Early Detection of Chronic Obstructive Pulmonary Disease Using Radionuclide Lung-Imaging Procedures

Taplin, George V.; Tashkin, Donald P.; Chopra, Sawtantra K.; Anselmi, Osvaldo E.; Elam, Dennis; Calvarese, Barry; Coulson, Anne H.; Detels, Roger; Rokaw, Stanley N.

doi:10.1378/chest.71.5.567

Cited by 65 publications

(23 citation statements)

References 15 publications

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“…FEV 1 is a rather insensitive method in detecting airway changes in COPD as these mainly occur in small airways. Ventilation lung scintigraphy is a more sensitive indicator of obstructive lung disease than spirometric flow rates and lung volumes [33]. In previous studies, V/P SPECT has also shown to be more sensitive than HRCT in identifying small airway disease and emphysema [34,35].…”

Section: Discussionmentioning

confidence: 99%

“…The effective radiation dose from V/P SPECT is also considerably lower than the radiation dose from HRCT [30]. Different V/P abnormalities observed with lung scintigraphy in COPD and emphysema have been described in the literature, including general unevenness of radio-pharmaceutical distribution, central and peripheral hot-spots, mismatch, reverse mismatch and matched defects [33,36]. These patterns are often simultaneously present in COPD, and the finding of high to very high correlations between them in our study is therefore not surprising.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Jögi

Ekberg

Jonson

et al. 2011

Eur J Nucl Med Mol Imaging

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Jögi

Ekberg

Jonson

et al. 2011

Eur J Nucl Med Mol Imaging

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“…Spirometry is primarily useful for identifying patients with significant expiratory airflow limitation or reduced lung volumes. Spirometry alone results in a substantial number of subjects with lung abnormalities remaining undetected [1]. The reliability of responses to a pulmonary questionnaire, another commonly used method, is limited [2].…”

mentioning

confidence: 99%

Respiratory health screening using pulmonary function tests and lung sound analysis

et al. 1994

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Lung sounds (LS) analysis is a potential source of additional objective, noninvasive and quantitative information on the status of the pulmonary system. We have examined the hypothesis that the addition of lung sounds analysis to spirometry increases the sensitivity of objective population screening, as compared to the use of spirometry alone. Questionnaires, spirometry and lung sounds were obtained in 493 active workers. Lung sounds analysis consisted of the averaged power spectra of breath sounds, measured separately during inspiration and expiration at four standard locations over the trachea and the chest-wall. Of the 493 subjects, 91 had an obstructive lung disease, including 27 with chronic bronchitis identified by a history of prolonged cough and sputum production but with normal spirometry. Twelve additional workers had a restrictive lung disease. Abnormal spirometric results were found in 74 of the patients. Abnormal lung sounds analyses were found in 54 patients, including 14 of the chronic bronchitis cases, so that the overall sensitivity of objective screening tests increased from 71% to 87% by combining the two tests. Thirty three of the subjects considered normal by evaluation of their questionnaire and spirometry had abnormal lung sounds. Of the twenty four who were re-evaluated 12-18 months after the first tests, three had developed a lung or heart disease. We conclude that the combination of spirometry and lung sounds analysis significantly increased the sensitivity of detection of pulmonary diseases by objective tests, and provided an early sign of lung disease that was not detected by spirometry alone.

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“…For particles 450 nm, measurements consistently showed an increase in the central deposition in COPD or asthma patients even at moderate flow rates. [48][49][50][51][52][53][54] There are few model calculations on deposition of nanoparticles in diseased lungs, and often these are limited to confined regions of the respiratory tract. In general, modeling of particle deposition in diseased lungs is difficult and requires numerous assumptions and simplifications of both the lung morphology and the airflow patterns, since the morphology of diseased lungs is more complex and heterogeneous compared to normal lungs.…”

mentioning

confidence: 99%

Do nanoparticles provide a new opportunity for diagnosis of distal airspace disease?

Löndahl¹,

Jakobsson²,

Broday³

et al. 2016

IJN

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There is a need for efficient techniques to assess abnormalities in the peripheral regions of the lungs, for example, for diagnosis of pulmonary emphysema. Considerable scientific efforts have been directed toward measuring lung morphology by studying recovery of inhaled micron-sized aerosol particles (0.4-1.5 µm). In contrast, it is suggested that the recovery of inhaled airborne nanoparticles may be more useful for diagnosis. The objective of this work is to provide a theoretical background for the use of nanoparticles in measuring lung morphology and to assess their applicability based on a review of the literature. Using nanoparticles for studying distal airspace dimensions is shown to have several advantages over other aerosol-based methods. 1) Nanoparticles deposit almost exclusively by diffusion, which allows a simpler breathing maneuver with minor artifacts from particle losses in the oropharyngeal and upper airways. 2) A higher breathing flow rate can be utilized, making it possible to rapidly inhale from residual volume to total lung capacity (TLC), thereby eliminating the need to determine the TLC before measurement. 3) Recent studies indicate better penetration of nanoparticles than micron-sized particles into poorly ventilated and diseased regions of the lungs; thus, a stronger signal from the abnormal parts is expected. 4) Changes in airspace dimensions have a larger impact on the recovery of nanoparticles. Compared to current diagnostic techniques with high specificity for morphometric changes of the lungs, computed tomography and magnetic resonance imaging with hyperpolarized gases, an aerosol-based method is likely to be less time consuming, considerably cheaper, simpler to use, and easier to interpret (providing a single value rather than an image that has to be analyzed). Compared to diagnosis by carbon monoxide (D L,CO ), the uptake of nanoparticles in the lung is not affected by blood flow, hemoglobin concentration or alterations of the alveolar membranes, but relies only on lung morphology.

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Early Detection of Chronic Obstructive Pulmonary Disease Using Radionuclide Lung-Imaging Procedures

Cited by 65 publications

References 15 publications

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Respiratory health screening using pulmonary function tests and lung sound analysis

Do nanoparticles provide a new opportunity for diagnosis of distal airspace disease?

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