UNLABELLED: 81mKr is widely used as a ventilation agent to diagnose pulmonary embolism (PE). However, (81m)Kr is expensive, which limits its continuous availability. Technegas can be an alternative ventilation agent with the advantage of being less expensive and available daily. The aim of this study was to compare the value of technegas with that of (81m)Kr in the detection of PE. METHODS: Ninety-two consecutive patients (29 men; mean +/- SD, 53 +/- 17 y old) with at least one segmental perfusion defect (Hull criteria) were studied prospectively. Perfusion and ventilation (V/Q) lung scintigraphy with both technegas and (81m)Kr were performed within 24 h on all patients. V/Q lung scan results were classified as high probability for PE (normal ventilation study) or nondiagnostic (abnormal ventilation study). All V/Q lung scans were read by two experienced nuclear physicians in consensus. For the intra- and interobserver variabilities, two experienced observers independently read the V/Q lung scans. RESULTS: (81m)Kr and technegas showed a good agreement (kappa, 0.68; 95% confidence interval [CI], 0.53-0.82). However, technegas significantly increased the number of nondiagnostic V/Q lung scans (P: = 0.035). In 15 patients, a discrepancy was found between (81m)Kr and technegas. False-positive V/Q lung scan results occurred in 4 of 12 patients (33%) with (81m)Kr and in 2 of 3 patients (66%) with technegas. The intra- and interobserver variabilities were 0.71-0.88 (95% CI, 0.56-1.0) for perfusion/(81m)Kr and 0.74-0.96 (95% CI, 0.58-1.0) for perfusion/technegas. CONCLUSION: In comparison with (81m)Kr, technegas does not result in more false-positive V/Q lung scan results. The use of technegas, however, increases the number of nondiagnostic V/Q lung scan results, which would increase the demand for further additional testing to confirm or refute PE.
UNLABELLED: 81mKr is widely used as a ventilation agent to diagnose pulmonary embolism (PE). However, (81m)Kr is expensive, which limits its continuous availability. Technegas can be an alternative ventilation agent with the advantage of being less expensive and available daily. The aim of this study was to compare the value of technegas with that of (81m)Kr in the detection of PE. METHODS: Ninety-two consecutive patients (29 men; mean +/- SD, 53 +/- 17 y old) with at least one segmental perfusion defect (Hull criteria) were studied prospectively. Perfusion and ventilation (V/Q) lung scintigraphy with both technegas and (81m)Kr were performed within 24 h on all patients. V/Q lung scan results were classified as high probability for PE (normal ventilation study) or nondiagnostic (abnormal ventilation study). All V/Q lung scans were read by two experienced nuclear physicians in consensus. For the intra- and interobserver variabilities, two experienced observers independently read the V/Q lung scans. RESULTS: (81m)Kr and technegas showed a good agreement (kappa, 0.68; 95% confidence interval [CI], 0.53-0.82). However, technegas significantly increased the number of nondiagnostic V/Q lung scans (P: = 0.035). In 15 patients, a discrepancy was found between (81m)Kr and technegas. False-positive V/Q lung scan results occurred in 4 of 12 patients (33%) with (81m)Kr and in 2 of 3 patients (66%) with technegas. The intra- and interobserver variabilities were 0.71-0.88 (95% CI, 0.56-1.0) for perfusion/(81m)Kr and 0.74-0.96 (95% CI, 0.58-1.0) for perfusion/technegas. CONCLUSION: In comparison with (81m)Kr, technegas does not result in more false-positive V/Q lung scan results. The use of technegas, however, increases the number of nondiagnostic V/Q lung scan results, which would increase the demand for further additional testing to confirm or refute PE.
Authors: Ana Cristina Lopes Albricker; Cláudia Maria Vilas Freire; Simone Nascimento Dos Santos; Monica Luiza de Alcantara; Mohamed Hassan Saleh; Armando Luis Cantisano; José Aldo Ribeiro Teodoro; Carmen Lucia Lascasas Porto; Salomon Israel do Amaral; Orlando Carlos Gloria Veloso; Ana Cláudia Gomes Pereira Petisco; Fanilda Souto Barros; Márcio Vinícius Lins de Barros; Adriano José de Souza; Marcone Lima Sobreira; Robson Barbosa de Miranda; Domingos de Moraes; Carlos Gustavo Yuji Verrastro; Alexandre Dias Mançano; Ronaldo de Souza Leão Lima; Valdair Francisco Muglia; Cristina Sebastião Matushita; Rafael Willain Lopes; Artur Martins Novaes Coutinho; Diego Bromfman Pianta; Alair Augusto Sarmet Moreira Damas Dos Santos; Bruno de Lima Naves; Marcelo Luiz Campos Vieira; Carlos Eduardo Rochitte Journal: Arq Bras Cardiol Date: 2022-04 Impact factor: 2.000
Authors: Robin de Nijs; Nienke D Sijtsema; Matthijs F Kruis; Claus Verner Jensen; Martin Iversen; Michael Perch; Jann Mortensen Journal: Nucl Med Commun Date: 2021-02-01 Impact factor: 1.698