Abnormal Uptake of Tc-99m MIBI, A Novel Myocardial Imaging Agent, in the Lungs of Patients With Systemic Sclerosis

Richard, Michael D.; Cox, Darrin; Earle, Linda; Varga, John

doi:10.1097/00003072-199801000-00007

Cited by 10 publications

(5 citation statements)

References 17 publications

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“…Based on the evidence, DTPA is recommended only in those patients with FASSc in whom reticulonodular changes on HRCT predominate, and further estimation of the risk of disease progression is required before treatment is considered. The use of other radionucleotides ( 67 gallium and 99m technetium methoxyisobutyl‐isonitrile) appears to be of limited value in FASSc 30,31 …”

Section: Investigationsmentioning

confidence: 99%

“…The use of other radionucleotides ( 67 gallium and 99m technetium methoxyisobutyl-isonitrile) appears to be of limited value in FASSc. 30,31 Bronchoalveolar lavage The BAL cellular differential has been used to assess disease activity and prognosis in IPF and FASSc. Patients with a BAL neutrophilia or eosinophilia at baseline show a significant reduction in DLCO and FVC, increased dyspnoea and greater radiological abnormalities at 2 years relative to those with a predominance of lymphocytes or a normal differential.…”

Section: High Resolution Computed Tomographymentioning

confidence: 99%

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Fibrosing alveolitis in systemic sclerosis: the need for early screening and treatment

Sahhar

Littlejohn

Conron

2004

Internal Medicine Journal

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Abnormalities in lung function occur in 70% of patients with systemic sclerosis (SSc). Fibrosing alveolitis in SSc (FASSc) is more commonly seen in the diffuse cutaneous form of SSc, particularly in the presence of antitopoisomerase antibodies (Scl70), and with the decreasing incidence of scleroderma renal crisis it is now the major cause of mortality in this patient population. Screening of patients recently diagnosed with SSc by pulmonary function tests and the performance of high resolution computed tomography when physiological abnormalities are identified has resulted in the identification of significant numbers of patients with early, asymptomatic FASSc. Whether these patients should be further investigated with a surgical lung biopsy or receive immunosuppression is unclear, because it cannot yet be reliably predicted who will develop progressive disease and the evidence to support the efficacy of treatment is not strong. The objective of the present article was to review the evidence to support the use of immunosuppressive therapy in FASSc and, based on these data, to propose an algorithm for the investigation and management of this difficult clinical problem.

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Section: Investigationsmentioning

confidence: 99%

Section: High Resolution Computed Tomographymentioning

confidence: 99%

Fibrosing alveolitis in systemic sclerosis: the need for early screening and treatment

Sahhar

Littlejohn

Conron

2004

Internal Medicine Journal

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“…The intensity of uptake in the lungs was correlated with the extent of maximal skin induration and with radiologic evidence of ILD, but not with other clinical or laboratory factors of disease activity or the extent of pulmonary involvement. 19 …”

Section: Discussionmentioning

confidence: 99%

“…Abnormal activity of 99mTc-MIBI by neoplastic tissues in the lungs has been mentioned previously, but pulmonary uptake in non-neoplastic conditions seems to be extremely infrequent. 19 …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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The differentiation of active inflammatory processes from an inactive form of the disease is of great value in the management of interstitial lung disease (ILD). The aim of this investigation was to assess the efficacy of 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) scans in distinguishing the severity of the disease compared to radiological and clinical parameters.In total, 19 known cases of ILD were included in this study and were followed up for 1 year. Five patients without lung disease were considered as the control group. The patients underwent pulmonary function tests (PFTs) and high-resolution computed tomography scans, followed by 99mTc-MIBI scanning. The 99mTc-MIBI scans were analyzed either qualitatively (subjectively) or semiquantitatively.All 19 ILD patients demonstrated a strong increase in 99mTc-MIBI uptake in the lungs compared to the control group. The 99mTc-MIBI scan scores were higher in the patient group in both the early phase (0.24[0.19–0.31] vs 0.11[0.10–0.15], P < 0.05) and the delayed phase (0.15[0.09–0.27] vs 0.04[0.01–0.09], P < 0.05) compared with the control group. A positive correlation was detected between the 99mTc-MIBI scan and the high-resolution computed tomography (HRCT) scores (Spearman's correlation coefficient = 0.65, P < 0.02) in the early phase but not in the delayed phase in patients (P > 0.14). The 99mTc-MIBI scan scores were not significantly correlated with the PFT findings (P > 0.05). In total, 5 patients died and 14 patients were still alive over the 1-year follow-up period. There was also a significant difference between the uptake intensity of 99mTc-MIBI and the outcome in the early phase (dead: 0.32[0.29–0.43] vs alive: 0.21[0.18–0.24], P < 0.05) and delayed phase (dead: 0.27[0.22–0.28] vs alive: 0.10[0.07–0.19], P < 0.05).The washout rate was ∼40 min starting from 20 min up to 60 min and this rate was significantly different in our 2 study groups (ILD: 46.61[15.61–50.39] vs NL: 70.91[27.09–116.36], P = 0.04).The present study demonstrated that 99mTc-MIBI lung scans might distinguish the severity of pulmonary involvement in early views, which were well correlated with HRCT findings. These results also revealed that 99mTc-MIBI lung scans might be used as a complement to other diagnostic and clinical examinations in terms of functional information in ILD; however, further investigations are strongly required.

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“…Some of these etiologies include chronic smoking ( 15 ), chemical pneumonitis ( 16 ), atypical pneumonias ( P. carinii , MAC), and interstitial pneumonitis secondary to systemic sclerosis ( 17 ), all of which were ruled out in our patient. Rarely, HIV is known to cause LIP, which is an inflammatory reaction of the lung interstitium to the virus.…”

Section: Discussionmentioning

confidence: 99%

HIV-associated lymphocytic interstitial pneumonitis causes diffuse sestamibi lung uptake in myocardial perfusion imaging

Gadiraju¹,

Bommireddipalli²,

Rangray³

et al. 2009

Radiology Case Reports

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Technetium-99m (99mTc) sestamibi myocardial perfusion scintigraphy (MPI) is widely used for the diagnosis and assessment of prognosis in patients with suspected coronary artery disease. During these investigations, inspection of raw projected data for the purpose of quality control may occasionally yield incidental noncardiac findings that suggest the presence of another primary noncardiac disease. We present a 66-year-old HIV patient with a tissue diagnosis of lymphoid interstitial pneumonitis (LIP), who demonstrated a diffuse increase of 99mTc sestamibi in bilateral lung fields both in rest and stress MPI.

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Abnormal Uptake of Tc-99m MIBI, A Novel Myocardial Imaging Agent, in the Lungs of Patients With Systemic Sclerosis

Cited by 10 publications

References 17 publications

Fibrosing alveolitis in systemic sclerosis: the need for early screening and treatment

Fibrosing alveolitis in systemic sclerosis: the need for early screening and treatment

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

HIV-associated lymphocytic interstitial pneumonitis causes diffuse sestamibi lung uptake in myocardial perfusion imaging

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