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Dynamic Pulmonary SPECT of Xenon-133 Gas Washout

Department of Radiology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan

Correspondence: For correspondence or reprints contact: Kazuyoshi Suga, MD, Department of Radiology, Yamaguchi University School of Medicine 1144, Kogushi, Ube 755, Japan.

ABSTRACT

A triple-detector SPECT data acquisition mode of "continuous repetitive rotation acquisition" was applied to dynamic pulmonary SPECT with ¹³³Xe gas. Methods: Subjects included 7 healthy volunteers, 22 patients with a space-occupying mass lesion, 22 with obstructive lung disease and 10 with restrictive lung disease. Following rebreathing of ¹³³Xe, equilibrium and washout SPECT images during spontaneous breathing were acquired every 30 sec for 5–7 min. Regional ¹³³Xe washout was assessed by the real half-time (T_1/2) and mean transit time (MTT) images. Results: SPECT and MTT images represented a gravity-induced gradient of ventilation in normal lungs and detailed the distribution of heterogeneous ¹³³Xe washout in patient's lungs with or without abnormalities on chest x-ray CT. The T_1/2 (111.4 ± 26.4 sec) and its coefficient of variation (0.36 ± 0.13) in obstructive lung diseases were significantly different from those (56.8 ± 3.9 sec and 0.16 ± 0.15) in restrictive lung diseases (p < 0.001, p < 0.05, respectively). Comparison of SPECT and planar studies assessed in 19 patients revealed superiority of SPECT in detecting ventilatory abnormalities and a high correlation of T_1/2 between the two studies (r = 0.977, p < 0.001). Conclusion: This modality has excellent potential for elucidating the distribution and nature of ventilatory abnormalities.

Key Words: SPECT • dynamic study • xenon-133 gas • lung ventilation

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