Radionuclide salivagram for salivary aspiration diagnosis and treatment response evaluation in patients with COPD Exacerbation

1731 Objectives The aim of this study was to assess the utility of radionuclide salivagram for detecting salivary aspiration and evaluating treatment responsein AECOPD patients. Methods The prospective study included 45 consecutive AECOPD patients (5 women and 40 men; age range from 53 to 88 years, mean age 73 ± 9 years) and 14 normal controls (7 women and 7 men; age range from 28 to 82 years, median age 65 years) underwent water swallow test and radionuclide salivagram. A dosage of 74.0 MBq 99Tcm-SC was added to 20 ml normal saline and was instilled into the mouths of the patients by micro-injection pump. The dynamic acquisition occurred over 30 minutes at a rate of one frame 30 seconds. The Pearsonχ2 test was used to compare the frequencies of aspiration between controls and AECOPD patients. Comparison of radionuclide salivagram and water swallow test results were evaluated using the kappa values. Results Salivary aspiration was demonstrated by salivagram in 14 of 45 AECOPD patients (31%) and 0 of 14 controls (0%) (χ2=4.121, P=0.042 ). Among the positive cases, aspiration into the right main bronchus and branch was seen in 6 patients (43%), bilateral main bronchi in 5 patients (36%), and left lung field in 3 patients (21%). Agreement between radionuclide salivagram and water swallow test was general (Kappa=0.713, 95%CI:0.486-0.940). 5 AECOPD patients with positive aspiration were evaluated by radionuclide salivagram after therapy, Salivary aspiration was demonstrated in 2 case, and 3 cases were negative. Imaging results were consistent with the final clinical diagnosis. Conclusions Radionuclide salivagram is an objective method for detecting salivary aspiration and evaluating treatment response in AECOPD patients.