Abstract
This study was designed to evaluate the accuracy of detecting pulmonary embolism (PE) using the Technegas SPECT/CT combined with 68Ga PET/CT in a rabbit model. One hour after artificial PE (n = 6) and sham (n = 6) models were created, Technegas SPECT/CT ventilation and 68Ga-MAA PET/CT perfusion scan (V/Q scan) were performed. Ventilation imaging was performed first on all cases. Technegas SPECT/CT and 68Ga-MAA PET/CT images were evaluated by a nuclear medicine physician who recorded the presence, number, and location of PE on a per-lobe basis. The sensitivity, specificity, and accuracy of Technegas SPECT/CT and 68Ga-MAA PET/CT for detecting PE were calculated using a histopathological evaluation as a reference standard. A total of 60 lung lobes were evaluated in 12 rabbits, and PE was detected in 20 lobes in V/Q scans and histopathological analysis. The overall sensitivity, specificity, and accuracy were 100%, 100%, and 100%, respectively, for both the Technegas SPECT/CT and 68Ga-MAA PET/CT V/Q scans. Technegas/68Ga-MAA V/Q scans have good sensitivity, specificity, and accuracy in the detection of PE in this animal model study.
Highlights
Pulmonary embolism is fatal [1]. e mortality of untreated PE is approximately 25–30%, and in treated patients, it has been reported to be less than 10% [1,2,3]. e high mortality rate for PE requires extreme alertness in diagnosis [4]. e most commonly used imaging methods for the diagnosis of PE are V/Q-SPECT and computed tomography pulmonary angiography (CTPA)
Radioactivity measurements were performed with a dose calibrator. e structure, morphology, and chemical composition of 68Ga-MAA were analyzed by scanning electron microscopy (SEM)/energy dispersive X-ray (EDX). e resulting 68Ga-labeled MAA particles were examined for structural degradation
We found that 99% radiochemical purity of 68Ga-MAA was obtained by washing with saline. 68Ga-MAA labelled at an optimized pH was available for clinical application at 80% total activity 15 minutes after labelling
Summary
Pulmonary embolism is fatal [1]. e mortality of untreated PE is approximately 25–30%, and in treated patients, it has been reported to be less than 10% [1,2,3]. e high mortality rate for PE requires extreme alertness in diagnosis [4]. e most commonly used imaging methods for the diagnosis of PE are V/Q-SPECT and computed tomography pulmonary angiography (CTPA). E most commonly used imaging methods for the diagnosis of PE are V/Q-SPECT and computed tomography pulmonary angiography (CTPA). These tests have been widely validated, they have some limitations [5]. 99mTc is obtained from a 99Mo/99mTc generator. With the spread of 68Ge/68Ga generators, new searches in nuclear medicine and molecular imaging have emerged for PE. Ere are a limited number of preclinical and clinical lung perfusion studies with 68Ga-MAA perfusion PET/CT [10]. E aim of our preclinical study was to evaluate the diagnostic accuracy of combined 68Ga-MAA perfusion PET/ CT and Technegas ventilation SPECT/CT to detect PE in a rabbit model For PET studies, V/Q radiopharmaceuticals (RFs) labelled with 68Ga are relatively easy to produce, offering higher spatial resolution than SPECT studies [8, 9]. ere are a limited number of preclinical and clinical lung perfusion studies with 68Ga-MAA perfusion PET/CT [10].
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