Radiopharmaceutical Options for the Ventilation Part of Ventilation-Perfusion Scintigraphy Performed for the Indication of Pulmonary Embolism: US Practice Survey.

Abstract

This US survey aimed to determine (1) relative utilization of the 2 techniques, a gas radiopharmaceutical technique (GRT) versus aerosolized radiopharmaceutical technique (ART), in ventilation-perfusion scintigraphy done for pulmonary embolism indication and (2) radiopharmaceuticals (RFs) used. Nuclear medicine physicians and technologists were sent a questionnaire asking which RF(s) their imaging facilities are using for ventilation imaging. Respondents were classified as reporting from academic/teaching facilities (ATFs) or from community-based facilities (CBFs). Of the 256 surveyed, 78 responded (30.5%), who reported about 158 facilities. Majority (90/158, 57%) were CBFs, whereas the rest (68/158, 43%) were ATFs. Overall, slight majority (92/158, 58%) used ART, 90 using (99m)Tc-DTPA, one using (99m)Tc-sulfur colloid (SC), and one using (99m)Tc-PYP. Minority (66/158, 42%) used GRT (all ¹³³Xe). In the CBFs, a slight majority (55/90, 61%) used ART (including one that used (99m)Tc-PYP), whereas the rest 35 (39%) of 90 used GRT. In the ATFs, a slight majority (37/68, 54.4%) used ART (including 1 facility that used (99m)Tc-SC), whereas the rest (31/68, 45.6%) used GRT. There was no statistically significant difference in ART:GRT ratios between CBFs and ATFs (P = 0.35). Aerosolized RF technique is overall more common (57%) than GRT, about the same at CBFs and at ATFs, and almost all ART using (99m)Tc-DTPA. Therefore, (99m)Tc-DTPA price increase would have impacted a significant number of the US facilities, which should increase interest in alternatives identified by this survey—(99m)Tc-SC and (99m)Tc-PYP.