核研所氪-81m肺通氣造影劑與氙-133評估臨床肺疾病之比較研究

Abstract

Background: The Institute of Nuclear Energy Research (INER) in Taiwan successfully developed a 81Rb/81mKr generator. The aims of this study were to evaluate whether the self-made 81mKr was safe and effective for ventilation (V) scintigraphy in humans and to compare the difference between 81mKr and 133Xe V imaging in detection of various lung disease.Methods: Five volunteers and 47 patients were enrolled in this study. Each volunteer or patient underwent studies with 81mKr V, 133Xe V and 99mTc MAA perfusion on the same days. Images were judged and scintigraphic results were consulted with the final diagnosis. A comparative analysis of 81mKr and 133Xe images was performed for clinical utility, safety, image quality and detective value in patients with various lung diseases.Results: All volunteers and patients successfully underwent lung scans. During 133Xe V studies, 7 patients had some temporary and minimal side effects, but none of the patients had side effects during 81mKr V studies. In general, the image quality of 81mKr was better than that of 133Xe. Of the 11 patients with pulmonary embolism (PE), six had PE alone; 81mKr and 133Xe results agreed in five patients, but 81mKr detected PE in the remaining patient. Of the remaining five patients who suffered from PE with obstructive airway disease, 81mKr and 133Xe agreed in three, but 81mKr detected PE in another two patients. Of these, 36 had obstructive airway disease; twenty-one of the 36 patients were detected by 81mKr and 133Xe, but nine were missed by both studies. Of the remaining six patients, two were detected only by 81mKr and four were detected only by 133Xe.Conclusions: Self-made 81mKr was safe and effective for V scintigraphy in humans. When 81mKr was used as a V agent to detect pulmonary embolism, it appeared superior to 133Xe.