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NUCLEAR MEDICINE OF THE LUNG Practice Radioisotopes for lung scintigraphy 99mTc T1/2: 6 hr generator product 140 keV gamma ray Perfusion: macroaggregates microspheres Ventillation: aerosol (Tc-99m) noble gases (eg. Kr-81m) 2 Clinical applications Pulmonary embolism: Perfusion & ventillation, from 6 views Lung tumor before operation: Quantitative estimation of breath capacity Congenital abnormality of the pulmonary artery: Perfusion scintigraphy Obstructive lung diseases: Dynamic inhalation lung study Interstitial lung diseases, alveolitis: Dynamic inhalation lung study 3 Normal 99mTc-MAA perfusion & 81mKr ventillation 4 Normal 99mTc-MAA perfusion & DTPA aerosol ventillation 5 Central lung tumour 6 Acute pulmonary embolism • Perfusion: (multi)segmental defect • Ventillation: normal „Ventillation-perfusion mismatch” 7 Embolism: ventillation-perfusion mismatch

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Page 1: (w1_2_  [Kompatibilis m\363d])

NUCLEAR MEDICINE OF

THE LUNG

Practice

Radioisotopes for lung scintigraphy

99mTc T1/2: 6 hr

generator

product

140 keV gammaray

Perfusion:

• macroaggregates

• microspheres

Ventillation:

• aerosol (Tc-99m)

• noble gases

(eg. Kr-81m)

2

Clinical applications

• Pulmonary embolism:

Perfusion & ventillation, from 6 views

• Lung tumor before operation:

Quantitative estimation of breath capacity

• Congenital abnormality of the pulmonary artery:

Perfusion scintigraphy

• Obstructive lung diseases:

Dynamic inhalation lung study

• Interstitial lung diseases, alveolitis:

Dynamic inhalation lung study

3

Normal 99mTc-MAA perfusion & 81mKr ventillation

4

Normal 99mTc-MAA perfusion & DTPA aerosol

ventillation

5

Central lung tumour

6

Acute pulmonary embolism

• Perfusion: (multi)segmental defect

• Ventillation: normal

• „Ventillation-perfusion mismatch”

7

Embolism: ventillation-perfusion mismatch

Page 2: (w1_2_  [Kompatibilis m\363d])

Role of SPECT – CT in lung scintigraphy

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Lung #1

10

Lung #2

11

T020036

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T_020040

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Lung #3

14