Diminished Tc-99m HMPAO pulmonary uptake in ex-smokers

Normally, there is no localization of Tc-99m HMPAO in the lungs. Tc-99m uptake in smokers' lungs has been reportedly higher than in nonsmokers. Thus, the lung uptake may be used as a barometer of cigarette smoking. To assess whether there is a decrease in pulmonary uptake of Tc-99m HMPAO after cessation of smoking, the authors investigated the lung uptake of 31 male ex-smokers in comparison to smokers and nonsmokers. Anterior and posterior images were taken 10 minutes after intravenous injection of 20-25 mCi of Tc-99m HMPAO. Regions-of-interest over the liver and lungs in the anterior view were calculated. Duration of abstinence from smoking ranged from 5 months to 50 years. The mean lung/liver uptake in ex-smokers was 0.489 +/- 0.019 (sem). In a previous report, the mean lung/liver ratio for smokers (N = 30) was 0.805 +/- 0.040 (sem) and 0.408 +/- 0.019 (sem) for nonsmokers (N = 25). Compared with smokers, the lung/liver uptake ratio of ex-smokers was significantly lower (P < 7 x 10(-9)). The lung/liver uptake ratio of ex-smokers was significantly higher than that of nonsmokers (P < 0.005). The authors conclude that pulmonary Tc-99m HMPAO uptake of smokers is significantly diminished after quitting smoking. However, the lung uptake of ex-smokers is higher than that of non-smokers. The uptake in the lung induced by smoking appears to be partially reversible after the cessation of smoking.