99mTc-IgG-Lung Scintigraphy in the Assessment of Pulmonary Involvement in Interstitial Lung Disease and Its Comparison With Pulmonary Function Tests and High-Resolution Computed Tomography: A Preliminary Study

Abstract

Background:The discrimination of inactive inflammatory processes from the active form of the disease is of great importance in the management of interstitial lung disease (ILD).Objectives:The aim of this study was to determine the efficacy of 99mTc-IgG scan for the detection of severity of disease compared to high-resolution computed tomography (HRCT) and pulmonary function test (PFT).Patients and Methods:Eight known cases of ILD including four cases of Mustard gas (MG) intoxication and four patients with ILD of unknown cause were included in this study. A population of six patients without lung disease was considered as the control group. The patients underwent PFT and high-resolution computed tomography, followed by 99mTc-IgG scan. They were followed up for one year. 99mTc-IgG scan assessment of IgG uptake was accomplished both qualitatively (subjectively) and semiquantitatively.Results:All eight ILD patients demonstrated a strong increase in 99mTc-IgG uptake in the lungs, compared to the control patients. The 99mTc-IgG scan scores were higher in the patient group (0.64[95% confidence interval(CI)=0.61-0.69])) than the control group (0.35 (0.35[95% CI=0.28-0.40]), (P<0.05)). In patients, a statistically significant positive correlation was detected between 99mTc-IgG scan and HRCT scores (Spearman’s correlation coefficient = 0.92, P < 0.008). The 99mTc-Human Immunoglobulin (HIG) scores were not significantly correlated with PFT findings (including FVC, FEV1, FEV1/FVC), O2 saturation and age ( P values > 0.05). There were no significant correlations between 99mTc-IgG score and HRCT patterns including ground glass opacity, reticular fibrosis and honeycombing (P value > 0.05).Conclusion:The present results confirmed that 99mTc-IgG scan could be applied to detect the severity of pulmonary involvement, which was well correlated with HRCT findings. This data also showed that the 99mTc-IgG scan might be used as a complement to HRCT in the functional evaluation of the clinical status in ILD; however, further studies are recommended.

99mTc-MIBI Lung Scintigraphy in the Assessment of Pulmonary Involvement in Interstitial Lung Disease and Its Comparison With Pulmonary Function Tests and High-Resolution Computed Tomography

“…We also worked on 99mTc-IgG lung scintigraphy in the assessment of pulmonary involvement in ILD in 8 patients with ILD and 6 control participants. 36 All 8 ILD patients showed a strong increase in 99mTc-IgG uptake in the lungs compared to the control patients. In the ILD patients, a statistically significant positive correlation was detected between 99mTc–IgG scans and HRCT scores (Spearman's correlation coefficient = 0.92, P < 0.008).…”

The Possibilities of Nuclear Medicine Methods in Inflammation Diagnosis

“…Для клинического применения иммуноглобулины метят как 111 In, так и 99m Tc, в зависимости от нозологии воспалительного процесса. 111 In-HIG показывают прекрасное накопление в мягкотканных, легочных и кишечных очагах воспаления, при острых и хронических воспалительных заболеваниях костной системы, инфицировании сосудистых протезов [39]. Также показанием для применения 111 In-HIG является лихорадка неясного генеза у пациентов с гранулоцитопенией, у которых сложно выделить необходимое количество лейкоцитов для их мечения.…”