Comparison between high-resolution computed tomography and 99mTc-technegas SPECT pulmonary emphysema]

Scintigraphy with 99mTc-technegas was recently introduced for clinical imaging of lung ventilation. This method has been found to be useful in emergencies, to be more suitable for single photon emission computed tomography (SPECT) than other agents used in ventilation scintigraphy, and could reveal abnormalities in ventilation more easily than high resolusion computed tomography (HRCT) in pulmonary emphysema. We compared 99mTc-technegas SPECT with HRCT in six regions: the right upper, middle, and lower lobes, the left upper lobe, the lingula, and the left lower lobe, in 15 patients with pulmonary emphysema. Patients with centrilobular emphysema tended to show stronger changes in upper lobes than in lower lobes on both 99mTc-technegas SPECT and HRCT. Some regions showed no change on HRCT but various changes on 99mTc-SPECT. Patients with panlobular emphysema showed severe changes on 99mTc-SPECT in lower lung fields in which well-demarcated areas of low attenuation were not seen on HRCT. We conclude that 99mTc-SPECT is useful for detecting early changes and panlobular changes in pulmonary emphysema.