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Diffusing capacity is not measurably affected by routine lung perfusion scanning.

T A Morris1, B T Thompson, D A Quinn

  • 1Pulmonary Unit, Massachusetts General Hospital, Boston 02144.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|July 1, 1988
PubMed
Summary
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Radiolabeled macroaggregated albumin (MAA) lung scans may cause adverse reactions. However, MAA particles did not significantly impact lung microcirculation or carbon monoxide transfer in patients undergoing perfusion scans.

Area of Science:

  • Nuclear Medicine
  • Pulmonary Physiology
  • Cardiovascular Medicine

Background:

  • Radiolabeled macroaggregated albumin (MAA) lung scans are used for perfusion imaging.
  • Adverse cardiovascular events have been reported, potentially due to MAA particle embolization.
  • Pulmonary microcirculation status is critical for gas exchange, assessed by diffusing capacity for carbon monoxide (DLCO).

Purpose of the Study:

  • To investigate the immediate effect of MAA particles on pulmonary microcirculation.
  • To assess if MAA injection impacts single breath diffusing capacity for carbon monoxide (SBDLCO).

Main Methods:

  • 11 patients undergoing lung perfusion scans were studied.
  • SBDLCO was measured before and immediately after MAA particle injection.

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  • Dosage ranged from 256,000 to 448,000 particles (20-40 microns).

    • Main Results:

    • Mean SBDLCO remained unchanged after MAA injection (18.9 vs 19.0 ml/min/mmHg).
    • No detectable change in SBDLCO was observed even in patients with significantly reduced baseline function (as low as 28% of predicted).
    • MAA particle occlusion of up to 448,000 pulmonary vessels had no measurable impact on carbon monoxide transfer.

    Conclusions:

    • MAA particle administration during lung perfusion scanning does not acutely impair pulmonary microcirculation.
    • The risk of cardiovascular collapse is unlikely due to MAA-induced occlusion of the pulmonary vasculature.
    • SBDLCO is a reliable measure for assessing the impact of MAA on lung microcirculation.