• Journal of Chest Surgery
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• 제17권1호
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• pp.94-100
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• 1984

The purpose of present study is to investigate the significance of preoperative evaluation with perfusion lung scintigraphy in patients with lung cancer. Lung scans with the use of macroaggregated human serum albumin labeled with technetlum-99m were carried out in 35 patients with lung cancer before thoracotomy at Seoul National University Hospital during the period from November 1981 to September 1983. The relationship between size of the perfusion defect as seen by perfusion lung scan and size of the mass lesion as seen radiologically was correlated with the presence of regional adenopathy and resectability. Among patients with a larger perfusion defect than mass lesion on chest X-ray film.86% were found to have regional lymph node involvement with 29% resectability, whereas among patients in whom a larger defect was not present only 14% had such extension of the disease with 93% resectability. The relative pulmonary arterial perfusion of affected lung was calculated from the counts of radioactivity recorded from affected lung on both anterior and posterior scans expressed as a percentage of the total counts in the scan. The mean relative pulmonary arterial perfusion of the inoperable group [34\ulcorner%] is significantly different from both that of the pneumonectomy group [39\ulcorner%] and that of the lobectomy group [48\ulcorner%].(p<0.01)

• Journal of Chest Surgery
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• 제55권4호
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• pp.288-292
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• 2022

Ex vivo lung perfusion (EVLP) is a technique that enables active metabolism of the lung by creating an environment similar to that inside the body, even though the explanted lungs are outside the body. The EVLP system enables the use of lung grafts that do not satisfy the acceptance criteria for lung transplantation (LTx) by making it possible to evaluate the function of the lung grafts and repair lungs in poor condition, thereby reducing the waiting time of patients requiring LTx and consequently mortality.

• Journal of Chest Surgery
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• 제33권10호
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• pp.798-805
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• 2000

Background : the prediction on changes in the lung function after lung surgery would be an important indicator in terms of the operability and postoperative complications. In order to predict the postoperative FEV1 - the commonly used method for measuring changes in lung function- a comparison between the quantitative CT and the perfusion lung scan was made and proved its usefulness. Material and Method : The subjects included 22 patients who received perfusion lung scan and quantitative CT preoperatively and with whom the follow-up of PFT were possibles out of the pool of patients who underwent right lobectomy or right pneumonectomy between June of 1997 and December of 1999. The FEV1 and FVC were calibrated by performing the PFT on each patient and then the predicted FEV1 and FVC were calculated after performing perfusion lung scan and quantitative CT postoperatively. The FEV1 and FVC were calibrated by performing the PFT after 1 week and after 3 momths following the surgery. Results : There was a significant mutual scan and the actual postoperative FEV1 and FVC at 1 week and 3 months. The predicted FEV1 and FVC(pneumonectomy group : r=0.962 and r=0.938 lobectomy group ; r=0.921 and r=913) using quantitative CT at 1 week postoperatively showed a higher mutual relationship than that predicted by perfusion lung scan(pneumonectomy group : r=0.927 and r=0.890 lobectomy group : r=0.910 and r=0.905) The result was likewise at 3 months postoperatively(CT -pneumonectomy group : r=0.799 and r=0.882 lobectomy group : r=0.934 and r=0.932) Conclusion ; In comparison to perfusion lung scan quantitative CT is more accurate in predicting lung function postoperatively and is cost-effective as well. Therefore it can be concluded that the quantitative CT is an effective method of replacing the perfusion lung scan in predicting lung function post-operatively. However it is noted that further comparative analysis using more data and follow-up studies of the patients is required.

• 대한핵의학회지
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• 제35권4호
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• pp.288-290
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• 2001

A 61 year-old woman underwent perfusion and inhalation lung scan for the evaluation of pulmonary thromboembolism. Tc-99m MAA perfusion lung scan showed multiple round hot spots in both lung fields. Tc-99m DTPA aerosol inhalation lung scan and chest radiography taken at the same time showed normal findings (Fig. 1, 2). A repeated perfusion lung scan taken 24 hours later demonstrated no abnormalities (Fig. 3). Hot spots on perfusion lung scan can be caused by microsphere clumping due to faulty injection technique or by radioactive embolization from upper extremity thrombophlebitis after injection. Focal hot spots can signify zones of atelectasis, where the hot spots probably represent a failure of hypoxic vasoconstriction. Artifactual hot spots due to microsphere clumping usually appear to be round and in peripheral location, and the lesions due to a loss of hypoxic vasoconstriction usually appear to be hot uptakes having linear $borders^{1-3)}$. Although these artifactual hot spots have been well-known, we rarely encounter them. This report presents a case with artifactual hot spots due to microsphere clumping on Tc-99m MAA perfusion lung scan.

• Journal of Chest Surgery
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• 제57권4호
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• pp.360-368
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• 2024

Background: The left pulmonary artery (LPA) may be kinked and stenotic, especially in tetralogy of Fallot, because of ductal tissue and anterior deviation of the conal septum. If LPA stenosis is not effectively treated during total correction, surgical angioplasty is occasionally performed. However, whether pulmonary artery (PA) angioplasty in adolescents or adults improves perfusion in the ipsilateral lung remains unclear. Methods: This retrospective review enrolled patients who underwent PA angioplasty for LPA stenosis between 2004 and 2019. Among patients who underwent a lung perfusion scan (LPS) or cardiac magnetic resonance imaging (cMRI) pre- and post-pulmonary angioplasty, those aged >13 years with <40% left lung perfusion (p-left) in the pre-angioplasty study were included. Preoperative and postoperative computed tomography, LPS, and cMRI data were collected. The perfusion ratio was analyzed according to the LPA's anatomical characteristics. Results: Seventeen adolescents and 16 adults (≥18 years old) were finally included (median age, 17 years). The most common primary diagnosis was tetralogy of Fallot (87.9%). In all patients, LPA angioplasty was performed concomitantly with right ventricular outflow tract reconstruction. No patients died. Preoperative p-left was not significantly different between adolescents and adults; however, adolescents had significantly higher postoperative p-left than adults. P-left significantly increased in adolescents, but not in adults. Seven patients had significant stenosis (z-score <-2.0) confined only to the proximal LPA and demonstrated significantly increased p-left. Conclusion: PA angioplasty significantly increased ipsilateral lung perfusion in adolescents. If focal stenosis is confined to the proximal LPA, PA angioplasty may improve ipsilateral lung perfusion, regardless of age.

• Journal of Pharmaceutical Investigation
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• 제31권2호
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• pp.73-80
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• 2001

Lung perfusion scanning, invariably combined with ventilation studies provides a reliable and non-invasive mean to diagnose lung related pathologies despite the availability of modern techniques such as angiography, magnetic resonance imaging, magnetic resonance angiography, and helical (spiral) computed tomography. The technique involves the generation of images by radiations emitted from radioisotopes introduced in to the lungs. Various radiopharmaceuticals have been proposed and designed to incorporate $Tc^{99m}$ in to macroparticulate form for lung perfusion imaging. However, most of these have associated difficulties such as reproducibility of the product with regards to particle size distribution and poor elimination from the lung capillary bed. $Tc^{99m}$ macroaggregated albumin $(Tc^{99m}-MAA)$ is used extensively for clinical lung perfusion imaging and is considered as the radiopharmaceutical of choice. It is non-toxic, safe, and being biodegradable, is easily eliminated from the lung capillary bed by proteolytic enzyme metabolism and by mechanical forces due to lung movement.

• Journal of Chest Surgery
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• 제19권2호
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• pp.209-216
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• 1986

The purpose of this study is to predict postoperative lung function by perfusion lung scanning method. 40 patients who underwent lobectomy or pneumonectomy between 1983-1985 were analyzed. Mean preoperative FEV1 was 2.36 L in lobectomy cases and 1.73 L in pneumonectomy cases. Preoperative and postoperative lung function were measured by routine spirometry in sitting position. Perfusion lung scanning was performed by 99mTc-MAA radioisotope. Postoperative FEV1 and VC were predicted by the formula; Postoperative FEV1 [VC]=Preoperative FEV1 [VC] x percent function of regions of lung not to be resected. In this study, I concluded that perfusion lung scanning is a simple and useful method to predict postoperative ventilatory function after pneumonectomy of lobectomy.

• Journal of Chest Surgery
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• 제54권6호
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• pp.487-493
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• 2021

Background: Predicting postoperative lung function after pneumonectomy is essential. We retrospectively compared postoperative lung function to predicted postoperative lung function based on computed tomography (CT) volumetry and perfusion scintigraphy in patients who underwent pneumonectomy. Methods: Predicted postoperative lung function was calculated based on perfusion scintigraphy and CT volumetry. The predicted function was compared to the postoperative lung function in terms of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁), using 4 parameters: FVC, FVC%, FEV₁, and FEV₁%. Results: The correlations between postoperative function and predicted function based on CT volumetry were r=0.632 (p=0.003) for FVC% and r=0.728 (p<0.001) for FEV₁%. The correlations between postoperative function and predicted postoperative function based on perfusion scintigraphy were r=0.654 (p=0.002) for FVC% and r=0.758 (p<0.001) for FEV₁%. The preoperative Eastern Cooperative Oncology Group (ECOG) scores were significantly higher in the group in which the gap between postoperative FEV₁ and predicted postoperative FEV₁ analyzed by CT was smaller than the gap analyzed by perfusion scintigraphy (1.2±0.62 vs. 0.4±0.52, p=0.006). Conclusion: This study affirms that CT volumetry can replace perfusion scintigraphy for preoperative evaluation of patients needing pneumonectomy. In particular, it was found to be a better predictor of postoperative lung function for poor-performance patients (i.e., those with high ECOG scores).

• Journal of Chest Surgery
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• 제28권12호
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• pp.1096-1106
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• 1995

We experienced 7 cases of left single lung transplantation in 14 mongrel dogs and analyzed graft lung function by hemodynamics, blood gas analysis, chest X-ray, biopsy and perfusion lung scan. We performed right pulmonary artery cuff[PA cuff for analysis of graft lung function in 3 cases. The donor lungs were flushed with modified Euro-Collins solution[n=3 or low potassium dextran glucose solution[n=4 and preserved for 4 to 5 hours[n=4 or 24 hours[n=3 at 10o C and implanted to the dogs with similar weight . Assessment of left graft lung was done by occluding the right pulmonary artery for 10 minutes using PA cuff. Assessment for graft lung function was done immediately after an operation and after 3 days, 7days and 3 weeks postoperatively. Four dogs survived for 3days, 7days[2 cases and 3 weeks respectively. Other three dogs expired within 3 hours of reperfusion. Immediate perfusion scans of left lung in four survived dogs after reperfusion were 42.1%, 36% , 11% and 5.9% respectively, and another dog with 4.8% perfusion to left lung was dead due to left atrial thrombi after 3 hours reperfusion. In one case among three acute rejections follow-up perfusion scan was done on 3rd and 11th postoperative day and the result decreased from 36% perfusion immediate postoperatively to 21% and 15% respectively. Three expired dogs postoperatively couldn`t tolerate occlusion of right pulmonary artery with above 40 mmHg of mean pulmonary artery pressure. On the other hand, three survival dogs postoperatively tolerated occlusion of right pulmonay artery with less than 30 mmHg of mean pulmonary artery pressure. and one dog couldn`t tolerate same procedure immediate postopertively but in 2 hours reperfusion later tolerated with 29 mmHg of mean pulmonary artery pressure.In conclusion we couldn`t compare the effect of two flushing solutions but low potassium dextran glucose solution showed relatively safe preservation effect in cases with preservation of more than 20 hours. Also canine left single lung transplantation model with PA cuff indicated useful method for the assessment of graft lung function with effect of lung preservation.

• 생명과학회지
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• 제20권11호
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• pp.1725-1728
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• 2010

미니돼지에서 폐 환기/관류 신티그라피를 실시한 결과 환기스캔에서는 기능적 분포는 왼쪽 폐가 44.2%, 오른쪽 폐에서는 56.2%로 나타났으며, 관류스캔에서는 왼쪽 폐가 46.87%, 오른쪽 폐가 54.97% 임을 확인할 수 있었고 사람의 폐용적과 유사한 결과를 보임을 확인할 수 있었다. 또한 다른 방사성가스보다 짧은 시간을 필요로 하며 기계적 환기로도 스캔이 가능한 Technegas로 환기 스캔을 실시하여 미니돼지의 마취시간을 줄 일 수 있었으며 미니돼지에서 더 용이하게 폐기능을 측정할 수 있었다. 따라서 본 연구를 통해 폐 환기/관류 신티그라피가 미니돼지에서 정상 폐기능 및 폐질환과 관련된 실험을 할 때 폐기능을 측정하는 좋은 진단법이 될 수 있으며 미니돼지의 정상 폐기능에 관한 연구가 앞으로 폐질환과 관련된 미니돼지의 실험에 대한 정보를 제공할 수 있으리라 생각된다.