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Strontium-87m lung scans in pulmonary aspergillosis
Abstract:
Experimental observations have indicated that radioactive strontium localizes in lesions infected with Aspergillus species. Preliminary clinical studies have recommended use of strontium lung scanning to evaluate patients thought to have pulmonary manifestations of aspergillosis. In view of the difficulty in accurately interpreting the clinical significance of recovery of Aspergillus species from sputum of patients with pulmonary disorders as well as the varied clinical presentations of pulmonary aspergillosis, we have attempted to confirm these reports. Ten patients with proven pulmonary aspergillosis and five selected control subjects without aspergillosis but with other pulmonary disorders were scanned after the injection of 2-3 mCi 87mSr citrate. The strontium lung scan correlated with the chest radiograph in four of 10 patients with aspergillosis; false positive scans were found in three of five patients with other pulmonary disorders. We conclude that strontium lung scans at present have no role in the diagnostic evaluation of patients suspected of clinically significant infections with aspergillus.
Insights
Radioactive strontium lung scans showed limited accuracy in diagnosing pulmonary aspergillosis. The study found the scans did not reliably correlate with other diagnostic methods for this Aspergillus infection.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Nuclear Medicine
Background:
- Radioactive strontium (87mSr) has shown localization in Aspergillus-infected lesions.
- Preliminary studies suggested strontium lung scanning for pulmonary aspergillosis evaluation.
- Interpreting Aspergillus recovery from sputum and varied clinical presentations pose diagnostic challenges.
Purpose of the Study:
- To confirm the utility of strontium lung scanning for diagnosing pulmonary aspergillosis.
- To assess the correlation between strontium lung scans and established diagnostic methods.
Main Methods:
- Ten patients with confirmed pulmonary aspergillosis and five controls with other pulmonary disorders underwent 87mSr citrate lung scanning.
- Scans were analyzed for correlation with chest radiographs and diagnostic accuracy.
Main Results:
- Strontium lung scans correlated with chest radiographs in only 40% (4/10) of aspergillosis patients.
- False positive scans occurred in 60% (3/5) of control patients with other pulmonary disorders.
Conclusions:
- Strontium lung scans currently lack a role in diagnosing suspected pulmonary aspergillosis.
- The diagnostic performance of 87mSr citrate lung scanning is insufficient for clinical application in aspergillosis.