Regional ventilatory evaluation using dynamic SPET imaging of xenon-133 washout in obstructive lung disease: an initial study

Abstract

Regional ventilatory abnormalities in obstructive lung disease were evaluated by dynamic single-photon emission tomography (SPET) of pulmonary washout of xenon-133 (133Xe) gas. The subjects included seven healthy volunteers. 17 patients with obstructive lung disease, and seven patients with restrictive lung disease. Following 6 min of inhalation of 133Xe gas (60-72 MBq/l), equilibrium and subsequent washout SPET images during spontaneous breathing were sequentially acquired every 30 s for 6-7 min, using a triple-head SPET system with the return mode of continuous repetitive rotating acquisition. A gravity-induced gradient of ventilation was demonstrated in the volunteers' lungs. Compared with the normal subjects, all the patients with obstructive disease showed abnormal 133Xe retention on the washout SPET images, with or without abnormalities on chest X-ray computed tomography, whereas the patients with restrictive disease did not show any significant delays in washout. This modality may assist in the evaluation of the three-dimensional dynamic process of ventilatory abnormalities in obstructive lung disease.

Gravity‐dependent signal gradients on MR images of the lung in supine and prone positions: A comparison with isogravitational signal variability

“…Previous studies indeed found that the spatial resolution of an imaging system was the key factor in detecting variability within isogravitational planes (13–18). Scintigraphic and single‐photon‐emission tomography data confirming these observations were recently obtained from lung samples averaging 1–1.5 cm 3 (24, 25). Our own data were generated from voxels of 0.16 cm 3 , which corresponds to an almost seven‐ to 10‐fold higher spatial resolution that consequently should have resulted in an even better sensitivity to isogravitational signal variability.…”

Assessment of mean transit time in the engrafted lung with 133Xe lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients

“…Moreover, bi-and unilateral changes associated with BOS could be detected with prolongedwashout images. Clearance of 133 Xe is reported markedly prolonged in obstructive airways disorder [5] and 133 Xe SPECT images frequently showed more extensive 133 Xe 1 3 retention than the spread of lesions visible on chest CT, even in lungs without any CT abnormalities [11,12]. Prolonged-washout images have been noted on lung fi elds in 133 Xe ventilation scan in two cases after bone marrow transplantation, indicating chronic obstructive lung disease [13].…”

Effect of ventilation distribution on aerosol bolus dispersion and recovery

“…On the other hand, disparities in time constants between parallel compartments may cause a multiexponential washout, the shape of which depends on the relative size of compartments, the concentration inhomogeneities between compartments before washout, and the magnitude of the difference in the time constants (18). Multiple-breath 133 Xe washout (MBW Xe ) has been utilized as a means of assessing regional ventilation distribution and whole lung washout (17,21,(23)(24)(25). Patients with severe obstructive lung disease not only have slow total washouts but also have markedly nonuniform washout across the lungs (21).…”