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⁹⁹Tc^mTechnegas and krypton-81m ventilation scintigraphy: a comparison in known respiratory disease

J. M. James, MB, ChB, MRCGP J. J. Lloyd, BSc, MSc B. C. Leahy, MB, ChB, MRCP ^*, S. Church, MRCP, MD ^*, C. C. Hardy, MRCP, MD R. A. Shields, MSc, PhD, FIPSM M. C. Prescott, MB, ChB, MD and H. J. Testa, PhD, FRCP, FRCR

Department of Nuclear Medicine and Medical Physics, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK ^* Department of Respiratory Medicine, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK

Krypton-81m gas, by virtue of its imaging characteristics, is often considered the "gold standard" for ventilation scintigraphy but its use is restricted by its high cost and limited availability. The new radiopharmaceutical ⁹⁹Tc^m-Technegas, a suspension of ultrafine technetium-99m labelled carbon particles, produces high-quality images of ventilation and has the advantage of continuous availability. As part of our evaluation of Technegas the two were compared in 40 patients with a variety of established respiratory diseases. Disparities were seen in five patients in five diagnostic groups and may be a consequence of the differing physical properties of the two agents and the different inhalation techniques used. In addition two interesting features were noted on the Technegas images. (1) Hot spots were seen in 50% of patients, particularly in those with a degree of airways obstruction; (2) preferential basal deposition of activity was seen in 30%, particularly in patients with idiopathic pulmonary fibrosis. Both features were significantly associated with parameters of pulmonary function indicating obstructive lung disease in the former case and restrictive lung disease in the latter.

Key Words: Tc-Technegas • Krypton-81m • Scintigraphy • Respiratory disease

Present address: Department of Medicine, Trafford General Hospital, Moorside Road, Urmston, Manchester, M31 3SL, UK.

Present address: Department of Medicine, Charing Cross Hospital, Fulham Palace Rd, London, W6 8RF, UK.

Received for publication May 28, 1992. Accepted for publication August 12, 1992.

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