VISUALIZATION OF THE LUNG BY METHODS OF SCINTIPHOTOGRAPHY

Abstract
Scintiphotograms of the lung using macroaggregates of albumin tagged with iodine 131 and technetium 99m were obtained on 115 patients. Seventy-eight of these have had sufficient follow-up to be included here. The dose administered intravenously was 300 µc in patients receiving the iodine 131 macroaggregates of albumin and up to 5 mc in patients receiving technetium 99m macroaggregates of albumin. The macroaggregates ranged in size from 10 to 100 µ. These studies have indicated the sites and magnitude of pulmonary arterial obstruction whether they were recognizable roentgenographically or not. Areas of decreased activity on the scintiphotograms relate to areas of ischemia, which are frequently due to pulmonary embolization but also can be secondary to pneumonia, atelectasis, emphysematous blebs, abscesses and cysts. We have used either a rectilinear scanner or scintillation camera for these studies. The two major disadvantages of rectilinear scanning relate to the time required to perform the scan and, secondly, to the prone positioning of the patient, which is desirable for best results but is difficult to obtain, particularly if the patient is severely ill. The scintillation camera obviates these problems but has the disadvantage of a restricted field size, making it necessary to obtain several studies in large patients. Scintiphotography of the lungs using macroaggregates of albumin is considered to be an excellent screening test prior to subjecting a patient to pulmonary angiography. Serial scintiphotograms can be very helpful in following closely disease processes within the pulmonary parenchyma. We are presently exploring the use of xenon 133 for studies of pulmonary function and perfusion. Preliminary results indicate that xenon 133 offers significant advantages over the use of macroaggregates, providing a device such as the scintillation camera is available for obtaining the scintiphotograms.

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