Tc-99m HMPAO scintigraphy in amiodarone-induced acute lung toxicity: comparison with Tc-99m DTPA inhalation scintigraphy

• Published in: Clinical nuclear medicine Vol. 31; no. 11; p. 697
• Main Authors: Kaya, Gamze Kapa, Ozdogan, O, Guneri, S, Tamc, B, Durak, H
• Format: Journal Article
• Language: English
• Published: United States 01.11.2006
• Subjects: Administration, Inhalation; Aged; Amiodarone - adverse effects; Anti-Arrhythmia Agents - adverse effects; Humans; Image Enhancement - methods; Lung Diseases - chemically induced; Lung Diseases - diagnostic imaging; Male; Radiography; Radiopharmaceuticals - administration & dosage; Technetium Tc 99m Exametazime; Technetium Tc 99m Pentetate - administration & dosage
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/01.rlu.0000242697.49893.e7

This case demonstrates the use of Tc-99m HMPAO scintigraphy in amiodarone (AD)-induced lung toxicity. The aim of this presentation is also to discuss different scintigraphic modalities in the diagnosis and follow up in AD-induced lung toxicity. A 77-year-old man, with a suspicious AD-induced acute lung toxicity, underwent Tc-99m DTPA aerosol inhalation scintigraphy and Tc-99m HMPAO scintigraphy. Rapid alveolar clearance of Tc-99m DTPA was found during AD therapy and increased lung uptake of Tc-99m HMPAO was also demonstrated. These findings supported the diagnosis AD lung toxicity. After cessation of therapy, Tc-99m DTPA alveolar clearance was decreased. Although there was some decrease in L/H and L/B ratios of Tc-99m HMPAO after 3 weeks of stopping therapy, Tc-99m HMPAO uptake in the lungs was still continued. This finding may be the result of ongoing pulmonary inflammation as a result of the long half-life of AD. Compared with Tc-99m DTPA aerosol inhalation scintigraphy, Tc-99m HMPAO scintigraphy may have a role in the diagnosis of AD lung toxicity. Nevertheless, there is a need for longitudinal studies investigating patients under AD therapy using follow-up Tc-9m HMPAO scintigraphy.