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Measurements of Pulmonary Vascular Permeability with PET and Gallium-68 Transferrin

Mallinckrodt Institute of Radiology and the Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri

Correspondence: For reprints contact: Daniel Schuster, MD, Respiratory and Critical Care Division, Box 8052, Washington University School of Medicine, 660 S. Euclid, St. Louis, MO 63110.

ABSTRACT

We quantified pulmonary vascular permeability with positron emission tomography (PET) and gallium-68- (⁶⁸Ga) labeled transferrin. Six dogs with oleic acid-induced lung injury confined to the left lower lobe, two normal human volunteers, and two patients with the adult respiratory distress syndrome (ARDS) were evaluated. Lung tissue-activity measurements were obtained from sequential 1–5 min PET scans collected over 60 min, after in vivo labeling of transferrin through intravenous administration of [⁶⁸Ga]citrate. Blood-activity measurements were measured from simultaneously obtained peripheral blood samples. A forward rate constant describing the movement of transferrin from pulmonary vascular to extravascular compartments, the pulmonary transcapillary escape rate (PTCER), was then calculated from these data using a two-compartment model. In dogs, PTCER was 49 ± 18 in normal lung tissue and 485 ± 114 10^–4 min^–1 in injured lung. A repeat study in these dogs 4 hr later showed no significant change. Values in the human subjects showed similarly marked differences between normal and abnormal lung tissue. We conclude that PET will be a useful method of evaluating vascular permeability changes after acute lung injury.

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