent perfusion of the left lung in the MAA 131 I scintigraphy. Considerations are made conderning the presumable diagnosis of infection by 'toxocara canis' larval form. The literature review don't point out a similar case. (author) [pt

A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

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Rhee, Chong Heon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1967-09-15

In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by {sup 131}I-Macroaggregated albumin, lung inhalation scans by colloidal {sup 198}Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5{+-}2.82% to the right lung and 45.5{+-}2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p<0.01). In the minimal pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 52.5{+-}5.3% to the right lung and 47.5{+-}1.0% to the left lung when the tuberculous lesion was in the right lung, and 56.2{+-}4.4% to the right lung and 43.8{+-}3.1% to the left lung when the tuberculous lesion was in the left lung. The difference of pulmonary arterial blood flow between the right and left lung was statistically not significant compared with the normal distribution. In the moderately advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 26.9{+-}13.9% to the right lung and 73.1{+-}13.9% to the left lung when the tuberculous lesion was more severe in the right lung, and 79.6{+-}12.8% to the right lung and 20.4{+-}13.0% to the left lung when the tuberculous lesion was more severe in the left lung. These were found to be highly significant statistically compared with the normal distribution of pulmonary arterial blood flow (p<0.01). When both lungs were evenly involved, the average distribution of pulmonary arterial blood flow was found to be 49.5{+-}8.01% to the right lung and 50.5{+-}8.01% to the left lung. In the far advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 18.5{+-}11.6% to the right lung and 81

Visceral Perfusion Scintigraphy with {sup 131}I-Labelled Albumin Macroaggregates

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Ueda, H.; Yamada, H.; Kitani, K.; Nagatani, M.; Takeda, T.; Migita, T.; Iio, M; Kameda, H. [University of Tokyo, Tokyo (Japan)

1969-05-15

The blood supply through the hepatic artery, superior mesenteric artery and portal vein to the visceral organs was studied in 60 cases of various hepatic disorders by scintigraphy after the selective introduction of {sup 131}I MAA by means of visceral arterial catheterization or percutaneous splenic puncture. A comparison of the radioactivities of the liver and the spleen after celiac arterial infusion (celiac perfusion scanning) indicated how much blood in the celiac artery was distributed to the two major arterial branches - the hepatic and splenic. Dominant perfusion was found through the hepatic branch in liver cirrhosis, whereas significantly dominant splenic blood perfusion was found in idiopathic non-cirrhotic portal hypertension. This remarkable contrast of the mode of celiac perfusion in two disorders indicated the etiological difference of these diseases. In malignant neoplasm of the liver, the dominant or exclusive celiac arterial perfusion was found in the tumour region. In these cases, liver scanning by the splenic injection of MAA (portal perfusion scanning) delineated the tumour region as a negative defect similar to the conventional {sup 198}Au colloid scanning. Consequently, from these two perfusion scintigrams the 'key and key-hole' pattern was demonstrated. It was concluded that a neoplastic lesion, primary or metastatic, has the predominant blood supply through the hepatic artery rather than through the portal vein. Celiac perfusion scanning of liver cystosis revealed multiple negative defects. This information was useful for differentiating a malignant tumour, which is usually impossible by conventional liver scanning. Celiac perfusion scanning was also useful for the diagnosis of arterial venous communication. In one case of liver .cancer with cirrhosis and another case with stomach varices, the arterial-v.enous communication was indicated by the appearance of the lung contour in the celiac perfusion scan. In both cases, the combined presence

Scintigraphic and MR perfusion imaging in preoperative evaluation for lung volume reduction surgery. Pilot study results

International Nuclear Information System (INIS)

Johkoh, Takeshi; Mueller, N.L.; Kavanagh, P.V

2000-01-01

To compare MR perfusion imaging with perfusion scintigraphy in the evaluation of patients with pulmonary emphysema being considered for lung volume reduction surgery. Six patients with pulmonary emphysema and two normal individuals were evaluated by MR perfusion imaging, perfusion scintigraphy, and selective bilateral pulmonary angiography. MR images were obtained with an enhanced fast gradient recalled echo with three-dimensional Fourier transformation technique (efgre 3D) (6.3/1.3; flip angle, 30 deg C; field of view, 45-48 cm; matrix, 256 x 160). The presence or absence of perfusion defects in each segment was evaluated by two independent observers. Using angiography as the gold standard, the sensitivity, specificity, and accuracy of MR perfusion imaging in detecting focal perfusion abnormalities were 90%, 87%, and 89%, respectively, while those of perfusion scintigraphy were 71%, 76%, and 71%, respectively. The diagnostic accuracy of MR perfusion imaging was significantly higher than that of scintigraphy (p<0.001, McNemar test). There was good agreement between two observers for MR perfusion imaging (kappa statistic, 0.66) and only moderate agreement for perfusion scintigraphy (kappa statistic, 0.51). MR perfusion imaging is superior to perfusion scintigraphy in the evaluation of pulmonary parenchymal perfusion in patients with pulmonary emphysema. (author)

Assessment of regional lung functional impairment with co-registered respiratory-gated ventilation/perfusion SPET-CT images: initial experiences

International Nuclear Information System (INIS)

Suga, Kazuyoshi; Yasuhiko, Kawakami; Zaki, Mohammed; Yamashita, Tomio; Seto, Aska; Matsumoto, Tsuneo; Matsunaga, Naofumi

2004-01-01

In this study, respiratory-gated ventilation and perfusion single-photon emission tomography (SPET) were used to define regional functional impairment and to obtain reliable co-registration with computed tomography (CT) images in various lung diseases. Using a triple-headed SPET unit and a physiological synchroniser, gated perfusion SPET was performed in a total of 78 patients with different pulmonary diseases, including metastatic nodules (n=15); in 34 of these patients, it was performed in combination with gated technetium-99m Technegas SPET. Projection data were acquired using 60 stops over 120 for each detector. Gated end-inspiration and ungated images were reconstructed from 1/8 data centered at peak inspiration for each regular respiratory cycle and full respiratory cycle data, respectively. Gated images were registered with tidal inspiration CT images using automated three-dimensional (3D) registration software. Registration mismatch was assessed by measuring 3D distance of the centroid of the nine selected round perfusion-defective nodules. Gated SPET images were completed within 29 min, and increased the number of visible ventilation and perfusion defects by 9.7% and 17.2%, respectively, as compared with ungated images; furthermore, lesion-to-normal lung contrast was significantly higher on gated SPET images. In the nine round perfusion-defective nodules, gated images yielded a significantly better SPET-CT match compared with ungated images (4.9±3.1 mm vs 19.0±9.1 mm, P<0.001). The co-registered SPET-CT images allowed accurate perception of the location and extent of each ventilation/perfusion defect on the underlying CT anatomy, and characterised the pathophysiology of the various diseases. By reducing respiratory motion effects and enhancing perfusion/ventilation defect clarity, gated SPET can provide reliable co-registered images with CT images to accurately characterise regional functional impairment in various lung diseases. (orig.)

Ex vivo lung perfusion to improve donor lung function and increase the number of organs available for transplantation.

Science.gov (United States)

Valenza, Franco; Rosso, Lorenzo; Coppola, Silvia; Froio, Sara; Palleschi, Alessandro; Tosi, Davide; Mendogni, Paolo; Salice, Valentina; Ruggeri, Giulia M; Fumagalli, Jacopo; Villa, Alessandro; Nosotti, Mario; Santambrogio, Luigi; Gattinoni, Luciano

2014-06-01

This paper describes the initial clinical experience of ex vivo lung perfusion (EVLP) at the Fondazione Ca' Granda in Milan between January 2011 and May 2013. EVLP was considered if donor PaO2 /FiO2 was below 300 mmHg or if lung function was doubtful. Donors with massive lung contusion, aspiration, purulent secretions, pneumonia, or sepsis were excluded. EVLP was run with a low-flow, open atrium and low hematocrit technique. Thirty-five lung transplants from brain death donors were performed, seven of which after EVLP. EVLP donors were older (54 ± 9 years vs. 40 ± 15 years, EVLP versus Standard, P donor organs and resulted in successful transplants with lungs that would have otherwise been rejected (ClinicalTrials.gov number: NCT01967953). © 2014 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.

TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

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Mendrik, Adrienne M; Van Ginneken, Bram; Viergever, Max A [Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Vonken, Evert-jan; De Jong, Hugo W; Riordan, Alan; Van Seeters, Tom; Smit, Ewoud J; Prokop, Mathias, E-mail: a.m.mendrik@gmail.com [Radiology Department, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

2011-07-07

Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray radiation that can be used per sequential scan is limited, which results in a high level of noise. To detect areas of abnormal perfusion, perfusion parameters are derived from the CTP data, such as the cerebral blood flow (CBF). Algorithms to determine perfusion parameters, especially singular value decomposition, are very sensitive to noise. Therefore, noise reduction is an important preprocessing step for CTP analysis. In this paper, we propose a time-intensity profile similarity (TIPS) bilateral filter to reduce noise in 4D CTP scans, while preserving the time-intensity profiles (fourth dimension) that are essential for determining the perfusion parameters. The proposed TIPS bilateral filter is compared to standard Gaussian filtering, and 4D and 3D (applied separately to each sequential scan) bilateral filtering on both phantom and patient data. Results on the phantom data show that the TIPS bilateral filter is best able to approach the ground truth (noise-free phantom), compared to the other filtering methods (lowest root mean square error). An observer study is performed using CBF maps derived from fifteen CTP scans of acute stroke patients filtered with standard Gaussian, 3D, 4D and TIPS bilateral filtering. These CBF maps were blindly presented to two observers that indicated which map they preferred for (1) gray/white matter differentiation, (2) detectability of infarcted area and (3) overall image quality. Based on these results, the TIPS bilateral filter ranked best and its CBF maps were scored to have the best overall image quality in 100% of the cases by both observers. Furthermore, quantitative CBF and cerebral blood volume values in both the phantom and the

Fuzzy modeling of electrical impedance tomography images of the lungs

International Nuclear Information System (INIS)

Tanaka, Harki; Ortega, Neli Regina Siqueira; Galizia, Mauricio Stanzione; Borges, Joao Batista; Amato, Marcelo Britto Passos

2008-01-01

Objectives: Aiming to improve the anatomical resolution of electrical impedance tomography images, we developed a fuzzy model based on electrical impedance tomography's high temporal resolution and on the functional pulmonary signals of perfusion and ventilation. Introduction: Electrical impedance tomography images carry information about both ventilation and perfusion. However, these images are difficult to interpret because of insufficient anatomical resolution, such that it becomes almost impossible to distinguish the heart from the lungs. Methods: Electrical impedance tomography data from an experimental animal model were collected during normal ventilation and apnoea while an injection of hypertonic saline was administered. The fuzzy model was elaborated in three parts: a modeling of the heart, the pulmonary ventilation map and the pulmonary perfusion map. Image segmentation was performed using a threshold method, and a ventilation/perfusion map was generated. Results: Electrical impedance tomography images treated by the fuzzy model were compared with the hypertonic saline injection method and computed tomography scan images, presenting good results. The average accuracy index was 0.80 when comparing the fuzzy modeled lung maps and the computed tomography scan lung mask. The average ROC curve area comparing a saline injection image and a fuzzy modeled pulmonary perfusion image was 0.77. Discussion: The innovative aspects of our work are the use of temporal information for the delineation of the heart structure and the use of two pulmonary functions for lung structure delineation. However, robustness of the method should be tested for the imaging of abnormal lung conditions. Conclusions: These results showed the adequacy of the fuzzy approach in treating the anatomical resolution uncertainties in electrical impedance tomography images. (author)

Lung ventilation-perfusion scintigraphy in children on long-term parenteral nutrition

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Pifarre, Paloma; Roca, Isabel [Universitat Autonoma de Barcelona, Department of Nuclear Medicine, Hospital de la Vall d' Hebron, Barcelona (Spain); Irastorza, Inaki; Hill, Susan [Great Ormond Street Hospital, Department of Gastroenterology, London (United Kingdom); Simo, Marc [Instituto Universitario Dexeus, Department of Nuclear Medicine, Barcelona (Spain); Biassoni, Lorenzo; Gordon, Isky [Great Ormond Street Hospital, Department of Nuclear Medicine, London (United Kingdom)

2009-06-15

Pulmonary emboli (PE) are one of the major complications associated with total parenteral nutrition (TPN). Ventilation-perfusion scintigraphy (V/Q) remains the most used test for the diagnosis of PE and follow-up of patients on TPN. The aim of our study was to demonstrate the high prevalence of undiagnosed PE in children on TPN. The medical and imaging files of 64 patients on TPN who underwent V/Q examinations covering the period of 1986-2004 were reviewed. Children were aged between 3.18 months and 21.6 years. TPN was started at birth (range 0-15 years). All children had a normal chest radiograph and no symptoms at the time of the V/Q scan. A comparative analysis between the prevalence of PE and risk factors number of days per week with lipophilic content of the TPN, bowel inflammation and thrombophilic factors (protein C and S) was performed. Of the 64 patients, 25 (39%) had an abnormal V/Q scan. A total of 29 PE episodes were diagnosed in all patients. Two children had three episodes of PE. The median age at PE diagnosis was 4.6 years. In 17 patients (68%) diagnosis was achieved on the first V/Q scan performed. PE was bilateral in 56% and unilateral in 44%. PE was the main cause of 2 out 15 recorded deaths. All risk factors were associated with an increase in PE prevalence by statistical analysis. PE is underdiagnosed in children on long-term TPN. Lung V/Q scintigraphy is useful in the diagnosis of PE in children with a low pretest probability. (orig.)

Analysis of decrease in lung perfusion blood volume with occlusive and non-occlusive pulmonary embolisms

International Nuclear Information System (INIS)

Ikeda, Yohei; Yoshimura, Norihiko; Hori, Yoshiro; Horii, Yosuke; Ishikawa, Hiroyuki; Yamazaki, Motohiko; Noto, Yoshiyuki; Aoyama, Hidefumi

2014-01-01

Highlights: • The proportion of preserved PE lesions in the non-occlusive group was 76.7% (33/43). • HUs of the iodine map were significantly higher in the non-occlusive group than in the occlusive group. • There was no significant difference in HUs between the non-occlusive and corresponding normal group. - Abstract: Purpose: The aim of this study was to determine if lung perfusion blood volume (lung PBV) with non-occlusive pulmonary embolism (PE) differs quantitatively and visually from that with occlusive PE and to investigate if lung PBV with non-occlusive PE remains the same as that without PE. Materials and methods: Totally, 108 patients suspected of having acute PE underwent pulmonary dual-energy computed tomography angiography (DECTA) between April 2011 and January 2012. Presence of PE on DECTA was evaluated by one radiologist. Two radiologists visually evaluated the PE distribution (segmental or subsegmental) and its nature (occlusive or non-occlusive) on DECTA and classified perfusion in lung PBV as “decreased,” “slightly decreased,” and “preserved”. Two radiologists used a lung PBV application to set a region of interest (ROI) in the center of the lesion and measured HU values of an iodine map. In the same slice as the ROI of the lesion and close to the lesion, another ROI was set in the normal perfusion area without PE, and HUs were measured. The proportion of lesions was compared between the occlusive and non-occlusive groups. HUs were compared among the occlusive, non-occlusive, and corresponding normal groups. Results: Twenty-five patients had 80 segmental or subsegmental lesions. There were 37 and 43 lesions in the occlusive and non-occlusive groups, respectively. The proportion of decreased lesions was 73.0% (27/37) in the occlusive group, while that of preserved lesions in the non-occlusive group was 76.7% (33/43). There was a significant difference in the proportion of lesions (P < 0.001) between the two groups. HUs of the

Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

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Krivonogov, Nikolay G., E-mail: kng@cardio-tomsk.ru [Research Institute of Cardiology, Kievskaya Street 111a, Tomsk, 634012 (Russian Federation); Efimova, Nataliya Y., E-mail: efimova@cardio-tomsk.ru; Zavadovsky, Konstantin W.; Lishmanov, Yuri B. [Research Institute of Cardiology, Kievskaya Street 111a, Tomsk, 634012 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation)

2016-08-02

Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

Science.gov (United States)

Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.

2016-08-01

Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

Respiratory lung motion analysis using a nonlinear motion correction technique for respiratory-gated lung perfusion SPECT images

International Nuclear Information System (INIS)

Ue, Hidenori; Haneishi, Hideaki; Iwanaga, Hideyuki; Suga, Kazuyoshi

2007-01-01

This study evaluated the respiratory motion of lungs using a nonlinear motion correction technique for respiratory-gated single photon emission computed tomography (SPECT) images. The motion correction technique corrects the respiratory motion of the lungs nonlinearly between two-phase images obtained by respiratory-gated SPECT. The displacement vectors resulting from respiration can be computed at every location of the lungs. Respiratory lung motion analysis is carried out by calculating the mean value of the body axis component of the displacement vector in each of the 12 small regions into which the lungs were divided. In order to enable inter-patient comparison, the 12 mean values were normalized by the length of the lung region along the direction of the body axis. This method was applied to 25 Technetium (Tc)-99m-macroaggregated albumin (MAA) perfusion SPECT images, and motion analysis results were compared with the diagnostic results. It was confirmed that the respiratory lung motion reflects the ventilation function. A statistically significant difference in the amount of the respiratory lung motion was observed between the obstructive pulmonary diseases and other conditions, based on an unpaired Student's t test (P<0.0001). A difference in the motion between normal lungs and lungs with a ventilation obstruction was detected by the proposed method. This method is effective for evaluating obstructive pulmonary diseases such as pulmonary emphysema and diffuse panbronchiolitis. (author)

Regional ventilation/perfusion mismatch pattern in patient with Swyer James (MacLeod′s syndrome

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Sait Sager

2014-01-01

Full Text Available Swyer James (McLeod′s syndrome (SJMS is an uncommon disease, which occurs as a result of childhood bronchiolitis obliterans. Patients may not be diagnosed until later in their life. A 46-year-old man underwent ventilation/perfusion scintigraphy for acute onset of dyspnea. The scan showed markedly diminished ventilation and perfusion unilaterally on the right middle and inferior lobes. However, mismatched ventilation-perfusion pattern was shown on the upper right lobe, which was consistent with pulmonary embolism. Unilaterally matched ventilation/perfusion defect can see in SJMS in lung scintigraphy; however, when pulmoner embolism may accompany, scintigraphy should be carefully examined.

Non-contrast-enhanced perfusion and ventilation assessment of the human lung by means of fourier decomposition in proton MRI.

Science.gov (United States)

Bauman, Grzegorz; Puderbach, Michael; Deimling, Michael; Jellus, Vladimir; Chefd'hotel, Christophe; Dinkel, Julien; Hintze, Christian; Kauczor, Hans-Ulrich; Schad, Lothar R

2009-09-01

Assessment of regional lung perfusion and ventilation has significant clinical value for the diagnosis and follow-up of pulmonary diseases. In this work a new method of non-contrast-enhanced functional lung MRI (not dependent on intravenous or inhalative contrast agents) is proposed. A two-dimensional (2D) true fast imaging with steady precession (TrueFISP) pulse sequence (TR/TE = 1.9 ms/0.8 ms, acquisition time [TA] = 112 ms/image) was implemented on a 1.5T whole-body MR scanner. The imaging protocol comprised sets of 198 lung images acquired with an imaging rate of 3.33 images/s in coronal and sagittal view. No electrocardiogram (ECG) or respiratory triggering was used. A nonrigid image registration algorithm was applied to compensate for respiratory motion. Rapid data acquisition allowed observing intensity changes in corresponding lung areas with respect to the cardiac and respiratory frequencies. After a Fourier analysis along the time domain, two spectral lines corresponding to both frequencies were used to calculate the perfusion- and ventilation-weighted images. The described method was applied in preliminary studies on volunteers and patients showing clinical relevance to obtain non-contrast-enhanced perfusion and ventilation data.

Study of regional lung ventilation and perfusion by xenon 133

International Nuclear Information System (INIS)

Lombard, Yves.

1976-01-01

The present work consists of a regional lung exploration after injection of xenon 133, dissolved in physiological serum, followed a few minutes later by that of 99m Tc-labelled serumalbumin microspheres. The aim is three fold: first of all to study perfusion and ventilation by xenon 133, next to compare the results obtained after xenon 133 and 99 m Tc-labelled microsphere injection, lastly to establish the value of the technique and its routine application. This examination has not solved all problems of lung exploration by xenon 133. For example we deliberately kept to intraveinous injection of the gas dissolved in physiological serum, leaving aside the breathing test. Xenon 133 scintigraphy in our opinion will not tend to replace 99m Tc-labelled microsphere scintigraphy, which has irreplaceable morphological qualities, but will serve as an excellent complement. The basic advantage of xenon 133 is the regional ventilation estimate it provides allowing any anomaly of the lung parenchyma to be located immediately or conversely the functional value of the healthy lung to be established with a view to a surgical removal of a diseased zone [fr

Activation of rho is involved in the mechanism of hydrogen-peroxide-induced lung edema in isolated perfused rabbit lung.

Science.gov (United States)

Chiba, Y; Ishii, Y; Kitamura, S; Sugiyama, Y

2001-09-01

Acute lung injury is attributed primarily to increased vascular permeability caused by reactive oxygen species derived from neutrophils, such as hydrogen peroxide (H2O2). Increased permeability is accompanied by the contraction and cytoskeleton reorganization of endothelial cells, resulting in intercellular gap formation. The Rho family of Ras-like GTPases is implicated in the regulation of the cytoskeleton and cell contraction. We examined the role of Rho in H2O2-induced pulmonary edema with the use of isolated perfused rabbit lungs. To our knowledge, this is the first study to examine the role of Rho in increased vascular permeability induced by H2O2 in perfused lungs. Vascular permeability was evaluated on the basis of the capillary filtration coefficient (Kfc, ml/min/cm H2O/100 g). We found that H2O2 (300 microM) increased lung weight, Kfc, and pulmonary capillary pressure. These effects of H2O2 were abolished by treatment with Y-27632 (50 microM), an inhibitor of the Rho effector p160 ROCK. In contrast, the muscular relaxant papaverine inhibited the H2O2-induced rise in pulmonary capillary pressure, but did not suppress the increases in lung weight and Kfc. These findings indicate that H2O2 causes pulmonary edema by elevating hydrostatic pressure and increasing vascular permeability. Y-27632 inhibited the formation of pulmonary edema by blocking both of these H2O2-induced effects. Our results suggest that Rho-related pathways have a part in the mechanism of H2O2-induced pulmonary edema. Copyright 2001 Academic Press.

Automated lung volumetry from routine thoracic CT scans: how reliable is the result?

Science.gov (United States)

Haas, Matthias; Hamm, Bernd; Niehues, Stefan M

2014-05-01

Today, lung volumes can be easily calculated from chest computed tomography (CT) scans. Modern postprocessing workstations allow automated volume measurement of data sets acquired. However, there are challenges in the use of lung volume as an indicator of pulmonary disease when it is obtained from routine CT. Intra-individual variation and methodologic aspects have to be considered. Our goal was to assess the reliability of volumetric measurements in routine CT lung scans. Forty adult cancer patients whose lungs were unaffected by the disease underwent routine chest CT scans in 3-month intervals, resulting in a total number of 302 chest CT scans. Lung volume was calculated by automatic volumetry software. On average of 7.2 CT scans were successfully evaluable per patient (range 2-15). Intra-individual changes were assessed. In the set of patients investigated, lung volume was approximately normally distributed, with a mean of 5283 cm(3) (standard deviation = 947 cm(3), skewness = -0.34, and curtosis = 0.16). Between different scans in one and the same patient the median intra-individual standard deviation in lung volume was 853 cm(3) (16% of the mean lung volume). Automatic lung segmentation of routine chest CT scans allows a technically stable estimation of lung volume. However, substantial intra-individual variations have to be considered. A median intra-individual deviation of 16% in lung volume between different routine scans was found. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Renal perfusion scintiscan

Science.gov (United States)

... Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion Images Kidney anatomy Kidney - blood and urine flow Intravenous pyelogram References Rottenberg G, Andi AC. Renal ...

Cyclooxygenase-2-dependent bronchoconstriction in perfused rat lungs exposed to endotoxin.

OpenAIRE

Uhlig, S.; Nüsing, R.; von Bethmann, A.; Featherstone, R. L.; Klein, T.; Brasch, F.; Müller, K. M.; Ullrich, V.; Wendel, A.

1996-01-01

BACKGROUND: Lipopolysaccharides (LPS), widely used to study the mechanisms of gram-negative sepsis, increase airway resistance by constriction of terminal bronchioles. The role of the cyclooxygenase (COX) isoenzymes and their prostanoid metabolites in this process was studied. MATERIALS AND METHODS: Pulmonary resistance, the release of thromboxane (TX) and the expression of COX-2 mRNA were measured in isolated blood-free perfused rat lungs exposed to LPS. RESULTS: LPS induced the release of T...

MRI of pulmonary perfusion; MRT der Lungenperfusion

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Fink, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany); Risse, F.; Semmler, W. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Medizinische Physik in der Radiologie, Heidelberg (Germany); Schoenberg, S.O.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Kauczor, H.-U. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany)

2006-04-15

Lung perfusion is a crucial prerequisite for effective gas exchange. Quantification of pulmonary perfusion is important for diagnostic considerations and treatment planning in various diseases of the lungs. Besides disorders of pulmonary vessels such as acute pulmonary embolism and pulmonary hypertension, these also include diseases of the respiratory tract and lung tissue as well as pulmonary tumors. This contribution presents the possibilities and technical requirements of MRI for diagnostic work-up of pulmonary perfusion. (orig.) [German] Die Perfusion der Lunge ist eine entscheidende Voraussetzung fuer einen effektiven Gasaustausch. Die Bestimmung der Lungenperfusion ist bei verschiedenen Erkrankungen der Lunge fuer Diagnostik und Therapieplanung bedeutsam. Hierzu zaehlen neben Erkrankungen der Lungengefaesse wie akute Lungenembolie und pulmonale Hypertension ebenso Erkrankungen der Atemwege, des Lungengeruests und Lungentumoren. In diesem Beitrag werden die Moeglichkeiten und technischen Voraussetzungen der MRT zur Diagnostik der Lungenperfusion dargestellt. (orig.)

Tissue ablation accelerated by peripheral scanning mode with high-intensity focused ultrasound: a study on isolated porcine liver perfusion.

Science.gov (United States)

Bu, Rui; Yin, Li; Yang, Han; Wang, Qi; Wu, Feng; Zou, Jian Zhong

2013-08-01

The aims of this study were to investigate the feasibility of accelerated tissue ablation using a peripheral scanning mode with high-intensity focused ultrasound (HIFU) and to explore the effect of flow rate on total energy consumption of the target tissues. Using a model of isolated porcine liver perfusion via the portal vein and hepatic artery, we conducted a scanning protocol along the periphery of the target tissues using linear-scanned HIFU to carefully adjust the varying focal depth, generator power, scanning velocity and line-by-line interval over the entire ablation range. Porcine livers were divided into four ablation groups: group 1, n = 12, with dual-vessel perfusion; group 2, n = 11, with portal vein perfusion alone; group 3, n = 10, with hepatic artery perfusion alone; and group 4, n = 11, control group with no-flow perfusion. The samples were cut open consecutively at a thickness of 3 mm, and the actual ablation ranges were calculated along the periphery of the target tissues after triphenyl tetrazolium chloride staining. Total energy consumption was calculated as the sum of the energy requirements at various focal depths in each group. On the basis of the pre-supposed scanning protocol, the peripheral region of the target tissue formed a complete coagulation necrosis barrier in each group with varying dose combinations, and the volume of the peripheral necrotic area did not differ significantly among the four groups (p > 0.05). Furthermore, total energy consumption in each group significantly decreased with the corresponding decrease in flow rate (p Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Pulmonary perfusion ''without ventilation''

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Chapman, C.N.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-12-01

An 88-yr-old man, with prior left upper lobectomy and phrenic nerve injury, had a ventilation/perfusion lung image. Both wash-in and equilibrium ventilation images showed no radioactive gas in the left lung. Nevertheless, the left lung was perfused. A similar result was obtained on a repeat study 8 days later. Delayed images, during washout, showed some radioactive gas in the left lung. Nearly absent ventilation (but continued perfusion) of that lung might have been related to altered gas dynamics brought about by the prior lobectomy, a submucosal bronchial lesion, phrenic nerve damage, and limited motion of the left part of the diaphragm. This case raises the issue of the degree of ventilation (and the phase relationship between the lungs) required for the entry of radioactive gas into a diseased lung, and the production of a ''reversed ventilation/perfusion mismatch.''

CT Perfusion Characteristics Identify Metastatic Sites in Liver

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Yuan Wang

2015-01-01

Full Text Available Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF, blood volume (BV, mean transit time (MTT, permeability (PS, and hepatic arterial fraction (HAF, for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

Pulmonary scanning: quantitative evaluation of pulmonary arterial flow

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Papaleo Netto, M; Fujioka, T [Sao Paulo Univ. (Brazil). Faculdade de Medicina; Dias Neto, A; Carvalho, N [Sao Paulo Univ. (Brazil). Centro de Medicina Nuclear

1974-01-01

From ten normal subjects of both sexes, the quantitative regional blood flow of the pulmonary artery was evaluated using scanning with macroaggregated radio-iodinated (/sup 131/I) albumin. It was possible to conclude that: the digital recording of data (counts/cm/sup 2/), from any particular area of interest, is the best method for this evaluation; the lung, even being a thick organ, can be well studied by quantitative scanning, since its structure doesn't hinder the passage of radiations because it is covered only by the thoracic wall; scanning can be used to evaluate regional perfusion of the pulmonary artery, based on the proportionality between density of aggregates and blood flux in the different areas; the concentration of macroaggregates on the lung's superior section never reaches more than 40% of the radioactivity of the whole lung; there is no significant difference between left and right lungs, concerning the relationship between radioactivity on the superior section and the total area and quantitative analysis of pulmonary artery flow by means of scanning is a possible, reliable, and safe technique, without distress for the patient.

Pulmonary scanning: quantitative evaluation of pulmonary arterial flow

International Nuclear Information System (INIS)

Papaleo Netto, M.; Fujioka, T.; Dias Neto, A.; Carvalho, N.

1974-01-01

From ten normal subjects of both sexes, the quantitative regional blood flow of the pulmonary artery was evaluated using scanning with macroaggregated radio-iodinated ( 131 I) albumin. It was possible to conclude that: the digital recording of data (counts/cm 2 ), from any particular area of interest, is the best method for this evaluation; the lung, even being a thick organ, can be well studied by quantitative scanning, since its structure doesn't hinder the passage of radiations because it is covered only by the thoracic wall; scanning can be used to evaluate regional perfusion of the pulmonary artery, based on the proportionality between density of aggregates and blood flux in the different areas; the concentration of macroaggregates on the lung's superior section never reaches more than 40% of the radioactivity of the whole lung; there is no significant difference between left and right lungs, concerning the relationship between radioactivity on the superior section and the total area and quantitative analysis of pulmonary artery flow by means of scanning is a possible, reliable and safe technique, without distress for the patient [pt

Evaluation of patients undergoing lung volume reduction surgery: Ancillary information available from computed tomography

International Nuclear Information System (INIS)

Cleverley, Joanne R.; Desai, Sujal R.; Wells, Athol U.; Koyama, Hiroshi; Eastick, Sian; Schmidt, Maria A.; Charrier, Clare L.; Gatehouse, Peter D.; Goldstraw, Peter; Pepper, John R.; Geddes, Duncan M.; Hansell, David M.

2000-01-01

AIM: A number of imaging techniques have been used for the pre-operative assessment of patients for lung volume reduction surgery (LVRS). We evaluated whether data currently acquired from perfusion scintigrams and cine MR of the diaphragm are obtainable from high resolution CT (HRCT) of the thorax. MATERIALS AND METHODS: Thirty patients taking part in a randomized controlled trial of LVRS against maximal medical therapy were evaluated. HRCT examinations (n= 30) were scored for (i) the extent and distribution of emphysema; (ii) the extent of normal pulmonary vasculature; and (iii) diaphragmatic contour, apparent defects and herniation. On scintigraphy, (n28), perfusion of the lower thirds of both lungs, as a proportion of total lung perfusion (LZ/T PERF ), was expressed as a percentage of predicted values (derived from 10 normal control subjects). On cine MR (n= 25) hemidiaphragmatic excursion and coordination were recorded. RESULTS: Extensive emphysema was present on HRCT (60% ± 13.2%). There was strong correlation between the extent of normal pulmonary vasculature on HRCT and on perfusion scanning (r s = 0.85, P< 0.00005). Hemidiaphragmatic incoordination on MR was weakly associated with hemidiaphragmatic eventration on HRCT (P0.04). CONCLUSION: The strong correlation between lung perfusion assessed by HRCT and lung perfusion on scintigraphy suggests that perfusion scintigraphy is superfluous in the pre-operative evaluation of patients with emphysema for LVRS. Cleverley, J.R. (2000)

Radioaerosol inhalation lung imaging for the diagnosis of chronic obstructive pulmonary diseases in Thailand. Final report for the period 10 December 1987 - 15 December 1993

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Buachum, V [Chulalongkorn Univ., Bangkok (Thailand). Nuclear Medicine Div.

1993-12-01

The radionuclide pulmonary function studies such as aerosol inhalation lung imaging, mucociliary clearance and pulmonary epithelial were developed and studied in normal and chronic obstructive pulmonary disease. The results of the aerosol inhalation lung imaging in 71 cases of COPD revealed that the aerosol inhalation lung scan was the most sensitive test for the diagnosis of early COPD as compared to the chest X-ray, vascular perfusion lung scan and spirometric test (% FEVI). The aerosol and perfusion lung scan were also performed in 21 cases of carcinoma of lung who had been treated with external radiation or chemotherapy. The result of study revealed 5 patients died during treatment, 5 patients were slightly improved, no significant change was detected in 10 cases and deterioration was found in one patient. The lung scintigraphy was studied in 15 cases of well differentiated carcinoma of thyroid with pulmonary metastasis who had I-131 treatment. The study showed that the radioactive iodine treatment dose had minimal effect on the post treatment lung imaging study. The perfusion and aerosol study in 15 cases of operated patients revealed no evidence of pulmonary embolism in post operative study. Abnormal vascular disease or pulmonary embolism was observed in one patient preoperatively. 12 refs, 13 figs, 13 tabs.

Radioaerosol inhalation lung imaging for the diagnosis of chronic obstructive pulmonary diseases in Thailand. Final report for the period 10 December 1987 - 15 December 1993

International Nuclear Information System (INIS)

Buachum, V.

1993-12-01

The radionuclide pulmonary function studies such as aerosol inhalation lung imaging, mucociliary clearance and pulmonary epithelial were developed and studied in normal and chronic obstructive pulmonary disease. The results of the aerosol inhalation lung imaging in 71 cases of COPD revealed that the aerosol inhalation lung scan was the most sensitive test for the diagnosis of early COPD as compared to the chest X-ray, vascular perfusion lung scan and spirometric test (% FEVI). The aerosol and perfusion lung scan were also performed in 21 cases of carcinoma of lung who had been treated with external radiation or chemotherapy. The result of study revealed 5 patients died during treatment, 5 patients were slightly improved, no significant change was detected in 10 cases and deterioration was found in one patient. The lung scintigraphy was studied in 15 cases of well differentiated carcinoma of thyroid with pulmonary metastasis who had I-131 treatment. The study showed that the radioactive iodine treatment dose had minimal effect on the post treatment lung imaging study. The perfusion and aerosol study in 15 cases of operated patients revealed no evidence of pulmonary embolism in post operative study. Abnormal vascular disease or pulmonary embolism was observed in one patient preoperatively. 12 refs, 13 figs, 13 tabs

Information for the diagnosis of broncho-pulmonary diseases obtained by the combined use of perfusion lung scintigraphy and selective bronchial arteriography

International Nuclear Information System (INIS)

Wouamba Foning, Michel.

1976-01-01

Our study is limited to perfusion lung scintigraphy and deals with the following in turn: - radioisotopes and their conditioning, - detection and recording equipment, - results and limits of the method. The tracers used here were radioiodine-labelled human albumin macro-aggregates and more especially technetium-labelled microspheres. Scintigraphy, which visualizes or charts the local distribution of radioactive indicators, is carried out with two kinds of apparatus, scanners and scintillation cameras. The information acquired may be accurately analysed at the same time owing to modern data processing systems. The interpretation of radiotracer lung transit curves made by several authors is not very useful for our work, consequently we have kept to the analysis of images obtained by the Anger camera or similar instruments. The Anger scintillation camera seems to be well suited to isotopic lung exploration providing morphological and functional data simultaneously. Perfusion lung scintigraphy, which reflects the quality of lung circulation at the capillary level, appears to be a valuable asset in the diagnostic approach to certain chest X-ray images. The technique is fast, painless, neat, harmless and almost never contra-indicated. However like other techniques it cannot solve every problem on its own. Under these conditions, we must admit, on weighing up the results of this study, that perfusion lung scintigraphy had to be followed in most cases by selective bronchial arteriography [fr

Pulmonary O2 transfer during pulsatile and non-pulsatile perfusion.

Science.gov (United States)

Hauge, A; Nicolaysen, G

1980-07-01

The importance of the perfusion pattern for the oxygen transfer has been examined in isolated rabbit lungs perfused with plasma at constant volume inflow. The lungs were ventilated with constant tidal volume and constant end-expiratory pressure. Following a standardized rise in FIO2 the rate of rise in pulmonary venous PO2 (delta PO2/delta t) was measured during alternately pulsatile and non-pulsatile perfusion in normal lungs and in lungs made edematous by elevation of left atrial pressure. In normal lungs there was no difference in delta PO2/delta t when the two modes of perfusion were compared. In edematous lungs delta PO/delta t was statistically higher during pulsatile perfusion, indicating a beneficial effect of flow- and pressure pulsations, e.g. a better distribution of V/Q ratios throughout the lungs. In a separate series of expts. the advancement of a high O2 front through the airways was measured, and the two perfusion patterns compared. Since no difference was found, we suggest that the phenomenon of "cardiogenic gas mixing" in the airways in vivo is a result of a direct action of the heart on the lungs rather than arterial pulsations.

Evaluation of mosaic pattern areas in HRCT with Min-IP reconstructions in patients with pulmonary hypertension: Could this evaluation replace lung perfusion scintigraphy?

International Nuclear Information System (INIS)

Rossi, A.; Attinà, D.; Borgonovi, A.; Buia, F.; De Luca, F.; Guidalotti, P.L.; Fughelli, P.; Galiè, N.; Zompatori, M.

2012-01-01

-segmental patchy defects, 5 with segmental defects) and homogeneous in LPS, in 5 cases inhomogeneous (1 with non-segmental patchy defects, 4 with segmental defects) in LPS images and homogeneous in Min-IP. In a general view, Min-IP reconstruction without contrast-medium showed a sensitivity of 100% and specificity of 96.1%, positive predictive value (PPV) of 92.3% and negative predictive value (NPV) of 100%, to recognize a pattern of lung attenuation inhomogeneous with segmental defects correspondent to a chronic thromboembolic condition, no false negative cases and three false positive cases; on the other hand LPS, on its own, showed a sensitivity of 91.67% and specificity of 93.51%, positive predictive value (PPV) of 86.84% and negative predictive value (NPV) of 96%, 3 false negative cases and 5 false positive cases. Conclusion: Min-IP obtained in HRCT without contrast-medium and in CTPA were equivalent. Min-IP images generally showed a higher sensitivity and specificity than LPS in the evaluation of lung perfusion regarding patients with pulmonary hypertension caused by different etiology, particularly in CTEPH patients. These results can be completed with the evaluation of HRCT and CTPA basal scans, providing more informations than ventilation/perfusion lung scintigraphy. HRCT images integrated by Min-IP reconstruction can represent the first step in the diagnostic algorithm of patients affected by dyspnoea and pulmonary hypertension of unknown causes, reserving the use of contrast-medium only in selected patients and reducing the patients’ X-ray-exposition.

A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

International Nuclear Information System (INIS)

Rhee, Chong Heon

1967-01-01

In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by 131 I-Macroaggregated albumin, lung inhalation scans by colloidal 198 Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5±2.82% to the right lung and 45.5±2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p 131 I-MAA in patients with pulmonary tuberculosis was as follows: a) In the pretreated minimal pulmonary tuberculosis, the decreased area of pulmonary arterial blood flow was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive than had been expected from the chest roentgenogram in the apparently healed minimal pulmonary tuberculosis. b) In the pretreated moderately advanced pulmonary tuberculosis, the decrease of pulmonary arterial blood flow to the diseased area was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive in the treated moderately advanced pulmonary tuberculosis as in the treated minimal pulmonary tuberculosis. c) Pulmonary arterial blood flow in the patients with far advanced pulmonary tuberculosis both before and after chemotherapy were almost similar to the chest roentgenogram. Especially the decrease of pulmonary arterial blood flow to the cavity was usually greater than had been expected from the chest roentgenogram. 3) Lung inhalation scan by colloidal 198 Au in patients with pulmonary tuberculosis was as follows: a) In the minimal pulmonary tuberculosis, lung inhalation scan showed almost similar decrease of radioactivity corresponding to the chest roentgenogram. b) In the moderately advanced pulmonary tuberculosis the decrease

Methodology for ventilation/perfusion SPECT

DEFF Research Database (Denmark)

Bajc, Marika; Neilly, Brian; Miniati, Massimo

2010-01-01

radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

Thallium-201 peripheral perfusion scans: feasibility of single-dose, single-day, rest and stress study

International Nuclear Information System (INIS)

Siegel, M.E.; Stewart, C.A.

1981-01-01

The distribution and redistribution kinetics of thallium-201 in the lower extremities were investigated to determine the relationships among the rest, stress, and delayed-stress perfusion studies. The distribution of perfusion when the tracer was administered at rest was compared with that when administered during stress, and the distribution 5--6 hr after the stress injection. The distribution was evaluated qualitatively by scanning and quantitatively by point counting. In nine of 10 subjects without peripheral vascular disease, the 5--6 poststress redistribution pattern was unchanged from the stress pattern and was different from the rest pattern. However, in all patients with peripheral vascular disease, the delayed poststress perfusion distribution had greater similarity to the rest pattern and was substantially different from that noted immediately after stress. Using the time frame of this study, the stress and delayed-stress 201 Tl perfusion study of the lower extremities cannot be used to represent true rest perfusion. However, because of the similarity of the delayed-stress to the true rest distribution in abnormals, it may be clinically useful in defining rest and stress alterations

Uptake of exogenous spermidine by rat lungs perfused in situ

International Nuclear Information System (INIS)

Rannels, D.E.; Addison, J.L.

1987-01-01

Uptake of the polyamine spermidine (SPD) from the pulmonary circulation was characterized by using ventilated rat lungs perfused in situ with Krebs-Henseleit-bicarbonate buffer containing 4.5% bovine serum albumin, 5.6 mM glucose, and 20 amino acids at plasma levels. [ 14 C]SPD was accumulated by the lungs in a time- and concentration-dependent manner. The pathway of SPD uptake exhibited saturation kinetics with an apparent K/sub m/ in the range of 1 μM and a V/sub max/ of 450-540 pmol/g lung min. SPD uptake was inhibited by the naturally occurring polyamines putrescine and spermine (SPM) and by the inhibitor of polyamine synthesis, methyglyoxal bis(guanylhydrazone) (MGBG). Inhibition of SPD uptake by SPM followed competitive kinetics; although MGBG was also a competitive inhibitor of SPD uptake, MGBG was less effective than SPM. These observations indicate that SPD is taken up from the pulmonary circulation by a carrier-mediated pathway that is inhibited by other natural polyamines and by MGBG and exhibits by other natural polyamines and by MGBG and exhibits substrate affinity in the range of plasma SPD concentrations

Uptake of exogenous spermidine by rat lungs perfused in situ

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Rannels, D.E.; Addison, J.L.

1987-01-01

Uptake of the polyamine spermidine (SPD) from the pulmonary circulation was characterized by using ventilated rat lungs perfused in situ with Krebs-Henseleit-bicarbonate buffer containing 4.5% bovine serum albumin, 5.6 mM glucose, and 20 amino acids at plasma levels. (/sup 14/C)SPD was accumulated by the lungs in a time- and concentration-dependent manner. The pathway of SPD uptake exhibited saturation kinetics with an apparent K/sub m/ in the range of 1 ..mu..M and a V/sub max/ of 450-540 pmol/g lung min. SPD uptake was inhibited by the naturally occurring polyamines putrescine and spermine (SPM) and by the inhibitor of polyamine synthesis, methyglyoxal bis(guanylhydrazone) (MGBG). Inhibition of SPD uptake by SPM followed competitive kinetics; although MGBG was also a competitive inhibitor of SPD uptake, MGBG was less effective than SPM. These observations indicate that SPD is taken up from the pulmonary circulation by a carrier-mediated pathway that is inhibited by other natural polyamines and by MGBG and exhibits by other natural polyamines and by MGBG and exhibits substrate affinity in the range of plasma SPD concentrations.

Studies on pulmonary ventilation-perfusion scintigraphy with Xe-133 in primary lung cancer, 1

International Nuclear Information System (INIS)

Oshibuchi, Masao

1984-01-01

Regional lung ventilation-perfusion scintigraphy by xenon gas was performed on 14 normal cases (normal group) and 86 cases of primary lung cancer (lung cancer group). The patients were measured in a sitting position using a scintillation camera. In normal group, the value of V, Q was higher in the lower lung field than in the upper lung field, the value of MTT was rather delayed in the upper lung field than in the lower lung field, proving to that lung clearance was better in the lower lung field than in the upper lung field. In lung cancer group, VQ match (pattern I, II) was 61 cases (71%) and VQ mismatch (pattern III, IV) was 25 cases (29%). The pattern II (VQ matched defect) accounted for 63% in lung cancer group. In this pattern, the region of disorder of V and Q was corresponded respectively, but disorder grade was not always accorded. The pattern III (normal V and disordered Q) was mainly seen in AH group (hilar type) and D group (lymph node swelling type). The V/Q in lung cancer group was widely distributed to the range of 0 to 5.8. The value of MTT was rather delayed in all cases of lung cancer group than in the normal group, because delayed MTT in focal lesion was markedly affected to whole lung. (author)

Assessment of pancreatic adenocarcinoma: use of low-dose whole pancreatic CT perfusion and individualized dual-energy CT scanning

International Nuclear Information System (INIS)

Li, Hai-ou; Guo, Jun; Li, Xiao; Qi, Yao-dong; Wang, Xi-ming; Xu, Zhuo-dong; Liu, Cheng; Chen, Jiu-hong

2015-01-01

The objective of this study was to investigate the value of low-dose whole pancreatic computed tomography (CT) perfusion integrated with individualized dual-energy CT (DECT) scanning in the diagnosis of pancreatic adenocarcinoma. Twenty patients with pancreatic adenocarcinoma underwent pancreatic CT perfusion as well as individualized dual-phase DECT pancreatic scans. Perfusion characteristics of non-tumourous pancreatic parenchyma and pancreatic adenocarcinoma were analysed. Weighted-average 120 kVp images and the optimal monoenergetic images in dual phase were reconstructed and the contrast noise ratio (CNR) of pancreas-to-tumour were compared. There were significant difference on blood flow as well as blood volume between pancreatic adenocarcinoma and the non-tumourous pancreatic parenchyma (P < 0.05), whereas no difference on permeability (P > 0.05). CNRs of pancreas-to-tumour in individualized pancreatic phase were significantly higher than those in venous phase (P < 0.05), and CNRs of optimal monoenergetic images were higher than those on weighted-average 120 kVp images (P < 0.05) in both phase. Total effective radiation dose of CT examination was around 9.32–13.75 mSv. Low-dose whole pancreatic CT perfusion can provide functional information, and the individualized pancreatic phase DECT scan is the optimal method for detecting pancreatic adenocarcinomas. The integration of the two techniques has great value in clinical application.

Comparison Between Postprocessing Software and Repeated Scanning to Eliminate Subdiaphragmatic Activity in Myocardial Perfusion Scintigraphy

International Nuclear Information System (INIS)

Theerakulpisut, Daris; Chotipanich, Chanisa

2016-01-01

Myocardial perfusion single photon emission computed tomography (SPECT) is a powerful test of evaluation for coronary artery disease, but subdiaphragmatic radiotracer activity often interferes with the interpretation of inferior wall findings. This study aims to evaluate the effectiveness of using software elimination of the subdiaphragmatic activity for the assessment of its efficacy in the correctness of image interpretation and the overall image quality of myocardial perfusion scintigraphy (MPS). MPS studies from January 2010 to October 2012 at our institution were reviewed. Thirty-two SPECT studies were included, all of which had significant subdiaphragmatic activity in the first scan and needed to be delayed to let the activity clear. Each scan was interpreted by using semiquantitative scoring in 17 segments according to the degree of radiotracer uptake. The first scan, which had interfering activity, was manipulated by masking out the unwanted activity with software native to our image processing software suite. The manipulated images were then compared with delayed images of the same patient, of which the subdiaphragmatic activity was spontaneously cleared with time. The first scan masked by software correlated with the delayed scan for myocardial regions supplied by the left circumflex (LCx) and right coronary artery (RCA), but not the left anterior descending (LAD). However, the quality of the masked scans was perceived by the observer to be better in terms of quality and ease of interpretation. Using software to mask out unwanted subdiaphragmatic activity has no detrimental effect on the interpretation of MPS images when compared with delayed scanning, but it can improve subjective scan quality and ease of interpretation

Two methods for isolating the lung area of a CT scan for density information

International Nuclear Information System (INIS)

Hedlund, L.W.; Anderson, R.F.; Goulding, P.L.; Beck, J.W.; Effmann, E.L.; Putman, C.E.

1982-01-01

Extracting density information from irregularly shaped tissue areas of CT scans requires automated methods when many scans are involved. We describe two computer methods that automatically isolate the lung area of a CT scan. Each starts from a single, operator specified point in the lung. The first method follows the steep density gradient boundary between lung and adjacent tissues; this tracking method is useful for estimating the overall density and total area of lung in a scan because all pixels within the lung area are available for statistical sampling. The second method finds all contiguous pixels of lung that are within the CT number range of air to water and are not a part of strong density gradient edges; this method is useful for estimating density and area of the lung parenchyma. Structures within the lung area that are surrounded by strong density gradient edges, such as large blood vessels, airways and nodules, are excluded from the lung sample while lung areas with diffuse borders, such as an area of mild or moderate edema, are retained. Both methods were tested on scans from an animal model of pulmonary edema and were found to be effective in isolating normal and diseased lungs. These methods are also suitable for isolating other organ areas of CT scans that are bounded by density gradient edges

Perfusion CT of the Brain and Liver and of Lung Tumors: Use of Monte Carlo Simulation for Patient Dose Estimation for Examinations With a Cone-Beam 320-MDCT Scanner.

Science.gov (United States)

Cros, Maria; Geleijns, Jacob; Joemai, Raoul M S; Salvadó, Marçal

2016-01-01

The purpose of this study was to estimate the patient dose from perfusion CT examinations of the brain, lung tumors, and the liver on a cone-beam 320-MDCT scanner using a Monte Carlo simulation and the recommendations of the International Commission on Radiological Protection (ICRP). A Monte Carlo simulation based on the Electron Gamma Shower Version 4 package code was used to calculate organ doses and the effective dose in the reference computational phantoms for an adult man and adult woman as published by the ICRP. Three perfusion CT acquisition protocols--brain, lung tumor, and liver perfusion--were evaluated. Additionally, dose assessments were performed for the skin and for the eye lens. Conversion factors were obtained to estimate effective doses and organ doses from the volume CT dose index and dose-length product. The sex-averaged effective doses were approximately 4 mSv for perfusion CT of the brain and were between 23 and 26 mSv for the perfusion CT body protocols. The eye lens dose from the brain perfusion CT examination was approximately 153 mGy. The sex-averaged peak entrance skin dose (ESD) was 255 mGy for the brain perfusion CT studies, 157 mGy for the lung tumor perfusion CT studies, and 172 mGy for the liver perfusion CT studies. The perfusion CT protocols for imaging the brain, lung tumors, and the liver performed on a 320-MDCT scanner yielded patient doses that are safely below the threshold doses for deterministic effects. The eye lens dose, peak ESD, and effective doses can be estimated for other clinical perfusion CT examinations from the conversion factors that were derived in this study.

Bone scanning in the evaluation of lung cancer

International Nuclear Information System (INIS)

Jung, Kun Sik; Zeon, Seok Kil; Lee, Hee Jung; Song, Hong Suk

1994-01-01

We studied the diagnostic significance of bone scan in evaluation of bone metastasis by lung cancer, prevalence rate, and the causes of false positive bone scan and soft tissue accumulation of bone seeking agent. This subject include 73 lung cancer patients with bone scan, We analyzed the frequency of the metastasis, its distribution and configuration, and any relationship between bone pain and corresponding region on bone scan. The positive findings of bone scans were compared with simple X-ray film, CT, MRI and other diagnostic modalities. The false positive bone scan and the soft tissue accumulation of bone seeking agent were analyzed. The positive findings on bone scan were noted in 26 cases(36%) and they were coexistent with bone pain in 30%. The correspondence between bone scan and bone X-ray was 38%. False positive bone scans were seen in 12 cases(16%), which include fracture due to thoracotomy and trauma, degenerative bone disease, and bifid rib. Accumulation of bone seeking agent in soft tissue were seen in 13 cases(18%), which included primary tumor, enlarged cervical lymph node, pleural effusion, ascites and pleural thickening. Bone scans should be carefully interpreted in detecting bone metastasis in primary malignancy, because of the 16% false positivity and 18% soft tissue accumulation rate. It is very important to note that the correlation between bone pain and positive findings of bone scans was only 38%

Bone scanning in the evaluation of lung cancer

Energy Technology Data Exchange (ETDEWEB)

Jung, Kun Sik; Zeon, Seok Kil; Lee, Hee Jung; Song, Hong Suk [School of Medicine, Keimyung University, Daegu (Korea, Republic of)

1994-05-15

We studied the diagnostic significance of bone scan in evaluation of bone metastasis by lung cancer, prevalence rate, and the causes of false positive bone scan and soft tissue accumulation of bone seeking agent. This subject include 73 lung cancer patients with bone scan, We analyzed the frequency of the metastasis, its distribution and configuration, and any relationship between bone pain and corresponding region on bone scan. The positive findings of bone scans were compared with simple X-ray film, CT, MRI and other diagnostic modalities. The false positive bone scan and the soft tissue accumulation of bone seeking agent were analyzed. The positive findings on bone scan were noted in 26 cases(36%) and they were coexistent with bone pain in 30%. The correspondence between bone scan and bone X-ray was 38%. False positive bone scans were seen in 12 cases(16%), which include fracture due to thoracotomy and trauma, degenerative bone disease, and bifid rib. Accumulation of bone seeking agent in soft tissue were seen in 13 cases(18%), which included primary tumor, enlarged cervical lymph node, pleural effusion, ascites and pleural thickening. Bone scans should be carefully interpreted in detecting bone metastasis in primary malignancy, because of the 16% false positivity and 18% soft tissue accumulation rate. It is very important to note that the correlation between bone pain and positive findings of bone scans was only 38%.

Usefulness of lung scanning in the evaluation of patients with pulmonary hypertension

International Nuclear Information System (INIS)

Powe, J.; McCarthy, K.; Palevsky, H.; Fishman, A.P.; Alavi, A.

1986-01-01

The ventilation-perfusion scans of 30 patients with pulmonary arterial hypertension and established final diagnoses were blindly classified as to the probability of showing pulmonary embolism. Eleven of 12 patients with primary pulmonary hypertension had normal or low-probability scans; one had an intermediate-probability scan. All six patients with thromboembolic pulmonary hypertension had high-probability scans. However, three of 12 patients with nonembolic secondary pulmonary hypetension also had high-probability scans. Although a normal or low-probability scan excludes the possibility of emboli as a cause, a high-probability scan may often be associated with nonembolic causes of secondary pulmonary hypertension

Production of lyophilized macroaggregated albumin (MAA) kits to be labelled with sup(99m)Tc for lung scanning

International Nuclear Information System (INIS)

Hamada, E.S.; Muramoto, E.; Brito, R.H.; Sosa de Pereira, N.P.; Almeida, M.A.T. de.

1991-06-01

Among the various macroaggregation procedures described in the literature, we have developed a rapid and reliable method for the routine production of lyophilized Sn-Macroaggregated Albumin (Sn-MAA) kits to be labelled with 99m Tc for lung perfusion scanning. The reaction vial contains a lyophilized suspension having the following components: 1,0mg of Aggregated Human Serum Albumin (MAA), 0,12mg of hydrated stannous chloride (SnCl 2 .2H 2 O), 5,0mg of Normal Human Serum Albumin (HSA) and 1% of Tween 80 as emulsifying agent. In this method the Sn-MAA kits were performed in a single step process, and a consistent suitable range of particle size (10-80 mu) was obtained. The size of the particles and the effect of storage time on the stability for the lyophilized kits were also investigated. The radiochemical purity, higher than 98% in 99m Tc Macroaggregated was determined by using ascending paper chromatography (Whatman n.3 and 85% methanol): biodistribution studies in rats have shown the high uptake in the lungs 85%/D with low liver uptake 2%/d and lung-liver ratios 98 ± 1%. Excellent human lung images for clinical practice were obtained with these kits, which are prepared at IPEN-CNEN/SP for brazilian physicians. (author)

Interactive lung segmentation in abnormal human and animal chest CT scans

International Nuclear Information System (INIS)

Kockelkorn, Thessa T. J. P.; Viergever, Max A.; Schaefer-Prokop, Cornelia M.; Bozovic, Gracijela; Muñoz-Barrutia, Arrate; Rikxoort, Eva M. van; Brown, Matthew S.; Jong, Pim A. de; Ginneken, Bram van

2014-01-01

Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in

Perfusion lung scintigraphy in primary broncho-pulmonary cancer

International Nuclear Information System (INIS)

Lapergue, Paul.

1976-01-01

Research on primary broncho-pulmonary cancer has called extensively on scintigraphy and it seemed interesting to weigh up the pros and cons of the technique in this particular case. Our intention is to sum up objectively from recent documents the applications of scintigraphy in the study of primary broncho-pulmonary cancers and to attempt, on the basis of the results compiled, to show what benefits have been gained from this technique and to find out whether it has any pre-surgical value and of what kind. The technique was invariable; the tracer consists of human albumin macro-aggregates labelled with technetium 99m which by its short half-life and slight penetration enables four exposures to be taken during the same examination (front, back, right and left profiles), thus reducing the risks of mistaken diagnoses due to the use of a single incidence. Similarly the detection method was always the scintillation camera which explores the whole organ at once, considerably shortening the examination time. Lung scintigraphy by perfusion of labelled human albumin macro-aggregates offers the great advantage of being simple to use and harmless. It is easy to understand the important place it has taken in the range of methods available for lung circulation exploration [fr

Lung scan alterations in congenital heart disease

Energy Technology Data Exchange (ETDEWEB)

Dietrich, R; Sanchez, J; Munoz, A; Lanaro, A E; Pico, A M

1975-04-01

This report analyzes the patterns in 54 lung scannings of 34 patients with altered pulmonary blood flow due to congenital heart disease. The technique and the results are presented. According to the images obtained, the patients are classified in three groups: Group I--normal distribution with more concentration of particles over the right lung and the bases. Group II--normal scannings found in left to right shunts unless there is pulmonary venous hypertension in which case the apex-base relationship was inverted. Group III--patients with right to left shunts of different types presenting various patterns according to severity, associated anomalies and palliative surgery. The hemodynamics created by cardiac defects and surgical procedures explain these alterations. This method is recommended in view of its advantages and accurate results.

Radioaerosol lung scanning in chronic obstructive pulmonary disease (COPD) and related disorders

International Nuclear Information System (INIS)

Yong Whee Bahk; Soo Kyo Chung

1994-01-01

As a coordinated research project of the International Atomic Energy Agency (IAEA), a multicentre joint study on radioaerosol lung scan using the BARC nebulizer has prospectively been carried out during 1988-1992 with the participation of 10 member countries in Asia [Bangladesh, China, India, Indonesia, Japan, Korea, Pakistan, Philippines, Singapore and Thailand]. The study was designed so that it would primarily cover chronic obstructive pulmonary disease (COPD) and the other related and common pulmonary diseases. The study also included normal controls and asymptomatic smokers. The purposes of this presentation are three fold: firstly, to document the usefulness of the nebulizer and the validity of user's protocol in imaging COPD and other lung diseases; secondly, to discuss scan features of the individual COPD and other disorders studied and thirdly, to correlate scan alterations with radiographic findings. Before proceeding with a systematic analysis of aerosol scan patterns in the disease groups, we documented normal pattern. The next step was the assessment of scan features in those who had been smoking for more than several years but had no symptoms or signs referable to airways. The lung diseases we analyzed included COPD [emphysema, chronic bronchitis, asthma and bronchiectasis], bronchial obstruction, compensatory overinflation and other common lung diseases such as lobar pneumonia, tuberculosis, interstitial fibrosis, diffuse panbronchiolitis, lung edema and primary and metastatic lung cancers. Lung embolism, inhalation bums and glue-sniffer's lung are separately discussed by Dr. Sundram of Singapore elsewhere in this book. The larger portion of this chapter is allocated to the discussion of COPD with a special effort made in sorting out differential scan features. Diagnostic criteria in individual COPD were defined for each category of disease and basic clinical symptoms and signs and pertinent laboratory data as well as radiographic manifestations are

Radioaerosol lung scanning in chronic obstructive pulmonary disease (COPD) and related disorders

Energy Technology Data Exchange (ETDEWEB)

Bahk, Yong Whee [Departments of Radiology and Nuclear Medicine, Kangnam St. Mary' s Hospital, Catholic University Medical College, Seoul (Korea, Republic of); Chung, Soo Kyo [Department of Nuclear Medicine, Kangnam St. Mary' s Hospital, Catholic University Medical College, Seoul (Korea, Republic of)

1994-07-01

As a coordinated research project of the International Atomic Energy Agency (IAEA), a multicentre joint study on radioaerosol lung scan using the BARC nebulizer has prospectively been carried out during 1988-1992 with the participation of 10 member countries in Asia [Bangladesh, China, India, Indonesia, Japan, Korea, Pakistan, Philippines, Singapore and Thailand]. The study was designed so that it would primarily cover chronic obstructive pulmonary disease (COPD) and the other related and common pulmonary diseases. The study also included normal controls and asymptomatic smokers. The purposes of this presentation are three fold: firstly, to document the usefulness of the nebulizer and the validity of user's protocol in imaging COPD and other lung diseases; secondly, to discuss scan features of the individual COPD and other disorders studied and thirdly, to correlate scan alterations with radiographic findings. Before proceeding with a systematic analysis of aerosol scan patterns in the disease groups, we documented normal pattern. The next step was the assessment of scan features in those who had been smoking for more than several years but had no symptoms or signs referable to airways. The lung diseases we analyzed included COPD [emphysema, chronic bronchitis, asthma and bronchiectasis], bronchial obstruction, compensatory overinflation and other common lung diseases such as lobar pneumonia, tuberculosis, interstitial fibrosis, diffuse panbronchiolitis, lung edema and primary and metastatic lung cancers. Lung embolism, inhalation bums and glue-sniffer's lung are separately discussed by Dr. Sundram of Singapore elsewhere in this book. The larger portion of this chapter is allocated to the discussion of COPD with a special effort made in sorting out differential scan features. Diagnostic criteria in individual COPD were defined for each category of disease and basic clinical symptoms and signs and pertinent laboratory data as well as radiographic manifestations are

Prediction of postoperative pulmonary function using 99mTc-MAA perfusion lung SPECT

International Nuclear Information System (INIS)

Hosokawa, Nobuyuki; Tanabe, Masatada; Satoh, Katashi; Takashima, Hitoshi; Ohkawa, Motoomi; Maeda, Masazumi; Tamai, Toyosato; Kojima, Kanji.

1995-01-01

In order to predict postoperative pulmonary function, 99m Tc-MAA perfusion lung SPECT and spirometry were performed preoperatively in 52 patients with resectable primary lung cancer; 44 underwent lobectomy, eight pneumonectomy. Local pulmonary function (called local effective volume) was evaluated according to the degree of radionuclide distribution of each voxel in the SPECT images. The total effective volume was defined as the sum of the local effective volume, and the residual effective volume was the total effective volume excluding loss after operation. Predicted pulmonary function (VC and FEV 1.0) was calculated by the following formula: Predicted value=preoperative value x percent of the residual effective volume. Postoperative pulmonary function was predicted in the same patients by means of 99m Tc-MAA perfusion lung planar scintigraphy and X-ray CT. The patients were reinvestigated with spirometry at one and four months after surgery, and the values were compared with the predicted values. The correlations between the predicted values using SPECT and measured postoperative pulmonary function were highly significant (VC: r=0.867, FEV1.0: r=0.864 one month after operation; VC: r=0.860, FEV1.0: r=0.907 4 months after operation). The predicted values calculated using SPECT were accurate compared with the predicted values calculated using planar scintigraphy or X-ray CT. The patients with predicted FEV1.0 of less than 0.8 liter required home oxygen therapy. This method is valuable for the prediction of postoperative pulmonary function before the surgical procedure. (author)

Nuclear magnetic resonance of perfused tissue

International Nuclear Information System (INIS)

Harpen, M.D.; Allison, R.C.

1986-01-01

The effect of perfusion on the NMR signal observed in NMR imaging is studied in a phantom and in two isolated perfused canine lungs. It is observed that perfusion in tissue has little effect on longitudinal relaxation times. Transverse relaxation rates are observed to correlate linearly with rates of perfusion, in accordance with a model presented. (author)

Lung scintigraphy

International Nuclear Information System (INIS)

Dalenz, Roberto.

1994-01-01

A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies

67Gallium citrate lung scans in interstitial lung disease

International Nuclear Information System (INIS)

Niden, A.H.; Mishkin, F.S.; Khurana, M.M.L.

1976-01-01

Patients with diffuse interstitial lung disease often require a lung biopsy to determine the diagnosis and proper therapy. However, once the diagnosis is established, clinical evaluation of symptoms, chest roentgenogram and pulmonary function testing are the only noninvasive means currently available to assess activity of the disease process and response to the therapy. Although these measures appear adequate in the presence of acute active disease in which response to therapy results in readily demonstrable changes in the above parameters, they may be insensitive to subtle changes that can occur in minimally active disease with slowly progressive interstitial pulmonary fibrosis over a period of years. A more sensitive noninvasive technique for identifying these cases with a smoldering diffuse interstitial inflammatory process might greatly improve our ability to effectively manage such patients. With this in mind, the value of gallium lung scan was investigated to assess its ability to predict inflammatory activity in such a clinical setting

Lung uptake in bone scan - Two case reports

International Nuclear Information System (INIS)

Nahar, N.; Kabir, F.; Islam, N.; Karim, M.A.

2001-01-01

Breast cancer is the 2nd most common cancer in female in our country. When a case of breast cancer is diagnosed a base line bone scan is asked for to exclude skeletal metastasis. This helps for treatment planning and future follow up. Scan pattern in bone metastasis is usually multiple, randomly distributed foci of intensely increased tracer accumulation. Uptake of radio pharmaceutical in breast tissue is frequently observed. Kidneys are another extra skeletal organs through which 99m Tc-MDP is excreted and that's why normal kidneys are faintly visualized in delayed views suggesting normal exertion of tracer. If there is any outflow obstruction in any kidney, it will show hold up of radiotracer on that side. Often radiopharmaceuticals are seen to accumulate in other organs like lungs. Here two cases of breast cancer are discussed where bone scan shows significant uptake of tracer in lungs

Value and pitfalls of the lateral lung scan

International Nuclear Information System (INIS)

Sy, W.M.; Krol, G.; Faunce, H.; Bay, R.

1975-01-01

Two hundred eighty-one of 443 lung scans composed of anterior, posterior, and lateral projections (done in our hospital) demonstrated defects. In 3.9 percent of them (11 cases), the defects were delineated in the lateral views only, while in 29.2 percent (82 cases), the lateral views either outlined additional defects not appreciated on the straight views, or showed more extensive lung involvement. In the majority of instances, 56.6 percent (159 cases), the lateral views showed comparable findings and also tended to segmentally localize the defects better. However, in 10.3 percent (29 cases), defects present on the straight projections were not detected on the lateral views. Various causes that could give rise to artefactual abnormalities in the lateral lung scan and therefore inhibit its proper interpretation are reviewed and discussed. Despite these problems, the lateral may be the only view to demonstrate abnormalities and, in fact, frequently provides additional useful information

Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice

International Nuclear Information System (INIS)

Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

2014-01-01

In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retrospectively collected. Planar V/Q images were interpreted according to 0.5 segment mismatch criteria and revised PIOPED II criteria and perfusion scans according to PISA-PED criteria. V/Q SPECT images were interpreted according to the criteria suggested in EANM guidelines. Final diagnosis of PE was based on the clinical decision of an attending physician and evaluation of a 12 months follow-up period. Using 0.5 segment mismatch criteria and revised PIOPED II, planar V/Q scans were diagnostic in 93% and 84% of cases, respectively. Among the diagnostic planar scans readings specificity for 0.5 segment mismatch criteria was 98%, and 99% for revised PIOPED II criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without any non-diagnostic cases. In patients with low pretest probability for PE, planar V/Q scans assessed by 0.5 segment mismatch criteria were diagnostic in 92%, and in 85% using revised PIOPED II criteria, while perfusion scintigraphy without ventilation scans was diagnostic in 80%. Lung scintigraphy yielded diagnostically definitive results and is reliable in ruling out PE in patients from ED. V/Q SPECT has excellent specificity and sensitivity without any non-diagnostic results. Percentage of non-diagnostic results in planar lung scintigraphy is considerably smaller when 0.5 segment mismatch criteria instead of revised PIOPED II criteria are used. Diagnostic value of perfusion scintigraphy according to PISA-PED criteria is inferior to combined V/Q scintigraphy; the difference is

Lung perfusion characteristics in pulmonary arterial hypertension (PAH) and peripheral forms of chronic thromboembolic pulmonary hypertension (pCTEPH): Dual-energy CT experience in 31 patients

Energy Technology Data Exchange (ETDEWEB)

Giordano, Jessica; Khung, Suonita; Remy, Jacques; Remy-Jardin, Martine [Hospital Calmette (EA 2694), Department of Thoracic Imaging, Lille (France); Duhamel, Alain [University Lille, CHU Lille, Department of Biostatistics, Lille (France); Hossein-Foucher, Claude; Bellevre, Dimitri [University Lille, CHU Lille, Department of Nuclear Medicine, Hospital Salengro, Lille (France); Lamblin, Nicolas [University Lille, CHU Lille, Department of Cardiology, Cardiology Hospital, Lille (France)

2017-04-15

To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations. Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alterations were analysed at a segmental level. V/Q scintigraphy was available in 22 patients (group 1: 13/19; group 2: 9/12). CT perfusion was abnormal in 52.6 % of group 1 patients and in 100 % of group 2 patients (p = 0.0051). The patterns of perfusion alteration significantly differed between the two groups (p < 0.0001): (1) in group 1, 96.6 % of segments with abnormal perfusion showed patchy defects; (2) in group 2, the most frequent abnormalities consisted of patchy (58.5 %) and PE-type (37.5 %) defects. Paired comparison of CT perfusion and scintigraphy showed concordant findings in 76.9 % of group 1 (10/13) and 100 % of group 2 (9/9) patients, with a predominant or an exclusive patchy pattern in group 1 and a mixed pattern of abnormalities in group 2. Lung perfusion alterations at DECT are less frequent and more homogeneous in PAH than in pCTEPH, with a high level of concordant findings with V/Q scintigraphy. (orig.)

Spectral imaging technique for retinal perfusion detection using confocal scanning laser ophthalmoscopy

Science.gov (United States)

Rasta, Seyed Hossein; Manivannan, Ayyakkannu; Sharp, Peter F.

2012-11-01

To evaluate retinal perfusion in the human eye, a dual-wavelength confocal scanning laser ophthalmoscope (cSLO) was developed that provides spectral imaging of the fundus using a combination of red (670 nm) and near-infrared (810 nm) wavelengths. The image of the ocular fundus was analyzed to find out if quantitative measurements of the reflectivity of tissue permit assessment of the oxygen perfusion of tissue. We explored problems that affect the reproducibility of patient measurements such as non-uniformity errors on the image. For the first time, an image processing technique was designed and used to minimize the errors of oxygen saturation measurements by illumination correction in retina wide field by increasing SNR. Retinal images were taken from healthy and diabetic retinopathy eyes using the cSLO with a confocal aperture of 100 μm. The ratio image (RI) of red/IR, as oxygen saturation (SO2) index, was calculated for normal eyes. The image correction technique improved the reproducibility of the measurements. Average RI intensity variation of healthy retina tissue was determined within a range of about 5.5%. The capability of the new technique to discriminate oxygenation levels of retinal artery and vein was successfully demonstrated and showed good promise in the diagnosis of the perfused retina.

Isolated lung perfusion with gemcitabine for the treatment of pulmonary metastases : Experimental study in a rat model

NARCIS (Netherlands)

Putte, B.P. van

2003-01-01

Isolated lung perfusion is an experimental surgical technique for the treatment of pulmonary metastases in order to improve the current 5-year survival of approximately 40 % after surgical resection of manually palpable metastases. Several drugs have been tested in animals models and five phase I

Removal of atrial natriuretic factor by perfused rabbit lungs in situ

International Nuclear Information System (INIS)

Turrin, M.; Maack, T.; Gillis, C.N.

1986-01-01

Because atrial natriuretic factor (ANF) can be released from the right atrium into pulmonary blood, the authors studied the possibility of uptake of the peptide by rabbit lung, perfused in situ, at 20 ml/min with Krebs-albumin medium. Single pass removal (multiple indicator dilution with 14 C-dextran as reference) of trace amounts (40 pmoles) of 125 I-ANF was 66 +/- 4% (n=12). This was reduced to 8 +/- 4% by co-injection of 10 μM ANF but was unchanged by co-injection of CPAP (340 nM), an inhibitor of angiotensin-converting enzyme (ACE). When 125 I-ANF was re-circulated through lung, uptake reached maximum at 14 min (64 +/- 5%; n=7). Efflux of 125 I-ANF from preloaded lungs was monoexponential with t/sub 1/2/ = 17.7 min. Recovery of 125 I-ANF uptake after block by unlabelled ANF was studied. For this purpose, lungs were loaded with 0.1 μM unlabelled ANF by recirculating for 20 minutes, after which medium was changed to Krebs-albumin and removal of bolus injections of 125 I-ANF was measured every 5 min. Removal of 125 I-ANF, initially 0%, returned to control levels after 20 min. Thus, 125 I-ANF is removed from the pulmonary circulation by a saturable and reversible process which probably does not involve binding to the ACE present on endothelial cells

Using the fourth dimension to distinguish between structures for anisotropic diffusion filtering in 4D CT perfusion scans

NARCIS (Netherlands)

Mendrik, AM; Vonken, EPA; Witkamp, TD; Prokop, Mathias; Van Ginneken, Bram; Viergever, Max A.

2015-01-01

High resolution 4D (3D+time) cerebral CT perfusion (CTP) scans can be used to create 3D arteriograms (showing only arteries) and venograms (only veins). However, due to the low X-ray radiation dose used for acquiring the CTP scans, they are inherently noisy. In this paper, we propose a time

Relative preservation of peripheral lung function in smoking-related pulmonary emphysema: assessment with 99mTc-MAA perfusion and dynamic 133Xe SPET

International Nuclear Information System (INIS)

Suga, Kazuyoshi; Kume, Norihiko; Matsunaga, Naofumi; Ogasawara, Nobuhiko; Motoyama, Kazumi; Hara, Akiko; Matsumoto, Tsuneo

2000-01-01

In this study the cross-sectional functional differences between the central and peripheral lung in smokers with pulmonary emphysema were evaluated by lung perfusion and dynamic xenon-133 single-photon emission tomography (SPET). The subjects were 81 patients with a long-term smoking history and relatively advanced emphysema, 17 non-smoker patients with non-obstructive lung diseases and six healthy non-smokers. Regional lung functional difference between the peripheral and central lung was assessed in the upper, middle and lower lung zones by technetium-99m macroaggregated albumin SPET and dynamic 133 Xe SPET. The distribution of emphysematous changes was assessed by density-mask computed tomography (CT) images which depicted abnormally low attenuation areas (LAAs) of less than -960 Hounsfield units. Two hundred and eighty-eight (59.2%) lung zones of 63 (77.7%) patients with pulmonary emphysema showed relative preservation of lung function in the peripheral lung, with a curvilinear band of normal perfusion (a stripe sign) and a significantly faster 133 Xe half-clearance time (T 1/2 ) than in central lung (P 1/2 in the peripheral lung area (P 1/2 values and LAA distributions between the central and peripheral lung. Relative preservation of peripheral lung function seems to be a characteristic feature in smoking-related pulmonary emphysema, and may indicate a lower susceptibility of peripheral parenchyma to the development of this disease. (orig.)

Hepatic Arterial Perfusion Scintigraphy with '99mTc-Macroaggregated Albumin in Hepatocellular Carcinoma

International Nuclear Information System (INIS)

Kim, Gang Deuk; Sohn, Kwang Joon; Min, Kyung Yoon; Kwon, Young Mi; Kim, Chang Guhn; Noh, Byung Suk; Won, Jong Jin

1994-01-01

Hepatic arterial perfusion scintigraphy with '9 9m Tc macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma (HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and use fullness of HAPS. HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4 5 mCi of MAA mixed with 2 ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1 ml/sec. We analysed 21 HCCs over 2 cm in diameter(average diameter: 6.4 cm) and 17 of 21 HCCs were over 4 cm in diameter. CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Three different pattern of tumor perfusion were observed in 16 patients with HCC. 1) diffuse increased perfusion in 16 of 21(76%) 2) increased peripheral perfusion in 4 of 21(19%) 3) diffuse decreased perfusion in 1 of 21 (5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16 (56% ). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16 (13%). There was no accumulation of radioactivity on RRC blood pool scan in all six patients with HCC examined. HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.

Quantative pre-surgical lung function estimation with SPECT/CT

International Nuclear Information System (INIS)

Bailey, Dale L.; Timmins, Sophi; Harris, Benjamin E.; Bailey, Elizabeth A.; Roach, Paul J.; Willowson, Kathy P.

2009-01-01

Full text: Objectives: To develop methodology to predict lobar lung function based on SPECT/CT ventilation 6 k perfusion (V/Q) scanning in candidates for lobectomy for lung cancer. This combines two development areas from our group: quantitative SPECT based on CT-derived corrections for scattering and attenuation of photons, and SPECT V/Q scanning with lobar segmentation from CT Six patients underwent baseline pulmonary function testing (PFT) including spirometry, measurement of DLCO and cardio-pulmonary exercise testing. A SPECT/CT V/Q scan was acquired at baseline. Using in-house software each lobe was anatomically defined using CT to provide lobar ROIs which could be applied to the SPECT data. From these, individual lobar contribution to overall function was calculated from counts within the lobe and post-operative FEVl, DLCO and V02 peak were predicted. This was compared with the quantitative planar scan method using 3 rectangular ROIs over each lung.

Relative preservation of peripheral lung function in smoking-related pulmonary emphysema: assessment with {sup 99m}Tc-MAA perfusion and dynamic {sup 133}Xe SPET

Energy Technology Data Exchange (ETDEWEB)

Suga, Kazuyoshi; Kume, Norihiko; Matsunaga, Naofumi; Ogasawara, Nobuhiko; Motoyama, Kazumi; Hara, Akiko; Matsumoto, Tsuneo [Department of Radiology, Yamaguchi University School of Medicine, Ube, Yamaguchi (Japan)

2000-07-01

In this study the cross-sectional functional differences between the central and peripheral lung in smokers with pulmonary emphysema were evaluated by lung perfusion and dynamic xenon-133 single-photon emission tomography (SPET). The subjects were 81 patients with a long-term smoking history and relatively advanced emphysema, 17 non-smoker patients with non-obstructive lung diseases and six healthy non-smokers. Regional lung functional difference between the peripheral and central lung was assessed in the upper, middle and lower lung zones by technetium-99m macroaggregated albumin SPET and dynamic {sup 133}Xe SPET. The distribution of emphysematous changes was assessed by density-mask computed tomography (CT) images which depicted abnormally low attenuation areas (LAAs) of less than -960 Hounsfield units. Two hundred and eighty-eight (59.2%) lung zones of 63 (77.7%) patients with pulmonary emphysema showed relative preservation of lung function in the peripheral lung, with a curvilinear band of normal perfusion (a stripe sign) and a significantly faster {sup 133}Xe half-clearance time (T{sub 1/2}) than in central lung (P<0.0001). Of these lung zones, 256 (88.8%) showed central-dominant LAA distributions on density-mask CT images, but the remaining 32 zones did not show any regional preference in LAA distribution. Conversely, 117 (24.0%) lung zones of 19 (23.4%) patients showed periphery-dominant perfusion defects and LAA distributions, with significantly prolonged T{sub 1/2} in the peripheral lung area (P<0.0001). The remaining 81 lung zones of the patients with pulmonary emphysema and all the lung zones of the healthy subjects and patients with non-obstructive lung diseases did not show a stripe sign, and no differences were observed in T{sub 1/2} values and LAA distributions between the central and peripheral lung. Relative preservation of peripheral lung function seems to be a characteristic feature in smoking-related pulmonary emphysema, and may indicate a

Correlation of the perfusion scintigram with pulmonary functions in chronic obstructive pulmonary disease

Energy Technology Data Exchange (ETDEWEB)

Uchida, Kou; Ashitaka, Tsuyoshi; Uchibori, Shigeyasu [Toho Univ., Tokyo (Japan). School of Medicine; Takano, Masaaki

1992-11-01

The authors carried out ventilation-perfusion scintigraphy and pulmonary function tests in 21 patients with chronic obstructive pulmonary disease. It was used [sup 99m]Tc-macroaggregate for perfusion scintigram and [sup 133]Xe gas for ventilation scintigram. It was added the radioactivities of rebreathing phase and made lung volume image using a computer. Regions of interest (ROIs) were derived from radioactivities in each image. ROIs on lung volume image included each whole lung and those on perfusion image included the areas which had relatively high radioactivity. The authors counted the area of ROIs on lung volume (L) and perfusion (P) images. Then it was used the ratio of perfusion to lung volume (P/L) as a parameter of pulmonary perfusion. P/L had the significant correlations with the vital capacity, the actual FFV[sub 1.0], arterial oxygen partial pressure, diffusing capacity, RV/TLC and peak flow rate. These results suggested that P/L was a useful parameter of pulmonary perfusion in chronic obstructive pulmonary disease. (author).

A new positive pressure ventilation delivery system: its impact on lung ventilation studies that are technically inadequate or non diagnostic

International Nuclear Information System (INIS)

Bui, C.; Leiper, C.; Lee, K.; Saunders, C.; Dixson, H.; Elison, B.; Bennett, G.; Gibian, T.; Rutland, J.; Tse, V.; Elzein, H.; Babicheva, R.

2000-01-01

Full text: The objective of this study was to evaluate the efficacy and safety of an improved Positive Pressure Ventilation Delivery System (PVDS) in the investigation of Pulmonary Embolism (PE). The major component of PVDS is a commercially available, self-inflating 1.6L Hudson Resuscitator Bag, filled with either oxygen or air (if the patient has CO 2 retention), which is squeezed by the operator to push Technegas from the Technegas Generator Chamber to the patient via the Patient Administration Set synchronously with patient inspiration. 27 spontaneously breathing in-patients (12 males, 15 females, age range 64-89, 21 with chronic airflow limitation), whose conventional lung ventilation images were technically inadequate or non diagnostic, were re-scanned using PVDS within four days after the conventional ventilation study. Randomised blinded visual interpretation of conventional ventilation/perfusion scan vs. PVDS-assisted ventilation/perfusion scan was performed by consensus reading with two experienced observers. In conclusion PVDS was safe and well tolerated. PVDS improved the image quality of the lung ventilation scans in this cohort of patients. This technique has the potential to improve the accuracy of lung scanning in patients with severe lung disease. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

Evaluation of 99mTc(CO)5I as a potential lung perfusion agent

International Nuclear Information System (INIS)

Miroslavov, Alexander E.; Gorshkov, Nikolay I.; Lumpov, Alexander L.; Yalfimov, Anatoly N.; Suglobov, Dmitrii N.; Ellis, Beverley L.; Braddock, Rattana; Smith, Anne-Marie; Prescott, Mary C.; Lawson, Richard S.; Sharma, Harbans L.

2009-01-01

Introduction: The use of 99m Tc-macroggregated albumin for lung perfusion imaging is well established in nuclear medicine. However, there have been safety concerns over the use of blood-derived products because of potential contamination by infective agents, for example, Variant Creutzfeldt Jakob Disease. Preliminary work has indicated that Tc(CO) 5 I is primarily taken up in the lungs following intravenous administration. The aim of this study was to evaluate the biodistribution and pharmacokinetics of 99m Tc(CO) 5 I and its potential as a lung perfusion agent. Methods: 99m Tc(CO) 5 I was synthesized by carbonylation of 99m TcO 4- at 160 atm of CO at 170 deg. C in the presence of HI for 40 min. Radiochemical purity was determined by HPLC using 99 Tc(CO) 5 I as a reference. 99m Tc(CO) 5 I was administered by ear-vein injection to three chinchilla rabbits, and dynamic images were acquired using a gamma camera (Siemens E-cam) over 20 min. Imaging studies were also performed with 99m Tc-labeled macroaggregated albumin ( 99m Tc-MAA) and 99m TcO 4- for comparison. 99m Tc(CO) 5 I was administered intravenously to Sprague-Dawley rats, and tissue distribution studies were obtained at 15 min and 1 h postinjection. Comparative studies were performed using 99m Tc-MAA. Results: Radiochemical purity, assessed by HPLC, was 98%. The retention time was similar to that of 99 Tc(CO) 5 I. The dynamic images showed that 70% of 99m Tc(CO) 5 I appeared promptly in the lungs and remained constant for at least 20 min. In contrast, 99m TcO 4- rapidly washed out of the lungs after administration. As expected 99m Tc-MAA showed 90% lung accumulation. The percentage of injected dose per gram of organ ±S.D. at 1 h for 99m Tc(CO) 5 I was as follows: blood, 0.22±0.02; lung, 12.8±2.87; liver, 0.8±0.15; heart, 0.15±0.01; kidney, 0.47±0.08. The percentage of injected dose per organ ±S.D. at 1 h was as follows: lung, 22.47±2.31; liver, 10.53±1.8; heart, 0.18±0.01; kidney, 1.2±0.17. Tissue

High resolution CT in cystic fibrosis--the contribution of expiratory scans

International Nuclear Information System (INIS)

Dorloechter, Ludger; Nes, Harald; Fluge, Gjermund; Rosendahl, Karen

2003-01-01

Introduction: The use of high-resolution computed tomography (HRCT) is well accepted as an accurate method for evaluation of lung parenchyma in cystic fibrosis (CF). Several scoring methods exist and, in common, all are based on HRCT findings during inspiration alone. Objective: To examine whether expiratory HRCT scans could add information about the degree of mosaic perfusion in patients with CF. Methods and patients: Pulmonary HRCT was performed in 17 CF patients (median age of 12 years) with 1-mm thin sections and 10-mm intervals during inspiration, followed by 1-mm thin sections with 20-mm intervals during expiration. HRCT was scored by using a modified Bhalla method. Results: The mean HRCT score was 8.2. Out of 17 patients, 11 (65%) demonstrated a pathological mosaic perfusion in expiration, while only three patients showed mosaic perfusion in inspiration. The degree of expiratory mosaic perfusion was graded as severe in nine patients and moderate in two patients. There was a significant correlation between our modified HRCT score and lung function, as measured by forced expiratory volume in 1 s (FEV1% predicted, P<0.01). Conclusion: Mosaic perfusion in expiration was a common pathological HRCT finding in our study group. The clinical significance of this finding needs further evaluation

/sup 67/Gallium citrate lung scans in interstitial lung disease

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Niden, A.H.; Mishkin, F.S.; Khurana, M.M.L.

1976-02-01

Patients with diffuse interstitial lung disease often require a lung biopsy to determine the diagnosis and proper therapy. However, once the diagnosis is established, clinical evaluation of symptoms, chest roentgenogram and pulmonary function testing are the only noninvasive means currently available to assess activity of the disease process and response to the therapy. Although these measures appear adequate in the presence of acute active disease in which response to therapy results in readily demonstrable changes in the above parameters, they may be insensitive to subtle changes that can occur in minimally active disease with slowly progressive interstitial pulmonary fibrosis over a period of years. A more sensitive noninvasive technique for identifying these cases with a smoldering diffuse interstitial inflammatory process might greatly improve our ability to effectively manage such patients. With this in mind, the value of gallium lung scan was investigated to assess its ability to predict inflammatory activity in such a clinical setting.

Dynamic volume perfusion CT in patients with lung cancer: Baseline perfusion characteristics of different histological subtypes

International Nuclear Information System (INIS)

Shi, Jingyun; Schmid-Bindert, Gerald; Fink, Christian; Sudarski, Sonja; Apfaltrer, Paul; Pilz, Lothar R.; Liu, Bo; Haberland, Ulrike; Klotz, Ernst

2013-01-01

Objective: To evaluate dynamic volume perfusion CT (dVPCT) tumor baseline characteristics of three different subtypes of lung cancer in untreated patients. Materials and methods: 173 consecutive patients (131 men, 42 women; mean age 61 ± 10 years) with newly diagnosed lung cancer underwent dVPCT prior to biopsy. Tumor permeability, blood flow (BF), blood volume (BV) and mean transit time (MTT) were quantitatively assessed as well as tumor diameter and volume. Tumor subtypes were histologically determined and compared concerning their dVPCT results. dVPCT results were correlated to tumor diameter and volume. Results: Histology revealed adenocarcinoma in 88, squamous cell carcinoma in 54 and small cell lung cancer (SCLC) in 31 patients. Tumor permeability was significantly differing between adenocarcinoma, squamous cell carcinoma and SCLC (all p < 0.05). Tumor BF and BV were higher in adenocarcinomathan in SCLC (p = 0.001 and p = 0.0002 respectively). BV was also higher in squamous cell carcinoma compared to SCLC (p = 0.01). MTT was not differing between tumor subtypes. Regarding all tumors, tumor diameter did not correlate with any of the dVPCT parameters, whereas tumor volume was negatively associated with permeability, BF and BV (r = −0.22, −0.24, −0.24, all p < 0.05). In squamous cell carcinoma, tumor diameter und volume correlated with BV (r = 0.53 and r = −0.40, all p < 0.05). In SCLC, tumor diameter und volume correlated with MTT (r = 0.46 and r = 0.39, all p < 0.05). In adenocarcinoma, no association between morphological and functional tumor characteristics was observed. Conclusions: dVPCT parameters are only partially related to tumor diameter and volume and are significantly differing between lung cancer subtypes

Pyrrolidine dithiocarbamate administered during ex-vivo lung perfusion promotes rehabilitation of injured donor rat lungs obtained after prolonged warm ischemia.

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Cyril Francioli

Full Text Available Damaged lung grafts obtained after circulatory death (DCD lungs and warm ischemia may be at high risk of reperfusion injury after transplantation. Such lungs could be pharmacologically reconditioned using ex-vivo lung perfusion (EVLP. Since acute inflammation related to the activation of nuclear factor kappaB (NF-κB is instrumental in lung reperfusion injury, we hypothesized that DCD lungs might be treated during EVLP by pyrrolidine dithiocarbamate (PDTC, an inhibitor of NF-κB. Rat lungs exposed to 1h warm ischemia and 2 h cold ischemia were subjected to EVLP during 4h, in absence (CTRL group, N = 6 or in presence of PDTC (2.5g/L, PDTC group, N = 6. Static pulmonary compliance (SPC, peak airway pressure (PAWP, pulmonary vascular resistance (PVR, and oxygenation capacity were determined during EVLP. After EVLP, we measured the weight gain of the heart-lung block (edema, and the concentration of LDH (cell damage, proteins (permeability edema and of the cytokines IL-6, TNF-α and CINC-1 in bronchoalveolar lavage (BAL, and we evaluated NF-κB activation by the degree of phosphorylation and degradation of its inhibitor IκBα in lung tissue. In CTRL, we found significant NF-κB activation, lung edema, and a massive release of LDH, proteins and cytokines. SPC significantly decreased, PAWP and PVR increased, while oxygenation tended to decrease. Treatment with PDTC during EVLP inhibited NF-κB activation, did not influence LDH release, but markedly reduced lung edema and protein concentration in BAL, suppressed TNFα and IL-6 release, and abrogated the changes in SPC, PAWP and PVR, with unchanged oxygenation. In conclusion, suppression of innate immune activation during EVLP using the NF-κB inhibitor PDTC promotes significant improvement of damaged rat DCD lungs. Future studies will determine if such rehabilitated lungs are suitable for in vivo transplantation.

Removal of atrial natriuretic factor by perfused rabbit lungs in situ

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Turrin, M.; Maack, T.; Gillis, C.N.

1986-03-05

Because atrial natriuretic factor (ANF) can be released from the right atrium into pulmonary blood, the authors studied the possibility of uptake of the peptide by rabbit lung, perfused in situ, at 20 ml/min with Krebs-albumin medium. Single pass removal (multiple indicator dilution with /sup 14/C-dextran as reference) of trace amounts (40 pmoles) of /sup 125/I-ANF was 66 +/- 4% (n=12). This was reduced to 8 +/- 4% by co-injection of 10 ..mu..M ANF but was unchanged by co-injection of CPAP (340 nM), an inhibitor of angiotensin-converting enzyme (ACE). When /sup 125/I-ANF was re-circulated through lung, uptake reached maximum at 14 min (64 +/- 5%; n=7). Efflux of /sup 125/I-ANF from preloaded lungs was monoexponential with t/sub 1/2/ = 17.7 min. Recovery of /sup 125/I-ANF uptake after block by unlabelled ANF was studied. For this purpose, lungs were loaded with 0.1 ..mu..M unlabelled ANF by recirculating for 20 minutes, after which medium was changed to Krebs-albumin and removal of bolus injections of /sup 125/I-ANF was measured every 5 min. Removal of /sup 125/I-ANF, initially 0%, returned to control levels after 20 min. Thus, /sup 125/I-ANF is removed from the pulmonary circulation by a saturable and reversible process which probably does not involve binding to the ACE present on endothelial cells.

Effect of endobronchial valve therapy on pulmonary perfusion and ventilation distribution.

Directory of Open Access Journals (Sweden)

Carmen Pizarro

Full Text Available Endoscopic lung volume reduction (ELVR is an emerging therapy for emphysematous COPD. However, any resulting changes in lung perfusion and ventilation remain undetermined. Here, we report ELVR-mediated adaptations in lung perfusion and ventilation, as investigated by means of pulmonary scintigraphy.In this observational study, we enrolled 26 patients (64.9 ± 9.4 yrs, 57.7% male with COPD heterogeneous emphysema undergoing ELVR with endobronchial valves (Zephyr, Pulmonx, Inc.. Mean baseline FEV1 and RV were 32.9% and 253.8% predicted, respectively. Lung scintigraphy was conducted prior to ELVR and eight weeks thereafter. Analyses of perfusion and ventilation shifts were performed and complemented by correlation analyses between paired zones.After ELVR, target zone perfusion showed a mean relative reduction of 43.32% (p<0.001, which was associated with a significant decrease in target zone ventilation (p<0.001. Perfusion of the contralateral untreated zone and of the contralateral total lung exhibited significant increases post-ELVR (p = 0.002 and p = 0.005, respectively; both correlated significantly with the corresponding target zone perfusion adaptations. Likewise, changes in target zone ventilation correlated significantly with ventilatory changes in the contralateral untreated zone and the total contralateral lung (Pearson's r: -0.42, p = 0.04 and Pearson's r: -0.42, p = 0.03, respectively. These effects were observed in case of clinical responsiveness to ELVR, as assessed by changes in the six-minute walk test distance.ELVR induces a relevant decrease in perfusion and ventilation of the treated zone with compensatory perfusional and ventilatory redistribution to the contralateral lung, primarily to the non-concordant, contralateral zone.

Volume Adjustment of Lung Density by Computed Tomography Scans in Patients with Emphysema

International Nuclear Information System (INIS)

Shaker, S.B.; Dirksen, A.; Laursen, L.C.; Skovgaard, L.T.; Holstein-Rathlou, N.H.

2004-01-01

Purpose: To determine how to adjust lung density measurements for the volume of the lung calculated from computed tomography (CT) scans in patients with emphysema. Material and Methods: Fifty patients with emphysema underwent 3 CT scans at 2-week intervals. The scans were analyzed with a software package that detected the lung in contiguous images and subsequently generated a histogram of the pixel attenuation values. The total lung volume (TLV), lung weight, percentile density (PD), and relative area of emphysema (RA) were calculated from this histogram. RA and PD are commonly applied measures of pulmonary emphysema derived from CT scans. These parameters are markedly influenced by changes in the level of inspiration. The variability of lung density due to within-subject variation in TLV was explored by plotting TLV against PD and RA. Results: The coefficients for volume adjustment for PD were relatively stable over a wide range from the 10th to the 80th percentile, whereas for RA the coefficients showed large variability especially in the lower range, which is the most relevant for quantitation of pulmonary emphysema. Conclusion: Volume adjustment is mandatory in repeated CT densitometry and is more robust for PD than for RA. Therefore, PD seems more suitable for monitoring the progression of emphysema

Loss of lung function after chemo-radiotherapy for NSCLC measured by perfusion SPECT/CT: Correlation with radiation dose and clinical morbidity

DEFF Research Database (Denmark)

Farr, Katherina P; Møller, Ditte S; Khalil, Azza A

2015-01-01

BACKGROUND: The purpose of the study was to assess dose and time dependence of radiotherapy (RT)-induced changes in regional lung function measured with single photon emission computed tomography (SPECT) of the lung and relate these changes to the symptomatic endpoint of radiation pneumonitis (RP......) in patients treated for non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: NSCLC patients scheduled to receive curative RT of minimum 60 Gy were included prospectively in the study. Lung perfusion SPECT/CT was performed before and three months after RT. Reconstructed SPECT/CT data were registered...

Assessment of pulmonary parenchyma perfusion with FAIR in comparison with DCE-MRI-Initial results

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Fan Li [Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003 (China)], E-mail: fanli0930@163.com; Liu Shiyuan [Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003 (China); Sun Fei [GE Healthcare China (China)], E-mail: Fei.sun@med.ge.com; Xiao Xiangsheng [Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003 (China)], E-mail: lizhaobin79@163.com

2009-04-15

Objective: The aim of this study was to assess pulmonary parenchyma perfusion with flow-sensitive alternating inversion recovery (FAIR) in comparison with 3D dynamic contrast-enhanced (DCE) imaging in healthy volunteers and in patients with pulmonary embolism or lung cancer. Materials and methods: Sixteen healthy volunteers and 16 patients with pulmonary embolism (5 cases) or lung cancer (11 cases) were included in this study. Firstly, the optimized inversion time of FAIR (TI) was determined in 12 healthy volunteers. Then, FAIR imaging with the optimized TI was performed followed by DCE-MRI on the other 4 healthy volunteers and 16 patients. Tagging efficiency of lung and SNR of perfusion images were calculated with different TI values. In the comparison of FAIR with DCE-MRI, the homogeneity of FAIR and DCE-MRI perfusion was assessed. In the cases of perfusion abnormality, the contrast between normal lung and perfusion defects was quantified by calculating a normalized signal intensity ratio. Results: One thousand milliseconds was the optimal TI, which generated the highest lung tagging efficiency and second highest PBF SNR. In the volunteers, the signal intensity of perfusion images acquired with both FAIR and DCE-MRI was homogeneous. Wedged-shaped or triangle perfusion defects were visualized in five pulmonary embolisms and three lung cancer cases. There was no significant statistical difference in signal intensity ratio between FAIR and DCE-MRI (P > 0.05). In the rest of eight lung cancers, all the lesions showed low perfusion against the higher perfused pulmonary parenchyma in both FAIR and DCE-MRI. Conclusion: Pulmonary parenchyma perfusion imaging with FAIR was feasible, consistent and could obtain similar functional information to that from DCE-MRI.

Assessment of pulmonary parenchyma perfusion with FAIR in comparison with DCE-MRI-Initial results

International Nuclear Information System (INIS)

Fan Li; Liu Shiyuan; Sun Fei; Xiao Xiangsheng

2009-01-01

Objective: The aim of this study was to assess pulmonary parenchyma perfusion with flow-sensitive alternating inversion recovery (FAIR) in comparison with 3D dynamic contrast-enhanced (DCE) imaging in healthy volunteers and in patients with pulmonary embolism or lung cancer. Materials and methods: Sixteen healthy volunteers and 16 patients with pulmonary embolism (5 cases) or lung cancer (11 cases) were included in this study. Firstly, the optimized inversion time of FAIR (TI) was determined in 12 healthy volunteers. Then, FAIR imaging with the optimized TI was performed followed by DCE-MRI on the other 4 healthy volunteers and 16 patients. Tagging efficiency of lung and SNR of perfusion images were calculated with different TI values. In the comparison of FAIR with DCE-MRI, the homogeneity of FAIR and DCE-MRI perfusion was assessed. In the cases of perfusion abnormality, the contrast between normal lung and perfusion defects was quantified by calculating a normalized signal intensity ratio. Results: One thousand milliseconds was the optimal TI, which generated the highest lung tagging efficiency and second highest PBF SNR. In the volunteers, the signal intensity of perfusion images acquired with both FAIR and DCE-MRI was homogeneous. Wedged-shaped or triangle perfusion defects were visualized in five pulmonary embolisms and three lung cancer cases. There was no significant statistical difference in signal intensity ratio between FAIR and DCE-MRI (P > 0.05). In the rest of eight lung cancers, all the lesions showed low perfusion against the higher perfused pulmonary parenchyma in both FAIR and DCE-MRI. Conclusion: Pulmonary parenchyma perfusion imaging with FAIR was feasible, consistent and could obtain similar functional information to that from DCE-MRI.

Experimental studies of the reimplantation of irradiated lung in dogs

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Kondo, T; Fujimura, S; Sohara, Y; Kawakami, M; Okaniwa, G [Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis and Cancer

1978-02-01

In order to treat the patients with lung cancer who have impaired cardiopulmonary function, a new method is designed, which includes the following steps; 1) pneumonectomy, 2) resection of tumor-bearing lobe, 3) /sup 60/Co irradiation to the remaining lobe, and 4) orthotopic reimplantation of the irradiated lung. The purpose of present study is to clarify the feasibility to use this method clinically. Using adult mongreal dogs, left lung was excised, irradiated and reimplanted. Radiation was carried out from 2,000 rad to 4,000 rad. Viability and function of reimplanted lungs were evaluated by their survival time, serial chest x-ray films, sup(99m)Tc-MAA perfusion scanning, unilateral pulmonary artery occlusion test and histologic examinations. Of 17 animals, 12 survived postoperative period and following results were obtained; 1) no dogs developed pulmonary edema, 2) only one dog was considered to die from acute radiation pneumonitis, 3) serial perfusion scanning showed a gradual decrease in flow distribution to the transplanted lung, 4) the right pulmonary occlusion test done in the dog irradiated with 2,000 rad revealed well reserved pulmonary function 2 months after the operation, and 5) histologically, most irradiated lungs revealed so-called ''late reaction'' of lung fibrosis, but there was the case with nearly normal findings after 6 months from the operation. Although many reports concerning to the radiation pneumonitis are published, there have not been any such reports as the present study. From our experiment, it may be indicated that there is a feasibility to use this new method clinically.

Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis

International Nuclear Information System (INIS)

Gelb, A.F.; Dreisen, R.B.; Epstein, J.D.; Silverthorne, J.D.; Bickel, Y.; Fields, M.; Border, W.A.; Taylor, C.R.

1983-01-01

We obtained results of lung immune complexes (LIC), circulating immune complexes (CIC), 48-hour gallium lung scans (scans), bronchoalveolar lavage (BAL), and pulmonary function tests in 20 patients with idiopathic interstitial pneumonitis-fibrosis. Sixteen patients had predominantly interstitial (13 cases UIP) and/or intraalveolar (3 cases DIP) cellular disease (group 1). Prior to corticosteroid therapy in group 1, scans were positive in 75 percent, CIC were elevated in 86 percent, LIC were present in 64 percent, and BAL was abnormal in 90 percent. Duration of follow-up after treatment was 3.5 +/- 1.0 year. In group 1 after treatment with corticosteroids in 13 patients and corticosteroids and penicillamine (three patients) and plasmapheresis (one patient), only four patients remain stable or improved. After corticosteroid therapy, elevated CIC returned to normal values despite progressive patient deterioration. In three patients, lung immune complexes were still detected after circulating immune complexes had returned to normal after corticosteroid therapy. In group 2 were four patients with fibrotic disease; scans and CIC were uniformly negative, LIC were weakly present in only one patient, and BAL was abnormal in all. Despite corticosteroid therapy, all have died or deteriorated. These results suggest that positive gallium lung scans, BAL, circulating immune complexes, and to a lesser extent, lung immune complexes are associated with the cellular phase of interstitial pneumonia, but do not reliably identify a corticosteroid-responsive group

Lung scintigraphy; Centellograma pulmonar

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Dalenz, Roberto

1994-12-31

A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies.

Prediction of postoperative lung function after pulmonary resection

International Nuclear Information System (INIS)

Yoshikawa, Koichi

1988-01-01

Lung scintigraphy and ordinary lung function test as well as split lung function test by using bronchospirometry was performed in 78 patients with primary lung cancer and clinical significance of ventilation and perfusion scintigraphy was evaluated. Results obtained from this study are as follows. 1) The ratio of right VC to total VC obtained by preoperative bronchospirometry was well correlated to the ratio of right lung count to the total lung count obtained by ventiration and/or perfusion scintigraphy (r = 0.84, r = 0.69). 2) Evaluation of the data obtained from the patients undergoing pneumonectomy indicated that the right and left VC obtained preoperatively by bronchospirometry have their clinical significance only in the form of left to right ratio not in the form their absolure value. 3) As to the reliability of predicting the residual vital capacity after pneumonectomy on the basis of left-to-right of lung scintigraphy, ventilation scintigraphy is more reliable than perfusion scintigraphy. 4) Irrespective of using ventilation scintigraphy or perfusion scintigraphy, Ali's formular showed high reliability in predicting the residual vital capacity as well as FEV 1.0 after lobectomy. 5) Reduction of the perfusion rate in the operated side of the lung is more marked than of the ventilation rate, resulting in a significant elevation of ventilation/perfusion ratio of the operated side of the lung. From the results descrived above, it can be said that lung ventilation and perfusion scintigraphy are very useful method to predict the residual lung function as well as the change of ventilation/perfusion ratio after pulmonary resection. (author)

Computer Vision Tool and Technician as First Reader of Lung Cancer Screening CT Scans.

Science.gov (United States)

Ritchie, Alexander J; Sanghera, Calvin; Jacobs, Colin; Zhang, Wei; Mayo, John; Schmidt, Heidi; Gingras, Michel; Pasian, Sergio; Stewart, Lori; Tsai, Scott; Manos, Daria; Seely, Jean M; Burrowes, Paul; Bhatia, Rick; Atkar-Khattra, Sukhinder; van Ginneken, Bram; Tammemagi, Martin; Tsao, Ming Sound; Lam, Stephen

2016-05-01

To implement a cost-effective low-dose computed tomography (LDCT) lung cancer screening program at the population level, accurate and efficient interpretation of a large volume of LDCT scans is needed. The objective of this study was to evaluate a workflow strategy to identify abnormal LDCT scans in which a technician assisted by computer vision (CV) software acts as a first reader with the aim to improve speed, consistency, and quality of scan interpretation. Without knowledge of the diagnosis, a technician reviewed 828 randomly batched scans (136 with lung cancers, 556 with benign nodules, and 136 without nodules) from the baseline Pan-Canadian Early Detection of Lung Cancer Study that had been annotated by the CV software CIRRUS Lung Screening (Diagnostic Image Analysis Group, Nijmegen, The Netherlands). The scans were classified as either normal (no nodules ≥1 mm or benign nodules) or abnormal (nodules or other abnormality). The results were compared with the diagnostic interpretation by Pan-Canadian Early Detection of Lung Cancer Study radiologists. The overall sensitivity and specificity of the technician in identifying an abnormal scan were 97.8% (95% confidence interval: 96.4-98.8) and 98.0% (95% confidence interval: 89.5-99.7), respectively. Of the 112 prevalent nodules that were found to be malignant in follow-up, 92.9% were correctly identified by the technician plus CV compared with 84.8% by the study radiologists. The average time taken by the technician to review a scan after CV processing was 208 ± 120 seconds. Prescreening CV software and a technician as first reader is a promising strategy for improving the consistency and quality of screening interpretation of LDCT scans. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Automatic delineation of functional lung volumes with 68Ga-ventilation/perfusion PET/CT.

Science.gov (United States)

Le Roux, Pierre-Yves; Siva, Shankar; Callahan, Jason; Claudic, Yannis; Bourhis, David; Steinfort, Daniel P; Hicks, Rodney J; Hofman, Michael S

2017-10-10

Functional volumes computed from 68 Ga-ventilation/perfusion (V/Q) PET/CT, which we have shown to correlate with pulmonary function test parameters (PFTs), have potential diagnostic utility in a variety of clinical applications, including radiotherapy planning. An automatic segmentation method would facilitate delineation of such volumes. The aim of this study was to develop an automated threshold-based approach to delineate functional volumes that best correlates with manual delineation. Thirty lung cancer patients undergoing both V/Q PET/CT and PFTs were analyzed. Images were acquired following inhalation of Galligas and, subsequently, intravenous administration of 68 Ga-macroaggreted-albumin (MAA). Using visually defined manual contours as the reference standard, various cutoff values, expressed as a percentage of the maximal pixel value, were applied. The average volume difference and Dice similarity coefficient (DSC) were calculated, measuring the similarity of the automatic segmentation and the reference standard. Pearson's correlation was also calculated to compare automated volumes with manual volumes, and automated volumes optimized to PFT indices. For ventilation volumes, mean volume difference was lowest (- 0.4%) using a 15%max threshold with Pearson's coefficient of 0.71. Applying this cutoff, median DSC was 0.93 (0.87-0.95). Nevertheless, limits of agreement in volume differences were large (- 31.0 and 30.2%) with differences ranging from - 40.4 to + 33.0%. For perfusion volumes, mean volume difference was lowest and Pearson's coefficient was highest using a 15%max threshold (3.3% and 0.81, respectively). Applying this cutoff, median DSC was 0.93 (0.88-0.93). Nevertheless, limits of agreement were again large (- 21.1 and 27.8%) with volume differences ranging from - 18.6 to + 35.5%. Using the 15%max threshold, moderate correlation was demonstrated with FEV1/FVC (r = 0.48 and r = 0.46 for ventilation and perfusion images, respectively

TU-CD-BRA-08: Single-Energy Computed Tomography-Based Pulmonary Perfusion Imaging: Proof-Of-Principle in a Canine Model

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Yamamoto, T; Boone, J [University of California Davis School of Medicine, Sacramento, CA (United States); Kent, M; Wisner, E [University of California Davis School of Veterinary Medicine, Davis, CA (United States); Fujita, Y [Tokai University, Isehara (Japan)

2015-06-15

Purpose: Pulmonary perfusion imaging has provided significant insights into pulmonary diseases, and can be useful in radiotherapy. The purpose of this study was to prospectively establish proof-of-principle in a canine model for single-energy CT-based perfusion imaging, which has the potential for widespread clinical implementation. Methods: Single-energy CT perfusion imaging is based on: (1) acquisition of inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast medium, (2) deformable image registration (DIR) of the two CT image data sets, and (3) subtraction of the pre-contrast image from post-contrast image, yielding a map of Hounsfield unit (HU) enhancement. These subtraction image data sets hypothetically represent perfused blood volume, a surrogate for perfusion. In an IACUC-approved clinical trial, we acquired pre- and post-contrast CT scans in the prone posture for six anesthetized, mechanically-ventilated dogs. The elastix algorithm was used for DIR. The registration accuracy was quantified using the target registration errors (TREs) for 50 pulmonary landmarks in each dog. The gradient of HU enhancement between gravity-dependent (ventral) and non-dependent (dorsal) regions was evaluated to quantify the known effect of gravity, i.e., greater perfusion in ventral regions. Results: The lung volume difference between the two scans was 4.3±3.5% on average (range 0.3%–10.1%). DIR demonstrated an average TRE of 0.7±1.0 mm. HU enhancement in lung parenchyma was 34±10 HU on average and varied considerably between individual dogs, indicating the need for improvement of the contrast injection protocol. HU enhancement in ventral (gravity-dependent) regions was found to be greater than in dorsal regions. A population average ventral-to-dorsal gradient of HU enhancement was strong (R{sup 2}=0.94) and statistically significant (p<0.01). Conclusion: This canine study demonstrated relatively accurate DIR and a strong ventral

TU-CD-BRA-08: Single-Energy Computed Tomography-Based Pulmonary Perfusion Imaging: Proof-Of-Principle in a Canine Model

International Nuclear Information System (INIS)

Yamamoto, T; Boone, J; Kent, M; Wisner, E; Fujita, Y

2015-01-01

Purpose: Pulmonary perfusion imaging has provided significant insights into pulmonary diseases, and can be useful in radiotherapy. The purpose of this study was to prospectively establish proof-of-principle in a canine model for single-energy CT-based perfusion imaging, which has the potential for widespread clinical implementation. Methods: Single-energy CT perfusion imaging is based on: (1) acquisition of inspiratory breath-hold CT scans before and after intravenous injection of iodinated contrast medium, (2) deformable image registration (DIR) of the two CT image data sets, and (3) subtraction of the pre-contrast image from post-contrast image, yielding a map of Hounsfield unit (HU) enhancement. These subtraction image data sets hypothetically represent perfused blood volume, a surrogate for perfusion. In an IACUC-approved clinical trial, we acquired pre- and post-contrast CT scans in the prone posture for six anesthetized, mechanically-ventilated dogs. The elastix algorithm was used for DIR. The registration accuracy was quantified using the target registration errors (TREs) for 50 pulmonary landmarks in each dog. The gradient of HU enhancement between gravity-dependent (ventral) and non-dependent (dorsal) regions was evaluated to quantify the known effect of gravity, i.e., greater perfusion in ventral regions. Results: The lung volume difference between the two scans was 4.3±3.5% on average (range 0.3%–10.1%). DIR demonstrated an average TRE of 0.7±1.0 mm. HU enhancement in lung parenchyma was 34±10 HU on average and varied considerably between individual dogs, indicating the need for improvement of the contrast injection protocol. HU enhancement in ventral (gravity-dependent) regions was found to be greater than in dorsal regions. A population average ventral-to-dorsal gradient of HU enhancement was strong (R"2=0.94) and statistically significant (p<0.01). Conclusion: This canine study demonstrated relatively accurate DIR and a strong ventral

The 'fragmented' scintigraphic lung pattern in pulmonary lymphangitic carcinomatosis secondary to breast cancer.

Science.gov (United States)

Vattimo, A V; Burroni, L; Bertelli, P; Vella, A; Volterrani, D

1998-01-01

Pulmonary lymphangitic carcinomatosis (PLC) is an unusual presentation of diffuse infiltrative lung disease. In this report we present two cases secondary to breast cancer; the diagnosis was made by means of transbronchial lung biopsy or postmortem examination. The goal of this study was to analyze the scintigraphic pattern of pulmonary perfusion performed with technetium-99m macroaggregated albumin (99mTc-MAA) in the hope of achieving improved recognition of PLC and its subsequent diagnosis. Upon admission, both patients underwent routine clinical exams followed by chest X-rays. The second patient also underwent CT examination, and both were ultimately examined using pulmonary perfusion scintigraphy with 99mTc-MAA. In the various exams performed, the most reliable and easily identified diagnostic finding turned out to be a characteristic 'fragmented' lung pattern revealed with the perfusion lung scan. Unfortunately, in both cases the patients' conditions rapidly worsened and death occurred shortly following scintigraphy. We were able to conclude that the recognition of the mentioned fragmented scintigraphic lung pattern may be useful in suspected PLC, whereas the nonspecific clinical presentation of this pathology makes diagnosis extremely difficult, with the most significant results being achieved through a comparison of scintigraphic and high resolution CT data.

Diagnosis of epidural hematoma by brain scan and perfusion study: case report. [/sup 99m/Tc tracer techniques

Energy Technology Data Exchange (ETDEWEB)

Buozas, D.J.; Barrett, I.R.; Mishkin, F.S.

1976-11-01

By using the arterial and venous phases of an anterior cerebral perfusion study, which showed downward displacement of the sagittal sinus, and the finding of a rim on the delayed scans, the specific diagnosis of epidural hematoma was established.

Correlation of 68Ga Ventilation-Perfusion PET/CT with Pulmonary Function Test Indices for Assessing Lung Function.

Science.gov (United States)

Le Roux, Pierre-Yves; Siva, Shankar; Steinfort, Daniel P; Callahan, Jason; Eu, Peter; Irving, Lou B; Hicks, Rodney J; Hofman, Michael S

2015-11-01

Pulmonary function tests (PFTs) are routinely used to assess lung function, but they do not provide information about regional pulmonary dysfunction. We aimed to assess correlation of quantitative ventilation-perfusion (V/Q) PET/CT with PFT indices. Thirty patients underwent V/Q PET/CT and PFT. Respiration-gated images were acquired after inhalation of (68)Ga-carbon nanoparticles and administration of (68)Ga-macroaggregated albumin. Functional volumes were calculated by dividing the volume of normal ventilated and perfused (%NVQ), unmatched and matched defects by the total lung volume. These functional volumes were correlated with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and diffusing capacity for carbon monoxide (DLCO). All functional volumes were significantly different in patients with chronic obstructive pulmonary disease (P volume of unmatched defects (r = -0.55). Considering %NVQ only, a cutoff value of 90% correctly categorized 28 of 30 patients with or without significant pulmonary function impairment. Our study demonstrates strong correlations between V/Q PET/CT functional volumes and PFT parameters. Because V/Q PET/CT is able to assess regional lung function, these data support the feasibility of its use in radiation therapy and preoperative planning and assessing pulmonary dysfunction in a variety of respiratory diseases. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Volume adjustment of lung density by computed tomography scans in patients with emphysema

DEFF Research Database (Denmark)

Shaker, S B; Dirksen, A; Laursen, Lars Christian

2004-01-01

of pulmonary emphysema derived from CT scans. These parameters are markedly influenced by changes in the level of inspiration. The variability of lung density due to within-subject variation in TLV was explored by plotting TLV against PD and RA. RESULTS: The coefficients for volume adjustment for PD were...... relatively stable over a wide range from the 10th to the 80th percentile, whereas for RA the coefficients showed large variability especially in the lower range, which is the most relevant for quantitation of pulmonary emphysema. CONCLUSION: Volume adjustment is mandatory in repeated CT densitometry......PURPOSE: To determine how to adjust lung density measurements for the volume of the lung calculated from computed tomography (CT) scans in patients with emphysema. MATERIAL AND METHODS: Fifty patients with emphysema underwent 3 CT scans at 2-week intervals. The scans were analyzed with a software...

Estimation of pulmonary hypertension by perfusion lung scintigraphy: Gravitational effect of postural changes between the lateral decubitus positions

International Nuclear Information System (INIS)

Tanaka, Masao; Fujii, Tadashige; Hirayama, Jiro; Okubo, Shinichi; Sekiguchi, Morie

1990-01-01

To estimate pulmonary hypertension in patients with various heart diseases, we devised a new method using perfusion lung scintigraphy with 99m Tc-labelled macroaggregated albumin. In this method, changes in the distribution of pulmonary perfusion caused by gravitational effects, namely, changes in the total count ratios of the right lung against the left lung between right and left lateral decubitus positions (rt/lt), were assessed in 62 patients and in 10 normal subjects. The rt/lt ratios were calculated as indices of the above changes. They correlated significantly with mean pulmonary arterial pressure (mPAP) (γ=-0.62, P<0.001), pulmonary capillary wedge pressure (γ=-0.63, P<0.001) and pulmonary arteriolar resistance (γ=0.50, P<0.001) in all subjects. In 17 patients with valvular heart diseases, the ratio correlated significantly with mPAP (γ=-0.84, P<0.001). In 10 patients with various heart diseases, the U/S ratio, i.e. the index of changes in the count ratios of the upper field against the lower field for the right lung following postural change from the uprigth to the supine position, was also obtained as well as the rt/lt ratio. The latter evidenced a better correlation with mPAP (γ=-0.90, P<0.001) than the former (γ=-0.64, P<0.05). We conclude that this method is valuable as a noninvasive approach for the estimation of pulmonary hypertension. (orig.)

Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.

LENUS (Irish Health Repository)

Wong, C F

2008-06-01

Because death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.

PET scan perfusion imaging in the Prader-Willi syndrome: new insights into the psychiatric and social disturbances

International Nuclear Information System (INIS)

Mantoulan, C.; Payoux, P.; Mantoulan, C.; Diene, G.; Glattard, M.; Molinas, C.; Tauber, M.; Payoux, P.; Sevely, A.; Glattard, M.; Roge, B.; Molinas, C.; Tauber, M.; Zilbovicius, M.; Celsis, P.; Celsis, P.

2011-01-01

The Prader-Willi syndrome (PWS), a rare multisystem genetic disease, leads to severe disabilities, such as morbid obesity, endocrine dysfunctions, psychiatric disorders, and social disturbances. We explored the whole brain of patients with PWS to detect abnormalities that might explain the behavioral and social disturbances, as well as the psychiatric disorders of these patients. Nine patients with PWS (six males, three females; mean age 16.4 years) underwent a positron emission tomography (PET) scan with H(2)(15)O as a tracer to measure regional cerebral blood flow (rCBF). The images were compared with those acquired from nine controls (six males, three females; mean age 21.2 years). A morphologic magnetic resonance imaging (MRI) was also performed in PWS patients, and their cognitive and behavioral skills were assessed with Wechsler Intelligence Scale for Children III and the Child Behavior Check List (CBCL). The MRI images showed no evident anatomic abnormalities, whereas PET scans revealed hypo-perfused brain regions in PWS patients compared with controls, particularly in the anterior cingulum and superior temporal regions. We observed a significant relationship (P≤0.05) between rCBF in the hypo-perfused regions and CBCL scores. The functional consequences of these perfusion abnormalities in specific brain regions might explain the behavioral and social problems observed in these individuals. (authors)

Lung perfusion analysis with dual energy CT in patients with suspected pulmonary embolism—Influence of window settings on the diagnosis of underlying pathologies of perfusion defects

International Nuclear Information System (INIS)

Bauer, Ralf W.; Kerl, J. Matthias; Weber, Eva; Weisser, Philipp; Korkusuz, Huedayi; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.

2011-01-01

Purpose: On lung perfusion analysis with dual energy CT (DECT) in patients with suspected pulmonary embolism (PE) commonly three patterns of perfusion defects (PD) are observed: wedge-shaped, circumscribed but not wedge-shaped, and patchy. We investigated the influence of different window settings on the identification of the underlying pathologies for these types of PD. Materials and methods: 3724 segments in 196 consecutive patients who underwent pulmonary DECT angiography for clinically suspected acute PE were analyzed. Iodine distribution in the lung parenchyma was calculated from the dual energy data and displayed as color map in axial, sagittal and coronal view. Afterwards, lung and angiography window were applied separately and assessed for pulmonary embolism and pathologies of the lung parenchyma. Results: 1420 segments in 141 patients showed PD, of which 276 were wedge-shaped, 287 circumscribed and 857 patchy. Circumscribed PD were associated in 99% with interstitial or alveolar fluid collections and in 1% with located bullae. Patchy PD were associated in 65% with emphysematous or fibrotic changes, in 38% with diffuse infiltrations or interstitial fluid collections and in 0.2% with PE. The underlying pathologies for wedge-shaped PD were in 78% PE, in 3% tumors compressing pulmonary arteries, in another 3% located bullae and in further 3% infiltrations. 13% (n = 15) of the segments in this group did not show vascular or parenchymal pathologies, but in 80% (n = 10) of these cases patients had PE in another segment. Totally n = 6 of wedge-shaped PD in 5 patients remained with unclear direct cause. Conclusion: Whereas patchy and circumscribed PD are almost exclusively associated with pathologies of the lung parenchyma, wedge-shaped PD are mostly associated with PE. For a small number of wedge-shaped PD the underlying cause cannot be detected with DECT. Very small peripherally situated micro-emboli may be discussed as a reason. However, prospective trials are

Selective Heart, Brain and Body Perfusion in Open Aortic Arch Replacement.

Science.gov (United States)

Maier, Sven; Kari, Fabian; Rylski, Bartosz; Siepe, Matthias; Benk, Christoph; Beyersdorf, Friedhelm

2016-09-01

Open aortic arch replacement is a complex and challenging procedure, especially in post dissection aneurysms and in redo procedures after previous surgery of the ascending aorta or aortic root. We report our experience with the simultaneous selective perfusion of heart, brain, and remaining body to ensure optimal perfusion and to minimize perfusion-related risks during these procedures. We used a specially configured heart-lung machine with a centrifugal pump as arterial pump and an additional roller pump for the selective cerebral perfusion. Initial arterial cannulation is achieved via femoral artery or right axillary artery. After lower body circulatory arrest and selective antegrade cerebral perfusion for the distal arch anastomosis, we started selective lower body perfusion simultaneously to the selective antegrade cerebral perfusion and heart perfusion. Eighteen patients were successfully treated with this perfusion strategy from October 2012 to November 2015. No complications related to the heart-lung machine and the cannulation occurred during the procedures. Mean cardiopulmonary bypass time was 239 ± 33 minutes, the simultaneous selective perfusion of brain, heart, and remaining body lasted 55 ± 23 minutes. One patient suffered temporary neurological deficit that resolved completely during intensive care unit stay. No patient experienced a permanent neurological deficit or end-organ dysfunction. These high-risk procedures require a concept with a special setup of the heart-lung machine. Our perfusion strategy for aortic arch replacement ensures a selective perfusion of heart, brain, and lower body during this complex procedure and we observed excellent outcomes in this small series. This perfusion strategy is also applicable for redo procedures.

Is a positive L-dimer result a sufficient indication for performing a V/Q lung scan?

International Nuclear Information System (INIS)

Salanitri, G.C.; Kelly, M.J.; O'Donnell, M.; Kalff, V.

2002-01-01

Full text: At our institution there has developed a practice of referring some patients for assessment of pulmonary embolism (PE) because of a positive L-dimer test but without standard clinical indications. Therefore this study aimed to determine whether a positive L-dimer test result by itself is a sufficient indication to perform a ventilation/perfusion V/Q study. V/Q lung scan results, L-dimer test results and appropriate radiology results of 949 consecutive patients from August 2000 to October 2001 were retrospectively reviewed. Prediction of V/Q results by L-dimer results was compared with that of clinical risk factors for PE (Risk factor + or -) These factors were dyspnoea, current deep vein thrombosis (DVT), recent orthopaedic procedure or a past history of PE/DVT, Of the 949 patients in the study population, 254 patients had an L-dimer study, with 206 positive and 48 negative L-dimer results. Helical CT was performed in 8 patients with an equivocal V/Q - 4 showed PE and 4 did not. In the 27 patients with a positive L-dimer result and PE on either V-Q scan or CT, 25 (92.6%) had additional recognised major risk factors for PE. A positive L-dimer test is a poor predictor of a positive V/Q scan compared to conventional clinical indications. Thus, a positive L-dimer test result in isolation does not constitute an appropriate indication to perform a V/Q scan. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Lung ventilation-perfusion imbalance in pulmonary emphysema: assessment with automated V/Q quotient SPECT.

Science.gov (United States)

Suga, Kazuyoshi; Kawakami, Yasuhiko; Koike, Hiroaki; Iwanaga, Hideyuki; Tokuda, Osamu; Okada, Munemasa; Matsunaga, Naofumi

2010-05-01

Tc-99m-Technegas-MAA single photon emission computed tomography (SPECT)-derived ventilation (V)/perfusion (Q) quotient SPECT was used to assess lung V-Q imbalance in patients with pulmonary emphysema. V/Q quotient SPECT and V/Q profile were automatically built in 38 patients with pulmonary emphysema and 12 controls, and V/Q distribution and V/Q profile parameters were compared. V/Q distribution on V/Q quotient SPECT was correlated with low attenuation areas (LAA) on density-mask computed tomography (CT). Parameters of V/Q profile such as the median, standard deviation (SD), kurtosis and skewness were proposed to objectively evaluate the severity of lung V-Q imbalance. In contrast to uniform V/Q distribution on V/Q quotient SPECT and a sharp peak with symmetrical V/Q distribution on V/Q profile in controls, lung areas showing heterogeneously high or low V/Q and flattened peaks with broadened V/Q distribution were frequently seen in patients with emphysema, including lung areas with only slight LAA. V/Q distribution was also often asymmetric regardless of symmetric LAA. All the proposed parameters of V/Q profile in entire lungs of patients with emphysema showed large variations compared with controls; SD and kurtosis were significantly different from controls (P emphysema. SD and kurtosis of V/Q profile can be adequate parameters to assess the severity of lung V-Q imbalance causing gas-exchange impairment in patients with emphysema.

Comparative analysis of radionuclide inhalation and perfusion lung imaging with X ray pulmonary angiography for the diagnosis of pulmonary embolism

International Nuclear Information System (INIS)

Zhang Yanyan; Chen Man; Shao Maogang; Zhang Songlin; Mao Jieming; Guo Jingxuan

1993-01-01

The result of radionuclide lung imaging was compared in 18 patients of pulmonary embolism (PE) and 2 normal persons. The discovered perfusion defects correlated well with the location of angiographic obstruction. The positive angiographic and radionuclide finding was in 141 and 104 emboli arteries respectively. The sensitivity of total emboli pulmonary segments of lung imaging was 73.8%, the specificity was 82.7 and the accuracy was 79%. The techniques correlated quite well (r = 0.83, P<0.001)

Compression of the Right Pulmonary Artery by a Massive Defects on Pulmonary Scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Makis, William [Brandon Regional Health Centre, Brandon (Canada); Derbekyan, Vilma [McGill Univ. Health Centre, Montreal (Canada)

2012-03-15

A 67 year old woman, who presented with a 2 month history of dyspnea, had a vectilation and perfusion lung scan that showed absent perfusion of the entire right lung scan that showed absent perfusion of the entire right lung with normal ventilation, as well as a rounded matched defect in the left lower lung adjacent to mialine, suspicious for an aortic aneurysm or dissection. CT pulmonary angiography revealed a massive descending aortic aneurysm compressing the right pulmonary artery as well as the left lung parenchyma, accounting for the bilateral perfusion scan defects. We present the Xe 133 ventilation, Tc 99m MAA perfusion and CT pulmonary angiography imaging findings of this rare case.

Quantitative pre-surgical lung function estimation with SPECT/CT

International Nuclear Information System (INIS)

Bailey, D. L.; Willowson, K. P.; Timmins, S.; Harris, B. E.; Bailey, E. A.; Roach, P. J.

2009-01-01

Full text:Objectives: To develop methodology to predict lobar lung function based on SPECT/CT ventilation and perfusion (V/Q) scanning in candidates for lobectomy for lung cancer. Methods: This combines two development areas from our group: quantitative SPECT based on CT-derived corrections for scattering and attenuation of photons, and SPECT V/Q scanning with lobar segmentation from CT. Eight patients underwent baseline pulmonary function testing (PFT) including spirometry, measure of DLCO and cario-pulmonary exercise testing. A SPECT/CT V/Q scan was acquired at baseline. Using in-house software each lobe was anatomically defined using CT to provide lobar ROIs which could be applied to the SPECT data. From these, individual lobar contribution to overall function was calculated from counts within the lobe and post-operative FEV1, DLCO and VO2 peak were predicted. This was compared with the quantitative planar scan method using 3 rectangular ROIs over each lung. Results: Post-operative FEV1 most closely matched that predicted by the planar quantification method, with SPECT V/Q over-estimating the loss of function by 8% (range - 7 - +23%). However, post-operative DLCO and VO2 peak were both accurately predicted by SPECT V/Q (average error of 0 and 2% respectively) compared with planar. Conclusions: More accurate anatomical definition of lobar anatomy provides better estimates of post-operative loss of function for DLCO and VO2 peak than traditional planar methods. SPECT/CT provides the tools for accurate anatomical defintions of the surgical target as well as being useful in producing quantitative 3D functional images for ventilation and perfusion.

Modelo experimental de perfusão pulmonar ex vivo em ratos: avaliação de desempenho de pulmões submetidos à administração de prostaciclina inalada versus parenteral An experimental rat model of ex vivo lung perfusion for the assessment of lungs after prostacyclin administration: inhaled versus parenteral routes

Directory of Open Access Journals (Sweden)

Paulo Francisco Guerreiro Cardoso

2011-10-01

Full Text Available OBJETIVO: Apresentar um modelo experimental de administração de prostaglandina I2 (PGI2 por via inalatória vs. parenteral e avaliar o desempenho funcional dos pulmões em um sistema de perfusão pulmonar ex vivo. MÉTODOS: Quarenta ratos Wistar foram anestesiados, ventilados, submetidos a laparotomia com ressecção do esterno e anticoagulados. O tronco da artéria pulmonar foi canulado. Todos os animais foram submetidos a ventilação mecânica. Os animais foram randomizados em quatro grupos (10 ratos/grupo: salina nebulizada (SN; salina parenteral (SP; PGI2 nebulizada (PGI2N; e PGI2 parenteral (PGI2P. A dose de PGI2 nos grupos PGI2N e PGI2P foi de 20 e 10 µg/kg, respectivamente. Os blocos cardiopulmonares foram submetidos in situ a perfusão anterógrada com solução de baixo potássio e dextrana a 4ºC via artéria pulmonar, extraídos em bloco e armazenados a 4ºC por 6 h. Os blocos foram ventilados e perfundidos em um sistema ex vivo por 50 min, sendo obtidas medidas de mecânica ventilatória, hemodinâmica e trocas gasosas. RESULTADOS: Houve redução da pressão arterial pulmonar média após a nebulização em todos os grupos (p OBJECTIVE:To present a model of prostaglandin I2 (PGI2 administration (inhaled vs. parenteral and to assess the functional performance of the lungs in an ex vivo lung perfusion system. METHODS: Forty Wistar rats were anesthetized and placed on mechanical ventilation followed by median sterno-laparotomy and anticoagulation. The main pulmonary artery was cannulated. All animals were maintained on mechanical ventilation and were randomized into four groups (10 rats/group: inhaled saline (IS; parenteral saline (PS; inhaled PGI2 (IPGI2; and parenteral PGI2 (PPGI2. The dose of PGI2 used in the IPGI2 and PPGI2 groups was 20 and 10 µg/kg, respectively. The heart-lung blocks were submitted to antegrade perfusion with a low potassium and dextran solution via the pulmonary artery, followed by en bloc extraction and

Cyclooxygenase-2-dependent bronchoconstriction in perfused rat lungs exposed to endotoxin.

Science.gov (United States)

Uhlig, S; Nüsing, R; von Bethmann, A; Featherstone, R L; Klein, T; Brasch, F; Müller, K M; Ullrich, V; Wendel, A

1996-05-01

Lipopolysaccharides (LPS), widely used to study the mechanisms of gram-negative sepsis, increase airway resistance by constriction of terminal bronchioles. The role of the cyclooxygenase (COX) isoenzymes and their prostanoid metabolites in this process was studied. Pulmonary resistance, the release of thromboxane (TX) and the expression of COX-2 mRNA were measured in isolated blood-free perfused rat lungs exposed to LPS. LPS induced the release of TX and caused increased airway resistance after about 30 min. Both TX formation and LPS-induced bronchoconstriction were prevented by treatment with the unspecific COX inhibitor acetyl salicylic acid, the specific COX-2 inhibitor CGP-28238, dexamethasone, actinomycin D, or cycloheximide. LPS-induced bronchoconstriction was also inhibited by the TX receptor antagonist BM-13177. The TX-mimetic compound, U-46619, increased airway resistance predominantly by constricting terminal bronchioles. COX-2-specific mRNA in lung tissue was elevated after LPS exposure, and this increase was attenuated by addition of dexamethasone or of actinomycin D. In contrast to LPS, platelet-activating factor (PAF) induced immediate TX release and bronchoconstriction that was prevented by acetyl salicylic acid, but not by CGP-28238. LPS elicits the following biochemical and functional changes in rat lungs: (i) induction of COX-2; (ii) formation of prostaglandins and TX; (iii) activation of the TX receptor on airway smooth muscle cells; (iv) constriction of terminal bronchioles; and (v) increased airway resistance. In contrast to LPS, the PAF-induced TX release is likely to depend on COX-1.

Evaluation of {sup 99m}Tc(CO){sub 5}I as a potential lung perfusion agent

Energy Technology Data Exchange (ETDEWEB)

Miroslavov, Alexander E.; Gorshkov, Nikolay I.; Lumpov, Alexander L. [Division of Radiochemical Research, Khlopin Radium Institute, 2nd Murinskii pr. 28, 194021, St Petersburg (Russian Federation); Yalfimov, Anatoly N. [Nuclear Medicine Department, Central Research Institute of Roentgenology and Radiology, Leningradskaya str. 70/4, 197000, St Petersburg (Russian Federation); Suglobov, Dmitrii N. [Division of Radiochemical Research, Khlopin Radium Institute, 2nd Murinskii pr. 28, 194021, St Petersburg (Russian Federation); Ellis, Beverley L. [Department of Nuclear Medicine, Manchester Royal Infirmary, M13 9WL Manchester (United Kingdom)], E-mail: bev.ellis@manchester.ac.uk; Braddock, Rattana; Smith, Anne-Marie [Imaging Science and Biomedical Engineering, School of Cancer and Imaging Science, Stopford Building, The University of Manchester, Oxford Road, Manchester M13 9PT (United Kingdom); Prescott, Mary C.; Lawson, Richard S. [Department of Nuclear Medicine, Manchester Royal Infirmary, M13 9WL Manchester (United Kingdom); Sharma, Harbans L. [Imaging Science and Biomedical Engineering, School of Cancer and Imaging Science, Stopford Building, The University of Manchester, Oxford Road, Manchester M13 9PT (United Kingdom)

2009-01-15

Introduction: The use of {sup 99m}Tc-macroggregated albumin for lung perfusion imaging is well established in nuclear medicine. However, there have been safety concerns over the use of blood-derived products because of potential contamination by infective agents, for example, Variant Creutzfeldt Jakob Disease. Preliminary work has indicated that Tc(CO){sub 5}I is primarily taken up in the lungs following intravenous administration. The aim of this study was to evaluate the biodistribution and pharmacokinetics of {sup 99m}Tc(CO){sub 5}I and its potential as a lung perfusion agent. Methods: {sup 99m}Tc(CO){sub 5}I was synthesized by carbonylation of {sup 99m}TcO{sub 4-} at 160 atm of CO at 170 deg. C in the presence of HI for 40 min. Radiochemical purity was determined by HPLC using {sup 99}Tc(CO){sub 5}I as a reference. {sup 99m}Tc(CO){sub 5}I was administered by ear-vein injection to three chinchilla rabbits, and dynamic images were acquired using a gamma camera (Siemens E-cam) over 20 min. Imaging studies were also performed with {sup 99m}Tc-labeled macroaggregated albumin ({sup 99m}Tc-MAA) and {sup 99m}TcO{sub 4-} for comparison. {sup 99m}Tc(CO){sub 5}I was administered intravenously to Sprague-Dawley rats, and tissue distribution studies were obtained at 15 min and 1 h postinjection. Comparative studies were performed using {sup 99m}Tc-MAA. Results: Radiochemical purity, assessed by HPLC, was 98%. The retention time was similar to that of {sup 99}Tc(CO){sub 5}I. The dynamic images showed that 70% of {sup 99m}Tc(CO){sub 5}I appeared promptly in the lungs and remained constant for at least 20 min. In contrast, {sup 99m}TcO{sub 4-} rapidly washed out of the lungs after administration. As expected {sup 99m}Tc-MAA showed 90% lung accumulation. The percentage of injected dose per gram of organ {+-}S.D. at 1 h for {sup 99m}Tc(CO){sub 5}I was as follows: blood, 0.22{+-}0.02; lung, 12.8{+-}2.87; liver, 0.8{+-}0.15; heart, 0.15{+-}0.01; kidney, 0.47{+-}0.08. The

Lung perfusion and ventilation scintigraphy in pre- and postoperative diagnostics; Lungenperfusions- und Ventilationsszintigraphie in der prae- und postoperativen Diagnostik

Energy Technology Data Exchange (ETDEWEB)

Sandrock, D.; Munz, D.L. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Charite, Medizinische Fakultaet der Humboldt-Univ. zu Berlin (Germany)

1998-03-01

Lung perfusion (Tc-99m labeled albumin particles) and ventilation (Xe-133 gas) are used prior to thoracic surgery in order to evaluate changes in perfusion and ventilation due to the underlying diseases. Furthermore, perfusion scintigraphy allows combined with spirometry the prediction of the postinterventional vital capacity and the forced expiratory volume in 1 s. The correlation coefficient for this procedure compared with values measured postoperatively are in the range of 0.8. The method allows the assessment of operability in terms of postinterventional function. (orig.) [Deutsch] Die Lungenperfusions- (mit Tc-99m-markierten Albuminpartikeln) und die Ventilationsszintigraphie (mit Xe-133 als Gas) werden vor thoraxchirugrischen Eingriffen zur Beurteilung der durch die Grund- oder weitere Erkrankungen bedingte Einschraenkungen von Perfusion und Belueftung eingesetzt. Die Perfusionsszintigraphie erlaubt in Kombination mit der Spirometrie ausserdem die Vorausberechnung der postoperativ zu erwartenden Vitalkapazitaet und des forcierten exspiratorischen Erstsekundenvolumens. Im Vergleich mit den postoperativ gemessenen Volumina liegen die Korrelationskoeffizienten um 0,8. Die Methode ermoeglicht daher eine Beurteilung der Operabilitaet bezueglich der postoperativen Lungenfunktion. (orig.)

Imaging of ventilation/perfusion ratio by gated regional spirometry

International Nuclear Information System (INIS)

Touya, J.J.; Jones, J.P.; Price, R.R.; Patton, J.A.; Erickson, J.J.; Rollo, F.D.

1981-01-01

Gated 133 Xe images of patients rebreathing into a closed system can provide images of the distribution of lung volumes, ventilation and specific ventilation. These have been shown to be accurate, precise, and do not require unusually sophisticated equipment or skills. A mathematical transformation is used to correct the images for lung movement, which does not alter the total number of counts in the image. Perfusion images are gated to remove motion blurring but not transformed. Ventilation/perfusion images showing the distribution of V/Q ratio are then generated from the individual ventilation and perfusion images. (author)

Critical study of the diagnostic value of lung scans using 67 gallium in respiratory diseases

International Nuclear Information System (INIS)

Perrin-Fayolle, M.; Brun, J.; Moret, R.; Kofman, J.; Ortonne, J.P.; Petigny, C.

1975-01-01

70 lungs scans using gallium 67 were carried out. Among the 41 malignant lesions, an uptake of the radio-isotope by the tumour in 51% of cases was noted. Among the 29 benign lesions, there were also 34% of cases which took up gallium 67. Their lack of reliability and selectivity make gallium 67 lung scans unsuitable for the recognition of the malignant nature of lung diseases [fr

Quantitative assessment of emphysema from whole lung CT scans: comparison with visual grading

Science.gov (United States)

Keller, Brad M.; Reeves, Anthony P.; Apanosovich, Tatiyana V.; Wang, Jianwei; Yankelevitz, David F.; Henschke, Claudia I.

2009-02-01

Emphysema is a disease of the lungs that destroys the alveolar air sacs and induces long-term respiratory dysfunction. CT scans allow for imaging of the anatomical basis of emphysema and for visual assessment by radiologists of the extent present in the lungs. Several measures have been introduced for the quantification of the extent of disease directly from CT data in order to add to the qualitative assessments made by radiologists. In this paper we compare emphysema index, mean lung density, histogram percentiles, and the fractal dimension to visual grade in order to evaluate the predictability of radiologist visual scoring of emphysema from low-dose CT scans through quantitative scores, in order to determine which measures can be useful as surrogates for visual assessment. All measures were computed over nine divisions of the lung field (whole lung, individual lungs, and upper/middle/lower thirds of each lung) for each of 148 low-dose, whole lung scans. In addition, a visual grade of each section was also given by an expert radiologist. One-way ANOVA and multinomial logistic regression were used to determine the ability of the measures to predict visual grade from quantitative score. We found that all measures were able to distinguish between normal and severe grades (p<0.01), and between mild/moderate and all other grades (p<0.05). However, no measure was able to distinguish between mild and moderate cases. Approximately 65% prediction accuracy was achieved from using quantitative score to predict visual grade, with 73% if mild and moderate cases are considered as a single class.

Validation of co-registration of clinical lung ventilation and perfusion SPECT

International Nuclear Information System (INIS)

Marsh, S.H.; O'Keeffe, D.S.; Barnden, L.R.

2010-01-01

Full text: This talk will present results from a recent validation study of coregistration of computed tomography ventilation and perfusion (SPECT V/Q) images. The coregistration algorithm was incorporated in Qonsub, a program to coregister, normalise and subtract the SPECT (V/Q) images. Ventilation and perfusion image data were acquired from 23 patients undergoing a routine clinical SPECT V/Q study. The only change to normal patient management was the placement of three Tc 9 9 m filled fiducial markers adhered to the skin on the patient's torso. To quantify coregistration accuracy, image data were modified (within software) to remove the markers and Qonsub determined a parameter set of six values fully describing the six degree rigid transformation. The accuracy with which the six parameters coregister the images was then quantified by applying the same transformation parameters to the ventilation markers and determining how well they locate to the perfusion marker positions. Results show that for 65% of patients surveyed co-registration accuracy was to within I pixel, 30% were co-registered with an accuracy between 1 and 2 pixels and 5% were co-registered with an accuracy of between 2 and 3 pixels. Because patient placement between scans resulted in a misregistration of at most five pixels, a more rigorous test of the algorithm was required. Ethics approval had not been sought to intentionally misregister patient images, so the algorithm had to be further tested by synthetically misregistering the images. For these images Qonsub generally co-registered with the same accuracy as the original image. (author)

Abnormal ventilation scans in middle-aged smokers. Comparison with tests of overall lung function

International Nuclear Information System (INIS)

Barter, S.J.; Cunningham, D.A.; Lavender, J.P.; Gibellino, F.; Connellan, S.J.; Pride, N.B.

1985-01-01

The uniformity of regional ventilation during tidal breathing has been assessed using continuous inhalation of krypton-81m in 43 male, lifelong nonsmokers and 46 male, current cigarette smokers (mean daily consumption 24.1 cigarettes/day) between 44 and 61 yr of age and with mild or no respiratory symptoms. All subjects had normal chest radiographs. The results of the ventilation scans were compared with tests of overall lung function (spirometry, maximal expiratory flow-volume curves, and single-breath N2 test). Diffuse abnormalities of the ventilation scan were found in 19 (41%) of the 46 smokers but in none of the nonsmokers. Focal abnormalities were found in 7 smokers and 3 nonsmokers. Smokers showed the expected abnormalities in overall lung function (reduced FEV1 and VC, increased single-breath N2 slope, and closing volume), but in individual smokers there was only a weak relation between the severity of abnormality of overall lung function and an abnormal ventilation scan. Abnormal scans could be found when overall lung function was normal and were not invariably found when significant abnormalities in FEV1/VC or N2 slope were present. There was no relation between the presence of chronic expectoration and an abnormal scan. The prognostic significance of an abnormal ventilation scan in such smokers remains to be established

Laser doppler perfusion imaging

International Nuclear Information System (INIS)

Waardell, K.

1992-01-01

Recording of tissue perfusion is important in assessing the influence of peripheral vascular diseases on the microcirculation. This thesis reports on a laser doppler perfusion imager based on dynamic light scattering in tissue. When a low power He-Ne laser beam sequentally scans the tissue, moving blood cells generate doppler components in the back-scattered light. A fraction of this light is detected by a photodetector and converted into an electrical signal. In the processor, a signal proportional to the tissue perfusion at each measurement site is calculated and stored. When the scanning procedure is completed, a color-coded perfusion image is presented on a monitor. To convert important aspects of the perfusion image into more quantitative parameters, data analysis functions are implemented in the software. A theory describing the dependence of the distance between individual measurement points and detector on the system amplification factor is proposed and correction algorithms are presented. The performance of the laser doppler perfusion imager was evaluated using a flow simulator. A linear relationship between processor output signal and flow through the simulator was demonstrated for blood cell concentrations below 0.2%. The median sampling depth of the laser beam was simulated by a Monte Carlo technique and estimated to 235 μm. The perfusion imager has been used in the clinic to study perfusion changes in port wine stains treated with argon laser and to investigate the intensity and extension of the cutaneous axon reflex response after electrical nerve stimulation. The fact that perfusion can be visualized without touching the tissue implies elimination of sterilization problems, thus simplifying clinical investigations of perfusion in association with diagnosis and treatment of peripheral vascular diseases. 22 refs

WE-G-18C-02: Estimation of Optimal B-Value Set for Obtaining Apparent Diffusion Coefficient Free From Perfusion in Non-Small Cell Lung Cancer

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Karki, K; Hugo, G; Ford, J; Saraiya, S; Weiss, E [Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Olsen, K; Groves, R [Radiology, Virginia Commonwealth University, Richmond, VA (United States)

2014-06-15

Purpose: Diffusion-weighted MRI (DW-MRI) is increasingly being investigated for radiotherapy planning and response assessment. Selection of a limited number of b-values in DW-MRI is important to keep geometrical variations low and imaging time short. We investigated various b-value sets to determine an optimal set for obtaining monoexponential apparent diffusion coefficient (ADC) close to perfusion-insensitive intravoxel incoherent motion (IVIM) model ADC (ADC_IVIM) in nonsmall cell lung cancer. Methods: Seven patients had 27 DW-MRI scans before and during radiotherapy in a 1.5T scanner. Respiratory triggering was applied to the echo-planar DW-MRI with TR=4500ms approximately, TE=74ms, pixel size=1.98X1.98mm{sub 2}, slice thickness=4–6mm and 7 axial slices. Diffusion gradients were applied to all three axes producing traceweighted images with eight b-values of 0–1000μs/μm{sup 2}. Monoexponential model ADC values using various b-value sets were compared to ADC_IVIM using all b-values. To compare the relative noise in ADC maps, intra-scan coefficient of variation (CV) of active tumor volumes was computed. Results: ADC_IVIM, perfusion coefficient and perfusion fraction for tumor volumes were in the range of 880-1622 μm{sup 2}/s, 8119-33834 μm{sup 2}/s and 0.104–0.349, respectively. ADC values using sets of 250, 800 and 1000; 250, 650 and 1000; and 250–1000μs/μm{sup 2} only were not significantly different from ADC_IVIM(p>0.05, paired t-test). Error in ADC values for 0–1000, 50–1000, 100–1000, 250–1000, 500–1000, and three b-value sets- 250, 500 and 1000; 250, 650 and 1000; and 250, 800 and 1000μs/μm{sup 2} were 15.0, 9.4, 5.6, 1.4, 11.7, 3.7, 2.0 and 0.2% relative to the reference-standard ADC_IVIM, respectively. Mean intrascan CV was 20.2, 20.9, 21.9, 24.9, 32.6, 25.8, 25.4 and 24.8%, respectively, whereas that for ADC_IVIM was 23.3%. Conclusion: ADC values of two 3 b-value sets

Perfusão pulmonar anterógrada "versus" retrógrada na preservação pulmonar para transplante em modelo canino de viabilidade pulmonar pós-morte Antegrade versus retrograde lung perfusion in pulmonary preservation for transplantation in a canine model of post-mortem lung viability

Directory of Open Access Journals (Sweden)

Jean Carlo Kohmann

1999-04-01

reperfusão (p = 0,01 e ao término do período de avaliação (p = 0,01. Os autores concluem que, neste modelo experimental, a perfusão retrógrada hipotérmica resulta em função superior do enxerto após 3 horas de isquemia normotérmica sob ventilação mecânica.Lung retrieval following cardio-circulatory arrest has been studied experimentally, however severe ischemia/reperfusion injury requires improved methods of graft preservation. Allograft perfusion with crystalloid solution delivered via pulmonary artery (antegrade perfusion remains the standard procedure, however it does not provide adequate washout of the blood retained within the bronchial circulation which may trigger reperfusion injury. This has led the authors to test the impact of antegrade versus retrograde (via left atrium perfusion of lung grafts submitted to 3 hours of warm ischemia after cardio-circulatory arrest in a dog model of left lung allotransplantation. Twelve donor dogs were sacrificed with thiopental sodium and kept under mechanical ventilation at room temperature for 3 hours. They were randomized and the heart-lung blocks harvested after being perfused in a retrograde (group I, n = 6 or antegrade (group II, n = 6 fashion with modified Euro-Collins solution. Twelve recipient animals were submitted to a left lung transplant receiving the grafts from both groups and the assessment was performed during 6 hours. Hemodynamic parameters were similar for animals in both groups. The gas exchange (arterial PaO2 and PaCO2 in recipients of group I (retrograde perfusion was significantly better when compared to recipients of grafts perfused via pulmonary artery. Intracellular ATP did not show difference between the groups, however there was a measurable drop in its values when samples obtained upon extraction were compared to those measured after reperfusion and at the end of the assessment. The authors concluded that retrograde perfusion yields better pulmonary function after 6 hours of reperfusion

Pulmonary ventilation and perfusion imaging with dual-energy CT

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Thieme, Sven F. [Klinikum Grosshadern, Department of Clinical Radiology, Ludwig Maximilians University, Muenchen (Germany); Klinikum Grosshadern, Institut fuer Klinische Radiologie, LMU Muenchen, Muenchen (Germany); Hoegl, Sandra; Fisahn, Juergen; Irlbeck, Michael [Klinikum Grosshadern, Department of Anesthesiology, Ludwig Maximilians University, Muenchen (Germany); Nikolaou, Konstantin; Maxien, Daniel; Reiser, Maximilian F.; Becker, Christoph R.; Johnson, Thorsten R.C. [Klinikum Grosshadern, Department of Clinical Radiology, Ludwig Maximilians University, Muenchen (Germany)

2010-12-15

To evaluate the feasibility of dual-energy CT (DECT) ventilation imaging in combination with DE perfusion mapping for a comprehensive assessment of ventilation, perfusion, morphology and structure of the pulmonary parenchyma. Two dual-energy CT acquisitions for xenon-enhanced ventilation and iodine-enhanced perfusion mapping were performed in patients under artificial respiration. Parenchymal xenon and iodine distribution were mapped and correlated with structural or vascular abnormalities. In all datasets, image quality was sufficient for a comprehensive image reading of the pulmonary CTA images, lung window images and pulmonary functional parameter maps and led to expedient results in each patient. With dual-source CT systems, DECT of the lung with iodine or xenon administration is technically feasible and makes it possible to depict the regional iodine or xenon distribution representing the local perfusion and ventilation. (orig.)

Role of stress myocardial perfusion SPECT scan in detection and management of coronary artery disease: Nairobi experience

International Nuclear Information System (INIS)

Makhdomi, K.B.; Warshow, M.M.; Patel, P.K.J.; Shah, D.; Githegi, D.R.M.

2002-01-01

Aim: Stress myocardial perfusion scans have acquired a significant role in the detection and management of Coronary Artery Disease. However, this mode of investigation has only recently been available in Nairobi, and this is the first such study from East Africa. We undertook a comparison of our results with that in the literature, to see whether they conformed to it. Materials and Methods: We performed a review of our initial 82 evaluable studies. The scans were performed with 99mTc-Tetrofosmin, using the single day stress-rest protocol with SPECT acquisitions. We carried out a correlation of our scan findings with angiographic data (where available), and clinical follow-up. The clinical end points where furnished by the referring physicians. We focused on myocardial infarction, need for re-vascularisation, and death. The mean clinical follow-up was 21.8 months (range of 12 months to 39 months). Results: Eighty (98%) of the studies revealed concordance with angiographic findings and/or were predictive of clinical outcome. Two studies were discordant, and will be discussed. The results are comparable with those in the literature. Conclusion: It is concluded that stress myocardial perfusion studies, done at our Centre, had a good predictive value, with regards to the presence and severity of disease, and correlated with the clinical outcome data

The role of lung imaging in pulmonary embolism

Science.gov (United States)

Mishkin, Fred S.; Johnson, Philip M.

1973-01-01

The advantages of lung scanning in suspected pulmonary embolism are its diagnostic sensitivity, simplicity and safety. The ability to delineate regional pulmonary ischaemia, to quantitate its extent and to follow its response to therapy provides valuable clinical data available by no other simple means. The negative scan effectively excludes pulmonary embolism but, although certain of its features favour the diagnosis of embolism, the positive scan inherently lacks specificity and requires angiographic confirmation when embolectomy, caval plication or infusion of a thrombolytic agent are contemplated. The addition of simple ventilation imaging techniques with radioxenon overcomes this limitation by providing accurate analog estimation or digital quantitation of regional ventilation: perfusion (V/Q) ratios fundamental to understanding the pathophysiologic consequences of embolism and other diseases of the lung. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7p495-bFig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 13 PMID:4602128

Lung cancer in hilar region: the resectability evaluation with dual phase enhanced EBCT scan

International Nuclear Information System (INIS)

Tan Guosheng; Zhou Xuhui; Li Xiangmin; Fan Miao; Meng Quanfei; Peng Qian; Tan Zhiyu

2005-01-01

Objective: To explore the clinical value of duralphase enhanced electronic beam computed tomography (EBCT) scans in resectability evaluation of lung cancer located in hilar region. Methods: Dual phase enhanced EBCT scans were available for 40 cases that were initially diagnosed as 'carcinoma of lung' in hilar region. The relations between masses and trachea, bronchi, hilar and mediastinal great vessels were analyzed and compared with operation. Results: 38 cases in our series confirmed by operation and pathological examination were divided two groups: respectable (28 cases) and non-resectable (10 cases) groups. 25 cases in the former group were consistent with operation, accounting for 89.3%, and 8 cases, in the latter group, accounting for 80%. The sensitivity, specificity and accuracy of dural-phase enhanced EBCT scan evaluating the relations between masses and hilar and mediastinal structure were as follows: 92.6%, 72.7% and 86.8%. Conclusion: Dural-phase enhanced EBCT scans can provide precise and feasible pre-operative evaluation of lung cancer in hilar region. (authors)

Reverse re-distribution in the myocardial perfusion scan with 201 Ti

International Nuclear Information System (INIS)

Eftekhari, M.; Sadeghi, R.; Fard-Esfahani, A.; Beiki, D.; Fallahi, B.; Saghari, M.

2004-01-01

Reverse re-distribution pattern id defined as decreased activity in the myocardium in the rest phase of the myocardial perfusion scan in comparison with the stress images. There are many studies concerning the etiology and clinical significance of this phenomenon in nuclear medicine literature. The dominant idea about etiology of reserve redistribution is early wash out of the radiotracer from the myocardium. There is rather unanimous agreement among researchers about viability of the areas of reverse redistribution and the majority of the studies point to existence of viable tissue in these regions. However from prognostic point of view, this issue is much more controversial. In this review, we tried to summarize the current literature and reach a guideline for practical significance of reverse redistribution in every day work of nuclear medicine specialists

Lung ventilation-perfusion imbalance in pulmonary emphysema. Assessment with automated V/Q quotient SPECT

International Nuclear Information System (INIS)

Suga, Kazuyoshi; Kawakami, Yasuhiko; Koike, Hiroaki; Iwanaga, Hideyuki; Tokuda, Osamu; Okada, Munemasa; Matsunaga, Naofumi

2010-01-01

Tc-99m-Technegas-macro-aggregated albumin (MAA) single photon emission computed tomography (SPECT)-derived ventilation (V)/perfusion (Q) quotient SPECT was used to assess lung V-Q imbalance in patients with pulmonary emphysema. V/Q quotient SPECT and V/Q profile were automatically built in 38 patients with pulmonary emphysema and 12 controls, and V/Q distribution and V/Q profile parameters were compared. V/Q distribution on V/Q quotient SPECT was correlated with low attenuation areas (LAA) on density-mask computed tomography (CT). Parameters of V/Q profile such as the median, standard deviation (SD), kurtosis and skewness were proposed to objectively evaluate the severity of lung V-Q imbalance. In contrast to uniform V/Q distribution on V/Q quotient SPECT and a sharp peak with symmetrical V/Q distribution on V/Q profile in controls, lung areas showing heterogeneously high or low V/Q and flattened peaks with broadened V/Q distribution were frequently seen in patients with emphysema, including lung areas with only slight LAA. V/Q distribution was also often asymmetric regardless of symmetric LAA. All the proposed parameters of V/Q profile in entire lungs of patients with emphysema showed large variations compared with controls; SD and kurtosis were significantly different from controls (P<0.0001 and P<0.001, respectively), and a significant correlation was found between SD and A-aDO2 (P<0.0001). V/Q quotient SPECT appears to be more sensitive to detect emphysematous lungs compared with morphologic CT in patients with emphysema. SD and kurtosis of V/Q profile can be adequate parameters to assess the severity of lung V-Q imbalance causing gas-exchange impairment in patients with emphysema. (author)

Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.F.; Freedman, B.; Bailey, I.K.; Uren, R.F.; Kelly, D.T.

1981-01-01

In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability [p] less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery

Computer program for regional assessment of lung perfusion defect. Part II - verification of the algorithm

International Nuclear Information System (INIS)

Stefaniak, B.

2002-01-01

As described earlier, a dedicated computer program was developed for quantitative evaluation of regional lung perfusion defects, visualized by pulmonary scintigraphy. The correctness of the basic assumptions accepted to construct the algorithms and of the all program functions needed to be checked, before application of the program into the clinical routine. The aim of this study was to verified the program using various software instruments and physical models. Evaluation of the proposed method was performed using software procedures, physical lung phantom, and selected lung image.The reproducibility of lung regions, defined by the program was found excellent. No significant distortion of registered data was observed after ROI transformation into the circle and retransformation into the original shape. The obtained results comprised parametric presentation of activity defects as well as a set of numerical indices which defined extent and intensity of decreased counts density. Among these indices PD2 and DM* were proved the most suitable for the above purposes. The obtained results indicate that the algorithms used for the program construction were correct and suitable for the aim of the study. The above algorithms enable function under study to be presented graphically with true imaging of activity distribution, as well as numerical indices, defining extent and intensity of activity defects to calculated. (author)

Thin-section spiral CT evaluation of morphologic effects of aging lung in asymptomatic adult subjects

International Nuclear Information System (INIS)

Li Kuncheng; Liu Jian; Yang Yanhui; Yao Xinyu; Yin Jianguo; Wang Shiwen; He Zuoxiang

2006-01-01

Objective: To evaluate the imaging signs of aging lung in asymptomatic adult subjects by using thin-section spiral CT, and analyze the correlation between the signs and the age of examined cases, as well as probe their clinical application value. Methods: One hundred and six healthy adult subjects were divided into 3 groups: 30 to 44 years (n=31), 45 to 59 years (n=30), and over 60 years (n=45), and all the subjects underwent thin-section spiral CT scans in the upper lung field, the middle lung field and the lower lung field. The evaluation indices included the lung interstitium changes, emphysematous changes, mosaic perfusion, dependent density difference, and pleural thickenning. According to the relative score standard, the above-mentioned indices were totally calculated and converted into the score value. The data were statistically processed with SPSS for Windows. Results: Among the three groups, there were remarkable differences in the indices including the lung interstitium changes, emphysematous changes, and mosaic perfusion, respectively (χ 2 =8.10, 9.73, 15.54, P 2 =3.66, 3.24, P> 0.05). The score values had a significant positive correlation with the age (r=0.709, P<0.01). Conclusion: The signs including the lung interstitium changes, emphysematous changes, mosaic perfusion, the dependent density difference, and pleural thickenning can be found in asymptomatic subjects, and they become prominent as the age increases. HRCT is one of the most important methods for evaluating the early signs of the senile lung. (authors)

Hepatic perfusion during hepatic artery infusion chemotherapy: Evaluation with perfusion CT and perfusion scintigraphy

International Nuclear Information System (INIS)

Miller, D.L.; Carrasquillo, J.A.; Lutz, R.J.; Chang, A.E.

1989-01-01

The standard method for the evaluation of hepatic perfusion during hepatic artery infusion (HAI) chemotherapy is planar hepatic artery perfusion scintigraphy (HAPS). Planar HAPS was performed with 2 mCi of [99mTc] macroaggregated albumin infused at 1 ml/min and compared with single photon emission CT (SPECT) HAPS and with a new study, CT performed during the slow injection of contrast material through the HAI catheter (HAI-CT). Thirteen patients underwent 16 HAI-CT studies, 14 planar HAPS studies, and 9 SPECT HAPS studies. In 13 of 14 studies (93%) HAI-CT and planar HAPS were in complete agreement as to the perfusion pattern of intrahepatic metastases and normal liver. In nine studies where all modalities were performed, the findings identified by HAI-CT and planar HAPS agreed in all cases, whereas the results of two SPECT scans disagreed with the other studies. With respect to perfusion of individual metastases, 14 of 14 HAI-CT studies, 12 of 13 planar HAPS studies, and 9 of 9 SPECT HAPS studies correctly demonstrated the perfusion status of individual lesions as indicated by the pattern of changes in tumor size determined on CT obtained before and after the perfusion studies. Hepatic artery infusion CT was superior for delineation of individual metastases, particularly small lesions, and for the evaluation of nonperfused portions of the liver. Planar HAPS detected extrahepatic perfusion in four patients, and this was not detected by HAI-CT. We conclude that HAI-CT and scintigraphy are complementary techniques. Hepatic artery infusion CT has advantages for the evaluation of intrahepatic perfusion, and planar HAPS is superior to HAI-CT for the detection of extrahepatic perfusion

Radioaerosol imaging of the lung. An IAEA [CRP] group study

International Nuclear Information System (INIS)

Yong Whee Bahk; Isawa, Toyoharu

1994-01-01

Nuclear scans, radiography and computed tomography (CT) of the lung make up three pantheonic pillars of the modem imaging diagnosis of pulmonary disorders and the contribution of these modalities to the progress of pulmonology has been immense. However the experiences accumulated during the past decades indicate that, with well-known advantages and drawbacks, not one of these imaging modalities can be perfect by itself alone, and it has become obvious that the individual tests are as much complementary to one another as unique. As a matter of fact, the nuclear lung imagings, that include inhalation scan, perfusion scan, ventilation scan and the most recently developed mucociliary transport and alveolar permeability tests, are very sensitive and efficient in respectively providing graphic information about airway patency and alveolar penetration, vascular patency and distribution pattern, alveolar gas exchange and bronchial epithelial integrity in both normal and pathological conditions. But these tests lack fine morphological information. In contrast, radiography with its extremely high level of resolution that is in the order of 30-100 line pairs/mm compared to 3-5 line/cm of nuclear scan resolution power, suffers from the lack of information about the alveolar gas exchange, pulmonary perfusion and respiratory function. Although incomparable to radiography, the resolution power of CT scan is also much greater than that of nuclear scan, but again this test cannot provide the information regarding function and physiology. The aerosol scan findings in each of these diseases are assessed in the i ht of and validated against chest radiography, conventional X-ray tomography and high resolution CT scan. The chapters in this monograph describe a history of radioaerosol lung imaging, radiopharmaceuticals, generation of aerosols by the BARC and other nebulizers, and pertinent lung physiology and the way how aerosol deposits in lung. The technical and constructional aspects

Radioaerosol imaging of the lung. An IAEA [CRP] group study

Energy Technology Data Exchange (ETDEWEB)

Bahk, Yong Whee [Departments of Radiology and Nuclear Medicine, Kangnam St. Mary' s Hospital, Catholic University Medical College, Seoul (Korea, Republic of); Isawa, Toyoharu [Tohoku University Research Institute for Chest Disease and Cancer, Sendai (Japan); eds.

1994-07-01

Nuclear scans, radiography and computed tomography (CT) of the lung make up three pantheonic pillars of the modem imaging diagnosis of pulmonary disorders and the contribution of these modalities to the progress of pulmonology has been immense. However the experiences accumulated during the past decades indicate that, with well-known advantages and drawbacks, not one of these imaging modalities can be perfect by itself alone, and it has become obvious that the individual tests are as much complementary to one another as unique. As a matter of fact, the nuclear lung imagings, that include inhalation scan, perfusion scan, ventilation scan and the most recently developed mucociliary transport and alveolar permeability tests, are very sensitive and efficient in respectively providing graphic information about airway patency and alveolar penetration, vascular patency and distribution pattern, alveolar gas exchange and bronchial epithelial integrity in both normal and pathological conditions. But these tests lack fine morphological information. In contrast, radiography with its extremely high level of resolution that is in the order of 30-100 line pairs/mm compared to 3-5 line/cm of nuclear scan resolution power, suffers from the lack of information about the alveolar gas exchange, pulmonary perfusion and respiratory function. Although incomparable to radiography, the resolution power of CT scan is also much greater than that of nuclear scan, but again this test cannot provide the information regarding function and physiology. The aerosol scan findings in each of these diseases are assessed in the i ht of and validated against chest radiography, conventional X-ray tomography and high resolution CT scan. The chapters in this monograph describe a history of radioaerosol lung imaging, radiopharmaceuticals, generation of aerosols by the BARC and other nebulizers, and pertinent lung physiology and the way how aerosol deposits in lung. The technical and constructional aspects

The effect of patient-specific factors on radiation-induced regional lung injury

International Nuclear Information System (INIS)

Garipagaoglu, Melahat; Munley, Michael T.; Hollis, Donna; Poulson, Jean M.; Bentel, Gunilla C.; Sibley, Gregory; Anscher, Mitchell S.; Fan Ming; Jaszczak, Ronald J.; Coleman, R. Edward; Marks, Lawrence B.

1999-01-01

Purpose: To assess the impact of patient-specific factors on radiation (RT)-induced reductions in regional lung perfusion. Methods: Fifty patients (32 lung carcinoma, 7 Hodgkin's disease, 9 breast carcinoma and 2 other thoracic tumors) had pre-RT and ≥24-week post-RT single photon emission computed tomography (SPECT) perfusion images to assess the dose dependence of RT-induced reductions in regional lung perfusion. The SPECT data were analyzed using a normalized and non-normalized approach. Furthermore, two different mathematical methods were used to assess the impact of patient-specific factors on the dose-response curve (DRC). First, DRCs for different patient subgroups were generated and compared. Second, in a more formal statistical approach, individual DRCs for regional lung injury for each patient were fit to a linear-quadratic model (reduction = coefficient 1 x dose + coefficient 2 x dose 2 ). Multiple patient-specific factors including tobacco history, pre-RT diffusion capacity to carbon monoxide (DLCO), transforming growth factor-beta (TGF-β), chemotherapy exposure, disease type, and mean lung dose were explored in a multivariate analysis to assess their impact on the coefficients. Results: None of the variables tested had a consistent impact on the radiation sensitivity of regional lung (i.e., the slope of the DRC). In the formal statistical analysis, there was a suggestion of a slight increase in radiation sensitivity in the dose range >40 Gy for nonsmokers (vs. smokers) and in those receiving chemotherapy (vs. no chemotherapy). However, this finding was very dependent on the specific statistical and normalization method used. Conclusion: Patient-specific factors do not have a dramatic effect on RT-induced reduction in regional lung perfusion. Additional studies are underway to better clarify this issue. We continue to postulate that patient-specific factors will impact on how the summation of regional injury translates into whole organ injury

Quantitative Xe-133 perfusion and exhalation scintigraphy of lungs in children with asthma

International Nuclear Information System (INIS)

Lederer, A.G.; Sternthal, H.M.; Nicoletti, R.; Fuger, G.F.

1990-01-01

In children with asthma, the authors quantified the extent of the obstructive lung disease by calculating a time to peak (TTP) and mean transit time (MTT) image. In this paper compare the results to common pulmonary function tests. The authors studied 17 children twice: first, after the initial intravenous therapy after an asthmatic attach and, second, before discharge from the hospital. After intravenous injection of 185-370 MBq of Xe-133, a dynamic computer acquisition was performed, and a TTP and MTT image were calculated. The authors were able to estimate the extent, intensity (qualified by the MTT), and location of the ventilation disorder as well as the changes of perfusion (expressed by the TTP) in sever disease

Evaluation of optimized magnetic resonance perfusion imaging scanning time window after contrast agent injection for differentiating benign and malignant breast lesions.

Science.gov (United States)

Dong, Jie; Wang, Dawei; Ma, Zhenshen; Deng, Guodong; Wang, Lanhua; Zhang, Jiandong

2017-03-01

The aim of the study was evaluate the 3.0 T magnetic resonance (MR) perfusion imaging scanning time window following contrast injection for differentiating benign and malignant breast lesions and to determine the optimum scanning time window for increased scanner usage efficiency and reduced diagnostic adverse risk factors. A total of 52 women with breast abnormalities were selected for conventional MR imaging and T1 dynamic-enhanced imaging. Quantitative parameters [volume transfer constant (K trans ), rate constant (K ep ) and extravascular extracellular volume fraction (V e )] were calculated at phases 10, 20, 30, 40 and 50, which represented time windows at 5, 10, 15, 20 and 25 min, respectively, following injection of contrast agent. The association of the parameters at different phases with benign and malignant tumor diagnosis was analyzed. MR perfusion imaging was verified as an effective modality in the diagnosis of breast malignancies and the best scanning time window was identified: i) Values of K trans and K ep at all phases were statistically significant in differentiating benign and malignant tumors (P0.05); ii) values of V e in benign tumors increased with phase number, but achieved no obvious changes at different phases in malignant tumors; iii) the optimum scanning time window of breast perfusion imaging with 3.0 T MR was between phases 10 and 30 (i.e., between 5 and 15 min after contrast agent injection). The variation trend of V e values at different phases may serve as a diagnostic reference for differentiating benign and malignant breast abnormalities. The most efficient scanning time window was indicated to be 5 min after contrast injection, based on the observation that the V e value only had statistical significance in diagnosis at stage 10. However, the optimal scanning time window is from 5 to 15 min following the injection of contrast agent, since that the variation trend of V e is able to serve as a diagnostic reference.

Acute tumor vascular effects following fractionated radiotherapy in human lung cancer: In vivo whole tumor assessment using volumetric perfusion computed tomography

International Nuclear Information System (INIS)

Ng, Q.-S.; Goh, Vicky; Milner, Jessica; Padhani, Anwar R.; Saunders, Michele I.; Hoskin, Peter J.

2007-01-01

Purpose: To quantitatively assess the in vivo acute vascular effects of fractionated radiotherapy for human non-small-cell lung cancer using volumetric perfusion computed tomography (CT). Methods and Materials: Sixteen patients with advanced non-small-cell lung cancer, undergoing palliative radiotherapy delivering 27 Gy in 6 fractions over 3 weeks, were scanned before treatment, and after the second (9 Gy), fourth (18 Gy), and sixth (27 Gy) radiation fraction. Using 16-detector CT, multiple sequential volumetric acquisitions were acquired after intravenous contrast agent injection. Measurements of vascular blood volume and permeability for the whole tumor volume were obtained. Vascular changes at the tumor periphery and center were also measured. Results: At baseline, lung tumor vascularity was spatially heterogeneous with the tumor rim showing a higher vascular blood volume and permeability than the center. After the second, fourth, and sixth fractions of radiotherapy, vascular blood volume increased by 31.6% (paired t test, p = 0.10), 49.3% (p = 0.034), and 44.6% (p = 0.0012) respectively at the tumor rim, and 16.4% (p = 0.29), 19.9% (p = 0.029), and 4.0% (p = 0.0050) respectively at the center of the tumor. After the second, fourth, and sixth fractions of radiotherapy, vessel permeability increased by 18.4% (p = 0.022), 44.8% (p = 0.0048), and 20.5% (p = 0.25) at the tumor rim. The increase in permeability at the tumor center was not significant after radiotherapy. Conclusion: Fractionated radiotherapy increases tumor vascular blood volume and permeability in human non-small-cell lung cancer. We have established the spatial distribution of vascular changes after radiotherapy; greater vascular changes were demonstrated at the tumor rim compared with the center

Prevention of reperfusion lung injury by lidocaine in isolated rat lung ventilated with higher oxygen levels.

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Das K

2003-01-01

Full Text Available BACKGROUND: Lidocaine, an antiarrhythmic drug has been shown to be effective against post-ischaemic reperfusion injury in heart. However, its effect on pulmonary reperfusion injury has not been investigated. AIMS: We investigated the effects of lidocaine on a postischaemic reperfused rat lung model. MATERIALS AND METHODS: Lungs were isolated and perfused at constant flow with Krebs-Henseilet buffer containing 4% bovine serum albumin, and ventilated with 95% oxygen mixed with 5% CO2. Lungs were subjected to ischaemia by stopping perfusion for 60 minutes followed by reperfusion for 10 minutes. Ischaemia was induced in normothermic conditions. RESULTS: Postischaemic reperfusion caused significant (p < 0.0001 higher wet-to-dry lung weight ratio, pulmonary arterial pressure and peak airway pressure compared to control lungs. Lidocaine, at a dose of 5mg/Kg b.w. was found to significantly (p < 0.0001 attenuate the increase in the wet-to-dry lung weight ratio, pulmonary arterial pressure and peak airway pressure observed in post-ischaemic lungs. CONCLUSION: Lidocaine is effective in preventing post-ischaemic reperfusion injury in isolated, perfused rat lung.

Dynamic (4D) CT perfusion offers simultaneous functional and anatomical insights into pulmonary embolism resolution

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Mirsadraee, Saeed, E-mail: saeed.mirsadraee@ed.ac.uk [Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom); Reid, John H.; Connell, Martin [Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom); MacNee, William; Hirani, Nikhil [The Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom); Murchison, John T. [Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA (United Kingdom); Beek, Edwin J. van [Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom)

2016-10-15

Objective: Resolution and long-term functional effects of pulmonary emboli are unpredictable. This study was carried out to assess persisting vascular bed perfusion abnormalities and resolution of arterial thrombus in patients with recent pulmonary embolism (PE). Methods and materials: 26 Patients were prospectively evaluated by dynamic (4D) contrast enhanced CT perfusion dynamic pulmonary CT perfusion. Intermittent volume imaging was performed every 1.5–1.7 s during breath-hold and perfusion values were calculated by maximum-slope technique. Thrombus load (modified Miller score; MMS) and ventricular diameter were determined. Perfusion maps were visually scored and correlated with residual endoluminal filling defects. Results: The mean initial thrombus load was 13.1 ± 4.6 MMS (3–16), and 1.2 ± 2.1 MMS (0–8) at follow up. From the 24 CTPs with diagnostic quality perfusion studies, normal perfusion was observed in 7 (29%), and mildly-severely abnormal in 17 (71%). In 15 patients with no residual thrombus on follow up CTPA, normal perfusion was observed in 6, and abnormal perfusion in 9. Perfusion was abnormal in all patients with residual thrombus on follow up CTPA. Pulmonary perfusion changes were classified as reduced (n = 4), delayed (systemic circulation pattern; n = 5), and absent (no-flow; n = 5). The right ventricle was dilated in 12/25 (48%) at presentation, and normal in all 26 follow up scans. Weak correlation was found between initial ventricular dilatation and perfusion abnormality at follow up (r = 0.15). Conclusions: Most patients had substantial perfusion abnormality at 3–6 months post PE. Abnormal perfusion patterns were frequently observed in patients and in regions with no corresponding evidence of residual thrombus on CTPA. Some defects exhibit delayed, presumed systemic, enhancement (which we have termed ‘stunned’ lung). CT perfusion provides combined anatomical and functional information about PE resolution.

Role of myocardial perfusion SPECT in asymptomatic diabetic patients

International Nuclear Information System (INIS)

Cho, I.; Chun, K.; Won, K.; Lee, H.; Park, J.; Shin, D.; Kim, Y.; Shim, B.; Lee, J.

2002-01-01

Purpose: It is important that early diagnosis and treatment of coronary artery disease in diabetic patients, but there are few reports on the prevalence of stress-induced myocardial perfusion abnormalities and the rates of cardiac event in patients with type 2 diabetes. We evaluated the scan findings on gated myocardial perfusion SPECT in asymptomatic diabetic patients. Methods: We performed pharmacological stress test and gated perfusion SPECT in 69 diabetic patients without cardiovascular symptom (mean age: 65 year, male 31 and female 38). Patients underwent two-day imaging protocol and stress study was performed injection of Tc-99m MIBI during adenosine infusion. We followed up these patients by reviewing medical records. Results: Fifty-two of 69 patients (74.5%) showed normal scan findings and 17 patients (24.6%) showed reversible or fixed perfusion defects. Three of 52 patients with normal scan findings showed decreased LV ejection fraction and decreased wall motion. Twenty-three patients with normal scan findings were possible to follow up for more than 1yr (mean time: 18.3±3.3 mo.) and they all had no cardiac event. Three patients with reversible perfusion defects were performed coronary angioplasty. Conclusion: Myocardial perfusion SPECT is a noninvasive method and maybe useful in early diagnosis and predicting prognosis in diabetic patients

Study of the ventilatory lung motion imaging in primary lung cancer

International Nuclear Information System (INIS)

Fujii, Tadashige; Tanaka, Masao; Yazaki, Yosikazu; Kitabayashi, Hiroshi; Sekiguchi, Morie.

1996-01-01

Using perfusion lung scintigrams with Tc-99m macroaggregated alubumin at maximal inspiration (I) and expiration (E), images of the ventilatory lung motion, which was calculated and delineated by an expression as (E-I)/I, were obtained in 84 cases with primary lung cancer, and its clinical significance in the diagnosis of primary lung cancer was studied. The image of (E-I)/I consisted of positive and negative components. The former visualized the motion of the regional intrapulmonary areas and the latter showed the motion of the lung border. The sum of positive (E-I)/I in the lung with the primary lesion which was lower than that in the contralateral lung, was significantly low in cases with hilar mass, pleural effusion and TNM classification of T3+T4. The sum of positive (E-I)/I in both lungs and vital capacity was relatively low in cases with hilar mass, pleural effusion, TNM classification of T3+T4 and M1. The distribution pattern of pulmonary perfusion and positive (E-I)/I was fairly matched in 48 cases, but mismatch was observed in 36 cases. In the image of negative (E-I)/I, decreased motion of the lung border including the diaphragm was shown in cases with pleural adhesion and thickening, pleural effusion, phrenic nerve palsy and other conditions with hypoventilation. This technique seems to be useful for the estimation of regional pulmonary function of pulmonary perfusion and lung motion, the extent and pathophysiology of primary lung cancer. (author)

Study of the ventilatory lung motion imaging in primary lung cancer

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Fujii, Tadashige [Shinshu Univ., Matsumoto, Nagano (Japan). Shool of Allied Medical Sciences; Tanaka, Masao; Yazaki, Yosikazu; Kitabayashi, Hiroshi; Sekiguchi, Morie

1996-12-01

Using perfusion lung scintigrams with Tc-99m macroaggregated alubumin at maximal inspiration (I) and expiration (E), images of the ventilatory lung motion, which was calculated and delineated by an expression as (E-I)/I, were obtained in 84 cases with primary lung cancer, and its clinical significance in the diagnosis of primary lung cancer was studied. The image of (E-I)/I consisted of positive and negative components. The former visualized the motion of the regional intrapulmonary areas and the latter showed the motion of the lung border. The sum of positive (E-I)/I in the lung with the primary lesion which was lower than that in the contralateral lung, was significantly low in cases with hilar mass, pleural effusion and TNM classification of T3+T4. The sum of positive (E-I)/I in both lungs and vital capacity was relatively low in cases with hilar mass, pleural effusion, TNM classification of T3+T4 and M1. The distribution pattern of pulmonary perfusion and positive (E-I)/I was fairly matched in 48 cases, but mismatch was observed in 36 cases. In the image of negative (E-I)/I, decreased motion of the lung border including the diaphragm was shown in cases with pleural adhesion and thickening, pleural effusion, phrenic nerve palsy and other conditions with hypoventilation. This technique seems to be useful for the estimation of regional pulmonary function of pulmonary perfusion and lung motion, the extent and pathophysiology of primary lung cancer. (author)

The matching of ventilation and perfusion in the lung of the Tegu lizard, Tupinambis nigropunctatus.

Science.gov (United States)

Hlastala, M P; Standaert, T A; Pierson, D J; Luchtel, D L

1985-06-01

Ventilation-perfusion (VA/Q) distribution was evaluated in the Tegu lizard, Tupinambis nigropunctatus, using the multiple inert gas elimination technique (MIGET) in order to define the limitations to gas exchange in the large chambered unicameral lung. The lizards (0.52-1.1 kg) were anesthetized with halothane and ventilated. Body temperature was maintained at 35 degrees C. Arterial and sinus venosus PO2 averaged 79.4 +/- 5.9 and 47.3 +/- 6.4 torr while breathing air and 232.1 +/- 31 and 64.8 +/- 11.5 torr while breathing oxygen. VA/Q distributions were broad and right-to-left shunt averaged 21% while breathing air and 27% while breathing oxygen. Gas exchange was significantly impaired due to the presence of both shunt and VA/Q heterogeneity. The walls of the lung enclose a large axial air chamber. Microscopic examination revealed approximately three generations of septa which subdivided the wall into tubular-shaped gas-exchange chambers. Wall thickness averages 2.8 mm at the anterior end of the lung, 2.1 mm in the middle portion of the lung and 1.4 mm at the posterior end. The thickness of the blood-air barrier (epithelial-basal lamina-endothelial cell layer) ranged from 0.35 to 0.90 micron. Although this barrier is slightly thicker than in the mammalian lung (0.1-0.5 micron), it is unlikely to be a source of diffusion limitation in gas exchange at rest.

Ventilation and perfusion display in a single image

International Nuclear Information System (INIS)

Lima, J.J.P. de; Botelho, M.F.R.; Pereira, A.M.S.; Rafael, J.A.S.; Pinto, A.J.; Marques, M.A.T.; Pereira, M.C.; Baganha, M.F.; Godinho, F.

1991-01-01

A new method of ventilation and perfusion display onto a single image is presented. From the data on regions of interest of the lungs, three-dimensional histograms are created, containing as parameters X and Y for the position of the pixels, Z for the perfusion and colour for local ventilation. The perfusion value is supplied by sets of curves having Z proportional to the local perfusion count rate. Ventilation modulates colour. Four perspective views of the histogram are simultaneously displayed to allow visualization of the entire organ. Information about the normal ranges for both ventilation and perfusion is also provided in the histograms. (orig.)

Feasibility of using intravenous contrast-enhanced computed tomography (CT) scans in lung cancer treatment planning

International Nuclear Information System (INIS)

Xiao Jianghong; Zhang Hong; Gong Youling; Fu Yuchuan; Tang Bin; Wang Shichao; Jiang Qingfeng; Li Ping

2010-01-01

Background and purpose: To investigate the feasibility of using intravenous contrast-enhanced computed tomography (CT) scans in 3-dimensional conformal radiotherapy (3D-CRT), stereotactic body radiation therapy (SBRT) and intensity-modulated radiotherapy (IMRT) treatment planning for lung cancers, respectively. Materials and methods: Twelve patients with bulky lung tumors and 14 patients with small lung tumors were retrospectively analyzed. Each patient took two sets of CT in the same position with active breathing control (ABC) technique before and after intravenous contrast agent (CA) injections. Bulky tumors were planned with 3D-CRT, while SBRT plans were generated for patients with small tumors based on CT scans with intravenous CA. In addition, IMRT plans were generated for patients with bulky tumors to continue on a planning study. All plans were copied and replaced on the scans without intravenous CA. The radiation doses calculated from the two sets of CTs were compared with regard to planning volumes (PTV), the organ at-risk (OAR) and the lungs using Wilcoxon's signed rank test. Results: In comparisons for 3D-CRT plans, CT scans with intravenous CA reduced the mean dose and the maximum dose of PTV with significant differences (p 95 ) for targets, respectively (p < 0.05). There was no statistical significance for lung parameters between two sets of scans in SBRT plans and IMRT plans. Conclusions: The enhanced CT scans can be used for both target delineation and treatment planning in 3D-CRT. The dose difference caused by intravenous CA is small. But for SBRT and IMRT, the minimum irradiation dose in targets may be estimated to be increased up to 2.71% while the maximum dose may be estimated to be decreased up to 1.36%. However, the difference in dose distribution in most cases were found to be clinical tolerable.

Topographic distribution of pulmonary ventilation and perfusion in the horse

International Nuclear Information System (INIS)

Amis, T.C.; Pascoe, J.R.; Hornof, W.

1984-01-01

The regional distribution of ventilation to perfusion ratios (VA/Q) in the lungs of 8 healthy standing Thoroughbred geldings (4.4 +/- 1.5 years, 465.7 +/- 46.6 kg) was studied, using steady-state inhalation and IV infusion of the radioactive gas krypton-81m. The VA/Q was uniformly distributed within a vertical lung strip centered over the 9th rib on the right side. Ventilation per unit of alveolar volume (V/VA) assessed from the clearance of inhaled radioactive gas in 5 horses increased from 0.49 +/- 0.13 (arbitrary units) in nondependent lung zones to 1.45 +/- 0.16 in dependent lung zones. Seemingly, a vertical gradient of pulmonary ventilation exists in the horse that is matched by a similar gradient of perfusion

Topographic distribution of pulmonary ventilation and perfusion in the horse

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Amis, T.C.; Pascoe, J.R.; Hornof, W.

1984-08-01

The regional distribution of ventilation to perfusion ratios (VA/Q) in the lungs of 8 healthy standing Thoroughbred geldings (4.4 +/- 1.5 years, 465.7 +/- 46.6 kg) was studied, using steady-state inhalation and IV infusion of the radioactive gas krypton-81m. The VA/Q was uniformly distributed within a vertical lung strip centered over the 9th rib on the right side. Ventilation per unit of alveolar volume (V/VA) assessed from the clearance of inhaled radioactive gas in 5 horses increased from 0.49 +/- 0.13 (arbitrary units) in nondependent lung zones to 1.45 +/- 0.16 in dependent lung zones. Seemingly, a vertical gradient of pulmonary ventilation exists in the horse that is matched by a similar gradient of perfusion.

Study on thallium-201 myocardial perfusion scanning for detection of right ventricular hypertrophy in chronic pulmonary disease

International Nuclear Information System (INIS)

Kawai, Seiki

1980-01-01

Thallium-201 myocardial perfusion scanning was performed in 34 patients with chronic pulmonary disease for the purpose of detecting right ventricular hypertrophy. Thallium-201 activity ratio of left ventricle plus ventricular septum/right ventricle (TAR) was significantly correlated with hemodynamic findings such as pulmonary arterial mean pressure (r = -0.75, p 2 (p < 0.001). Assuming that TAR < 2 or TAR = 2 would indicate pulmonary hypertension, sensitivity was 95%, specificity 79%, validity score 75%, false positive 14% and false negative was 8%. TAR was compared with left to right ventricular mass ratio using Fulton's method in 6 autopsied patients in whom thallium-201 myocardial perfusion scanning were performed within three months before death. TAR closely correlated with left to right ventricular mass ratio (r = 0.978, p < 0.001). The comparison of validity of TAR with those of electrocardiographic interpretation according to WHO, Sasamoto, Roman or Milnor for the detection of right ventricular hypertrophy revealed the former was much superior to all of latters. From the results obtained, it may be inferred that TAR reflects the degree of pulmonary hypertension and anatomical right ventricular hypertrophy and is a useful non-invasive method to detect right ventricular hypertrophy in chronic pulmonary disease. (J.P.N.)

Perfusion abnormalities in congenital and neoplastic pulmonary disease: comparison of MR perfusion and multislice CT imaging

International Nuclear Information System (INIS)

Boll, Daniel T.; Lewin, Jonathan S.; Young, Philip; Gilkeson, Robert C.; Siwik, Ernest S.

2005-01-01

The aim of this work was to assess magnetic resonance (MR) perfusion patterns of chronic, nonembolic pulmonary diseases of congenital and neoplastic origin and to compare the findings with results obtained with pulmonary, contrast-enhanced multislice computed tomography (CT) imaging to prove that congenital and neoplastic pulmonary conditions require MR imaging over the pulmonary perfusion cycle to successfully and directly detect changes in lung perfusion patterns. Twenty-five patients underwent concurrent CT and MR evaluation of chronic pulmonary diseases of congenital (n=15) or neoplastic (n=10) origin. Analysis of MR perfusion and contrast-enhanced CT datasets was realized by defining pulmonary and vascular regions of interest in corresponding positions. MR perfusion calculated time-to-peak enhancement, maximal enhancement and the area under the perfusion curve. CT datasets provided pulmonary signal-to-noise ratio measurements. Vessel centerlines of bronchial arteries were determined. Underlying perfusion type, such as pulmonary arterial or systemic arterial supply, as well as regions with significant variations in perfusion were determined statistically. Analysis of the pulmonary perfusion pattern detected pulmonary arterial supply in 19 patients; six patients showed systemic arterial supply. In pulmonary arterial perfusion, MR and multislice CT imaging consistently detected the perfusion type and regions with altered perfusion patterns. In bronchial arterial supply, MR perfusion and CT imaging showed significant perfusion differences. Patients with bronchial arterial supply had bronchial arteries ranging from 2.0 to 3.6 mm compared with submillimeter diameters in pulmonary arterial perfusion. Dynamic MR imaging of congenital and neoplastic pulmonary conditions allowed characterization of the pulmonary perfusion type. CT imaging suggested the presence of systemic arterial perfusion by visualizing hypertrophied bronchial arteries. (orig.)

Cystic lung disease: a comparison of cystic size, as seen on expiratory and inspiratory HRCT scans

International Nuclear Information System (INIS)

Lee, Ki Nam; Yoon, Seong Kuk; Nam, Kyung Jin; Choi, Seok Jin; Goo, Jin Mo

2000-01-01

To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary

Cystic lung disease: a comparison of cystic size, as seen on expiratory and inspiratory HRCT scans

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Lee, Ki Nam; Yoon, Seong Kuk; Nam, Kyung Jin [Donga University College of Medicine, Pusan (Korea, Republic of); Choi, Seok Jin [Inje University College of Medicine, Gimhae (Korea, Republic of); Goo, Jin Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2000-06-01

To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary.

How to optimize the lung donor.

Science.gov (United States)

Sales, Gabriele; Costamagna, Andrea; Fanelli, Vito; Boffini, Massimo; Pugliese, Francesco; Mascia, Luciana; Brazzi, Luca

2018-02-01

Over the last two decades, lung transplantation emerged as the standard of care for patients with advanced and terminal lung disease. Despite the increment in lung transplantation rates, in 2016 the overall mortality while on waiting list in Italy reached 10%, whereas only 39% of the wait-list patients were successfully transplanted. A number of approaches, including protective ventilatory strategy, accurate management of fluid balance, and administration of a hormonal resuscitation therapy, have been reported to improve lung donor performance before organ retrieval. These approaches, in conjunction with the use of ex-vivo lung perfusion technique contributed to expand the lung donor pool, without affecting the harvest of other organs and the outcomes of lung recipients. However, the efficacy of issues related to the ex-vivo lung perfusion technique, such as the optimal ventilation strategy, the ischemia-reperfusion induced lung injury management, the prophylaxis of germs transmission from donor to recipient and the application of targeted pharmacologic therapies to treat specific donor lung injuries are still to be explored. The main objective of the present review is to summarize the "state-of-art" strategies to optimize the donor lungs and to present the actual role of ex-vivo lung perfusion in the process of lung transplant. Moreover, different approaches about the technique reported in literature and several issues that are under investigation to treat specific donor lung injury will be discussed.

The multi-slice CT perfusion imaging in evaluating the prevention and treatment by edaravone on lung ischemia-reperfusion injury after pulmonary thromboembolism

International Nuclear Information System (INIS)

Li Jianjun; Zhai Renyou; Zhang Dongpo; Huang Qiang; Dai Dingke; Yu Ping; Bao Na

2008-01-01

Objective: To evaluate the multi-slice CT perfusion imaging in investigating whether edaravone can prevent and treat pulmonary thromboembolism ischemia-reperfusion injury (PTE-IRI). Methods: Twenty mongrel canines were included. A Swan-Ganz catheter was introduced into the right internal jugular vein using the Seldinger technique, and then was inserted into the pulmonary artery. Balloon occlusion of the right inferior lobe pulmonary artery for 4 h was followed by removing catheter and 4 h o reperfusion. Animals were divided into four groups of A (no edaravone during ischenmia and reperfusion), B (edaravone used only during ischemia), C (edaravone used during both ischemia and reperfusion) and D group (edaravone used only during reperfusion) (n=5 per group). Every group was divided into three time points including before ischemia, 4 h after ischemia and 4 h after reperfusion. CT scan and CT perfusion were performed at the three time points. The blood flow (BF), blood volume (BV) and mean transit time (MTT) of the bilateral inferior regional lung parenchyma were measured with the software of perfusion 3. Results: CT examination showed pulmonary edema in the right inferior lung lobe at 4 h after reperfusion. (1) The BF and MTT of A, B, C and D group were[(259.4±15.7)ml·min -1 ·100 g -1 , (293.7± 7.9) ml·min -1 ·100 g -1 , (379.4±14.5)ml·min -1 ·100 g -1 , (382.5±16.6)ml·min -1 ·. 100 g -1 ] and [(3.1±0.2)s, (2.6±0.2)s, (2.2±0.1)s, (1.9±0.2)s] respectively at 4 h after reperfusion. The BF and MTT were statistically different (P 0.05) at 4 h after reperfusion, but the BV was not statistically different between groups (P>0.05). (2) The BF [(397.2± 19.2)ml·min -1 ·100 g -1 and (259.4±15.7) ml·min -1 ·100 g -1 in group A, (393.2±16.1) ml· min -1 ·100 g -1 and (293.7±7.9) ml·min -1 ·100 g -1 in group B] and MTF [(1.8±0.1)s and (3.1±0.2) s in group A, (1.8±0.2) s and (2.6±0.2) s in group B] were statistically different (P 0.05) between groups

Correlation of semiquantitative analysis of the distribution of pulmonary perfusion with pulmonary function in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Uchida, Kou; Nakayama, Hiroyuki; Yamagami, Ikue; Takahashi, Hideki; Takano, Masaaki.

1997-01-01

We carried out ventilation-perfusion scintigraphy and pulmonary function tests in 56 patients with chronic obstructive pulmonary disease (COPD) and 19 healthy volunteers. We used 99m Tc-macroaggregated albumin for the perfusion scintigraphy and 133 Xe gas for the ventilation scintigraphy. The lung volume image was created by computerized summation of the radioactivity in the rebreathing phase. Regions of interest (ROIs) were set automatically on lung volume image, which included each whole lung, and on perfusion image, including areas with relatively high radioactivity, with cut-off levels of 50%, 70%, and 90%. The number of pixels in each ROI was used as an index of lung volume (L) or perfusion (P). Perfusion per unit of lung volume (P/L) was also used as an index of perfusion. P70 and P70/L showed the better correlations than the other parameters, including significant correlations with vital capacity, FEV 1.0 , peak flow rate, RV/TLC, diffusing capacity and arterial oxygen partial pressure. The significant difference in P70 and P70/L between patients with hypoxemia and those without hypoxemia suggested that P70 and P70/L are useful indicators of the severity of COPD. We conclude that semiquantified values of pulmonary perfusion scintigraphy are significantly correlated with pulmonary function and the severity of COPD. (author)

Myocardial visualization on a routine perfusion lung scintigram: Relationship to the amount of right-to-left shunt

International Nuclear Information System (INIS)

Seto, H.; Futatsuya, R.; Kamei, T.; Kakishita, M.; Hisada, K.

1983-01-01

Three cases of myocardial visualization on a routine perfusion lung scintigram with sup(99m)Tc-macroaggregaed albumin were reported in patients with congenital heart diseases; two cases of tetralogy of Fallot and one case of truncus arteriosus type IV. Large right-to-left shunts greater than 39% and marked hypertrophy of the ventricle suggesting the presence of increased coronary blood flow were noted in all cases. In the two patients with tetralogy of Fallot myocardial activity appeared to be located in the hypertrophic right venticles. (orig.)

Myocardial visualization on a routine perfusion lung scintigram: Relationship to the amount of right-to-left shunt

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Seto, H.; Futatsuya, R.; Kamei, T.; Kakishita, M.; Hisada, K.

1983-11-14

Three cases of myocardial visualization on a routine perfusion lung scintigram with sup(99m)Tc-macroaggregated albumin were reported in patients with congenital heart diseases; two cases of tetralogy of Fallot and one case of truncus arteriosus type IV. Large right-to-left shunts greater than 39% and marked hypertrophy of the ventricle suggesting the presence of increased coronary blood flow were noted in all cases. In the two patients with tetralogy of Fallot myocardial activity appeared to be located in the hypertrophic right venticles.

Assessment of anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema with breath-hold SPECT-CT fusion images

International Nuclear Information System (INIS)

Suga, Kazuyoshi; Kawakami, Yasuhiko; Iwanaga, Hideyuki; Hayashi, Noriko; Seto, Akiko; Matsunaga, Naofumi

2008-01-01

Anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema was assessed on deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images. Subjects were 38 patients with pulmonary emphysema and 11 non-smoker controls, who successfully underwent DIBrH and non-BrH perfusion SPECT using a dual-headed SPECT system during the period between January 2004 and June 2006. DIBrH SPECT was three-dimensionally co-registered with DIBrH CT to comprehend the relationship between lung perfusion defects and CT low attenuation areas (LAA). By comparing the appearance of lung perfusion on DIBrH with non-BrH SPECT, the correlation with the rate constant for the alveolar-capillary transfer of carbon monoxide (DLCO/VA) was compared between perfusion abnormalities on these SPECTs and LAA on CT. DIBrH SPECT provided fairly uniform perfusion in controls, but significantly enhanced perfusion heterogeneity when compared with non-BrH SPECT in pulmonary emphysema patients (P<0.001). The reliable DIBrH SPECT-CT fusion images confirmed more extended perfusion defects than LAA on CT in majority (73%) of patients. Perfusion abnormalities on DIBrH SPECT were more closely correlated with DLCO/VA than LAA on CT (P<0.05). DIBrH SPECT identifies affected lungs with perfusion abnormality better than does non-BrH SPECT in pulmonary emphysema. DIBrH SPECT-CT fusion images are useful for more accurately localizing affected lungs than morphologic CT alone in this disease. (author)

High-resolution imaging of pulmonary ventilation and perfusion with 68Ga-VQ respiratory gated (4-D) PET/CT

International Nuclear Information System (INIS)

Callahan, Jason; Hofman, Michael S.; Siva, Shankar; Kron, Tomas; Schneider, Michal E.; Binns, David; Eu, Peter; Hicks, Rodney J.

2014-01-01

Our group has previously reported on the use of 68 Ga-ventilation/perfusion (VQ) PET/CT scanning for the diagnosis of pulmonary embolism. We describe here the acquisition methodology for 68 Ga-VQ respiratory gated (4-D) PET/CT and the effects of respiratory motion on image coregistration in VQ scanning. A prospective study was performed in 15 patients with non-small-cell lung cancer. 4-D PET and 4-D CT images were acquired using an infrared marker on the patient's abdomen as a surrogate for breathing motion following inhalation of Galligas and intravenous administration of 68 Ga-macroaggregated albumin. Images were reconstructed with phase-matched attenuation correction. The lungs were contoured on CT and PET VQ images during free-breathing (FB) and at maximum inspiration (Insp) and expiration (Exp). The similarity between PET and CT volumes was measured using the Dice coefficient (DC) comparing the following groups; (1) FB-PET/CT, (2) InspPET/InspCT, (3) ExpPET/Exp CT, and (4) FB-PET/AveCT. A repeated measures one-way ANOVA with multiple comparison Tukey tests were performed to evaluate any difference between the groups. Diaphragmatic motion in the superior-inferior direction on the 4-D CT scan was also measured. 4-D VQ scanning was successful in all patients without additional acquisition time compared to the nongated technique. The highest volume overlap was between ExpPET and ExpCT and between FB-PET and AveCT with a DC of 0.82 and 0.80 for ventilation and perfusion, respectively. This was significantly better than the DC comparing the other groups (0.78-0.79, p 68 Ga-VQ 4-D PET/CT is feasible and the blurring caused by respiratory motion is well corrected with 4-D acquisition, which principally reduces artefact at the lung bases. The images with the highest spatial overlap were the combined expiration phase or FB PET and average CT. With higher resolution than SPECT/CT, the PET/CT technique has a broad range of potential clinical applications including

Introduction of helical computed tomography affects patient selection for V/Q lung scan

International Nuclear Information System (INIS)

Zettinig, G.; Baudrexel, S.; Leitha, Th.

2002-01-01

Aim: Retrospective analysis for determination of the effect of helical computed tomography (HCT) on utilization of V/Q lung scanning to diagnose pulmonary embolism (PE) in a large general hospital. Methods: A total number of 2676 V/Q scans of in- and out-patients referred to our department between March 1992 and December 1998 and between April 1997 and December 1998 were analyzed by an identical group of nuclear physicians. Results: Neither the total number of annually performed V/Q scans (446 ± 135) nor the mean age of patients (56 years ± 17) changed significantly since the introduction of HCT. However, the referral pattern was different. The percentage of patients with high and intermediate probability for PE decreased significantly from 15.2% to 9.4% (p <0.01) and from 10.2% to 7.3% (p <0.05), respectively. Low probability scans significantly increased from 37.8% to 42.7% (p <0.05). The percentage of normal scans did not change significantly, however, there was a highly significant increase summarizing patients with normal and low probability scans (74.6% to 83.3%; p <0.01). Conclusion: The introduction of HCT affected the selection of patients referred for V/Q lung scanning since V/Q scanning was primarily used to exclude rather to confirm PE. (orig.)

Recent lung imaging studies

International Nuclear Information System (INIS)

Taplin, G.V.; Chopra, S.K.

1976-01-01

Radionuclide lung imaging procedures have been available for 11 years but only the perfusion examination has been used extensively and mainly for the diagnosis of pulmonary embolism (P.E.). Its ability to reveal localized ischemia makes it a valuable test of regional lung function as well as a useful diagnostic aid in P.E. Although it had been recognized for several years that chronic obstructive pulmonary disease (COPD) can cause lung perfusion defects which may simulate pulmonary embolism, relatively little use has been made of either the radioxenon or the radioaerosol inhalation lung imaging procedures until the last few years as a means of distinguishing P.E. from COPD. In this review emphasis is placed on our recent experience with both of these inhalation procedures in comparison with pulmonary function tests and roentgenography for the early detection of COPD in population studies. Equal emphasis is given to simultaneous aerosol ventilation-perfusion (V/P) imaging for a functional diagnosis of P.E. Two new developments in regional lung diffusion imaging, performed after the inhalation of radioactive gases and/or rapidly absorbed radioaerosols are described. The experimental basis for their potential clinical application in pulmonary embolism detection is presented

Lung radiopharmaceuticals

International Nuclear Information System (INIS)

Gonzalez, B.M.

1994-01-01

Indication or main clinical use of Lung radiopharmaceuticals is presented and clasification of radiopharmaceuticals as ventilation and perfusion studies. Perfusion radiopharmaceuticals, main controls for administration quality acceptance. Clearence after blood administration and main clinical applications. Ventilation radiopharmaceuticals, gases and aerosols, characteristics of a ideal radioaerosol, techniques of good inhalation procedure, clinical applications. Comparison of several radiopharmaceuticals reflering to retention time as 50% administered dose, percent administered dose at 6 hours post inhalation, blood activity at 30 and 60 minutes post inhalation, initial lung absorbed dose, cumulated activity.Kinetic description of two radiopharmaceuticals, 99mTcDTPA and 99mTc-PYP

Ventilation/perfusion SPECT or SPECT/CT for lung function imaging in patients with pulmonary emphysema?

Science.gov (United States)

Froeling, Vera; Heimann, Uwe; Huebner, Ralf-Harto; Kroencke, Thomas J; Maurer, Martin H; Doellinger, Felix; Geisel, Dominik; Hamm, Bernd; Brenner, Winfried; Schreiter, Nils F

2015-07-01

To evaluate the utility of attenuation correction (AC) of V/P SPECT images for patients with pulmonary emphysema. Twenty-one patients (mean age 67.6 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. AC/non-AC V/P SPECT images were compared visually and semiquantitatively. Visual comparison of AC/non-AC images was based on a 5-point likert scale. Semiquantitative comparison assessed absolute counts per lung (aCpLu) and lung lobe (aCpLo) for AC/non-AC images using software-based analysis; percentage counts (PC = (aCpLo/aCpLu) × 100) were calculated. Correlation between AC/non-AC V/P SPECT images was analyzed using Spearman's rho correlation coefficient; differences were tested for significance with the Wilcoxon rank sum test. Visual analysis revealed high conformity for AC and non-AC V/P SPECT images. Semiquantitative analysis of PC in AC/non-AC images had an excellent correlation and showed no significant differences in perfusion (ρ = 0.986) or ventilation (ρ = 0.979, p = 0.809) SPECT/CT images. AC of V/P SPECT images for lung lobe-based function imaging in patients with pulmonary emphysema do not improve visual or semiquantitative image analysis.

Methodology for ventilation/perfusion SPECT

DEFF Research Database (Denmark)

Bajc, Marika; Neilly, Brian; Miniati, Massimo

2010-01-01

Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas ov...