HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Susskind, H. Articles by Wielopolski, L. Search for Related Content PubMed PubMed Citation Articles by Susskind, H. Articles by Wielopolski, L.

Impaired Permeability in Radiation-Induced Lung Injury Detected by Technetium-99m-DTPA Lung Clearance

Clinical Research Center, Brookhaven National Laboratory, Upton, New York; Department of Radiation Oncology, University Hospital, SUNY-Stony Brook, Stony Brook, New York

Correspondence: For correspondence or reprints contact: Herbert Susskind, PE, Clinical Research Center, Brookhaven National Laboratory, Box 5000, Upton, NY 11973-5000.

ABSTRACT

This study evaluates the use of the ^99mTc-DTPA aerosol lung clearance method to investigate radiation-induced lung changes in eight patients undergoing radiotherapy for lung or breast carcinoma. The sensitivity of the method was compared with chest radiography for detecting radiation-induced changes in the lung, regional alterations within (irradiated region) and outside (shielded region) the treatment ports, effect of irradiated lung volume, and dependence on time after radiotherapy. Methods: Serial DTPA lung clearance studies were performed before the first radiation treatment (base line), then weekly during a 5- to 7-wk course, and up to 12 times post-therapy over periods of 56-574 days. The total activity deposited in the lungs for each study was 150 µCi (5.6 MBq). DTPA clearance, expressed in terms of the biological half-time, t, was computed from the slopes of the least-squares fit regression lines of the time-activity curves for the first 10 min for irradiated and shielded lung regions. Results: Major findings include: (a) significant and early DTPA t changes were observed in all patients during and after radiotherapy; (b) changes in DTPA t values were observed in both irradiated and shielded lung regions in all patients suggesting a radiation-induced systemic reaction; (c) changes in DTPA t values were correlated (p < 0.05) with the irradiated lung volumes; (d) significantly reduced DTPA t values were observed in three patients who subsequently presented with clinical symptoms and/or radiographic changes consistent with radiation pneumonitis (t fell to 19% ± 6% of baseline values, compared with 64% ± 17% in the remaining patients [p < 0.01]); (e) the onset of decreased DTPA t values in these three patients occurred 35–84 days before clinical symptoms and/or radiographic changes; and (f) DTPA t tended to approach baseline values with time after radiotherapy, suggesting a long-term recovery in lung injury. Conclusion: These observations show significant and early alterations in DTPA lung clearance during and after radiotherapy that may provide a sensitive assay to monitor changes in radiation-induced lung injury and may facilitate early therapeutic intervention.

Key Words: radiation-induced lung injury • radiation pneumonitis • radiotherapy • technetium-99m-DTPA • lung clearance

This article has been cited by other articles:

				J. Petersson, A. Sanchez-Crespo, S. A. Larsson, and M. Mure Physiological imaging of the lung: single-photon-emission computed tomography (SPECT) J Appl Physiol, January 1, 2007; 102(1): 468 - 476. [Abstract] [Full Text] [PDF]

				N. A. Maskell, Y. C. G. Lee, F. V. Gleeson, E. L. Hedley, G. Pengelly, and R. J. O. Davies Randomized Trials Describing Lung Inflammation after Pleurodesis with Talc of Varying Particle Size Am. J. Respir. Crit. Care Med., August 15, 2004; 170(4): 377 - 382. [Abstract] [Full Text] [PDF]

				I. Goethals, R. Dierckx, G. De Meerleer, J. De Sutter, O. De Winter, W. De Neve, and C. Van de Wiele The Role of Nuclear Medicine in the Prediction and Detection of Radiation-Associated Normal Pulmonary and Cardiac Damage J. Nucl. Med., September 1, 2003; 44(9): 1531 - 1539. [Abstract] [Full Text] [PDF]

				K. Suga, P. O. Alderson, A. Mitra, C. Domingues, J. Rescigno, L. G. Smith, N. Ogasawara, N. Matsunaga, and K. Sasai Early Retardation of 99mTc-DTPA Radioaerosol Transalveolar Clearance in Irradiated Canine Lung J. Nucl. Med., February 1, 2001; 42(2): 292 - 299. [Abstract] [Full Text]