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Nuclear Medicine Procedures made easy
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LUNG PERFUSION
BY
DR. ASHRAF ANAS ZYTOON MD, PHD, FJRS
MENOUFIYA UNIVERSITY - EGYPT
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RadiopharmacyRadionuclide• 99mTc• T1/2: 6 hours
• Energies: 140 keV• Type: γ, generator
Radiopharmaceutical• MAA (macroaggregated albumin) or HAM (human
albumin microspheres)
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Adult Dose Range•2–6 mCi (74–222 MBq)
Method of Administration• Before injection, the patient should cough and
take several deep breaths.• Intravenous (IV) injection.
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Indications• Evaluation for pulmonary embolism (PE).• Evaluation of pulmonary perfusion.• Evaluation of chest pain.• Evaluation of shortness of breath.• Evaluation of lungs for pre- and post-lung surgery.
Contraindications• Should not be performed on patients with
pulmonary hypertension. • Active pneumonia.• Hypersensitivity to human serum albumin.
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Patient Preparation• Identify the patient. Verify doctor's order. Explain
the procedure.• Obtain a recent (within 24 hours) chest x-ray.
EquipmentCamera• Large field of viewCollimator• Low energy, all purpose, or low energy, high
resolution
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Procedure • (Time: ~15–30 Minutes)• Images (typically): anterior, RAO, RLAT, RPO,
posterior, LPO, LLAT, and LAO.
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Lung Ventilation
(Usually Performed with Lung Perfusion)
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RadiopharmacyRadionuclide133Xe • t1/2: 5.3 days
Energies: 81 keVType: β-, γ
99mTc • t1/2: 6 hours
Energies: 140 keVType: γ, generator
Radiopharmaceutical• 133Xe: gas• 99mTc-DTPA (diethylenetriaminepentaacetic acid)
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Localization• Compartmental by inhalation into lung space.
Adult Dose Range• 133Xe: 10–20 mCi (370–740 MBq); Tb = ~30
seconds.• 99mTc-DTPA: 25–40 mCi (925–1480 MBq); Tb = >1
hour.
Method of Administration• Inhalation through mask or mouth apparatus.
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Indications• Evaluation and detection of pulmonary embolism
(PE) in conjunction with lung perfusion (mismatching defects).
• Evaluation of chronic obstructive pulmonary disease (COPD) in conjunction with lung perfusion (matching defects).
• Evaluation of shortness of breath.• Evaluation of chest pain.
Contraindications• Active pneumonia.
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Patient Preparation• Identify the patient. Verify doctor's order. Explain
the procedure.• Obtain recent (within 24 hours) chest X-ray.
EquipmentCollimator• 133Xe: Low energy, all purpose, or low energy,
high sensitivity• 99mTc-DTPA: Low energy, all purpose, or low
energy, high resolution
Procedure (Time: ~15–30 Minutes)
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Dacryoscintigraphy
(Lacrimal Study)
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RadiopharmacyRadionuclide• 99mTc • t1/2: 6 hours• Energies: 140 KeV• Type: γ, generator
Radiopharmaceutical• Na 99mTcO4- (Pertechnetate)
Localization• Passive transport, following path of tears in
nasolacrimal system from eye to nose.
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Adult Dose Range• 50–200 uCi (1.85–7.4 MBq).
Method of Administration• Application of drops using eye-dropper to one or
both eyes.
Indications• Assessment of lacrimal duct patency.• Localization of functional nasolacrimal duct
obstruction.• Assessment of epiphora (pathological watering of
eyes).
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EquipmentCollimator• Low Energy, All Purpose or Low Energy, High
Resolution, pinhole if available with 1-mm or 2-mm insert.
Computer Set-upFlow• 1–5 seconds/frame for 5 minutes.Dynamic• Obtain immediate image and, one image every 5
minutes up to 30 minutes, then every 10 minutes up to 60 minutes post application.
Procedure Apply 1 to 10 drops per eye
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