Source: Annual Congress 2010 - State of the art imaging
Disease area: Airway diseases

Abstract

Gamma camera imaging is widely used to evaluate devices for inhaled therapy by assessing pulmonary aerosol deposition. Conventional planar imaging provides limited information on its regional distribution.
In this study, single photon emission computed tomography (SPECT) was used to describe deposition in three dimensions (3D) and combined with x-ray computed tomography (CT) to relate this to lung anatomy. Its performance was compared to planar scintigraphy.
Ten SPECT/CT studies were performed in healthy volunteers following carefully controlled inhalation of radioaerosol from a nebuliser, using a variety of inhalation regimes. The 3D spatial distribution was assessed using a central to peripheral ratio (C/P) normalised to lung volume and for the right lung was compared to planar C/P analysis. The deposition by airway generation was calculated for each lung and the conducting airways deposition fraction (cadf) compared to 24 h clearance.
The 3D normalised C/P ratio correlated more closely with 24 h clearance than the 2D ratio for the right lung (coefficient of variation, COV, 9% compared to 15% p<0.05). Analysis of regional distribution was possible for both lungs in 3D but not in 2D due to overlap of the stomach on the left lung. The mean cadf from SPECT for both lungs was not significantly different from 24 h clearance (COV 18%).
Combined SPECT/CT enabled improved analysis of aerosol deposition from gamma camera imaging compared to planar scintigraphy. 3D radionuclide imaging combined with anatomical information from CT and computer analysis is recommended for applications requiring regional information on deposition.

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J. Fleming, I. Katz, J. Conway, G. Caillibotte, C. Majoral, D. Perchet, M. Pichelin, B. Muellinger, G. Apiou-Sbirlea, T. Martonen, L. Tossici-Bolt, P. Kroneberg (Southampton, United Kingdom; Les Loges-en-Josas, France; Easton, Laguna Beach, Chapel Hill, United States Of America; Gemunden, Germany). Measurement of pulmonary aerosol deposition with combined SPECT-CT. Eur Respir J 2010; 36: Suppl. 54, 5281

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