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Clinical

Guidelines

2009 EANM guidelines quoting Technegas

The European Association of Nuclear Medicine

EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond

Bajc M, et al. Eur J Nucl Med Mol Imaging 2019; [Epub ahead of print]

EANM guidelines for ventilation/perfusion scintigraphy – Part 1

Bajc M, et al. Eur J Nucl Med Mol Imaging 2009; 36: 1356-1370

EANM guidelines for ventilation/perfusion scintigraphy – Part 2

Bajc M, et al. Eur J Nucl Med Mol Imaging 2009; 36: 1528-1538

Education

TechnegasTM Functional Lung Imaging
Ventilation SPECT/CT using TechnegasTM to quantify pulmonary function

Pulmonary study
V/Q SPECT using TechnegasTM to detect pulmonary embolism

 

Testimonials

Beyond PE clinical uses - results from clinical studies

Airflow limitation assessment in chronic airway diseases
Images were kindly provided by the Hunter New England Imaging (HNEI) at John Hunter Hospital and clinical data by the Hunter Medical Research Institute (HMRI)

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Monitoring treatment response in asthmatic patients
Images and clinical data were kindly provided by the Woolcock Institute of Medical Research

 

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Lung function evaluation before lung volume reduction surgery
Images were kindly provided by Macquarie Medical Imaging (MMI) and clinical data by Macquarie Respiratory & Sleep department at Macquarie University

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Literature highlights

Edition 1 – May 2017
COPD, a new indication for using TECHNEGASTM V/Q SPECT?

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Edition 3 – October 2017
Economical value of hybrid SPECT/CT in pulmonary embolism diagnosis

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Edition 2 – August 2017
V/Q SPECT/CT as first-line modality for pulmonary embolism diagnosis

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Edition 4 – December 2018
Summary of the Lancet Commissions report on redefining airways diseases

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Clinical References

Peripheral ventilation heterogeneity determines the extent of bronchoconstriction in asthma
Farrow CE, et al. J Appl Physiol (1985). 2017; 123(5): 1188-1194

"Ventilation SPECT imaging with Technegas was used as an estimation of regional ventilation [in asthma patients]."

Ventilation defect typical for COPD is frequent among patients suspected for pulmonary embolism but does not prevent the diagnosis of PE by V/P SPECT
Nasr A, et al. EC Pulmonology and Respiratory Medicine. 2017; 4(3): 85-91

"The introduction of the tomographic technique and the implementation of Technegas as a novel ventilation agent facilitated imaging of pulmonary embolism in comparison with planar imaging and particularly in COPD patients together with the new interpretation criteria."

Diagnosing and grading heart failure with tomographic perfusion lung scintigraphy: validation with right heart catheterization
Jögi J, et al. ESC Heart Fail 2018; 5(5): 902-910

"Although not as available as chest X-ray, V/P SPECT is a feasible alternative, especially because the introduction of SPECT and new ventilation tracers (i.e. Technegas) has lowered the number of non-diagnostic studies to <3%, even in the presence of obstructive lung disease."

CANM Guidelines for V/P SPECT in PE
Leblanc M, et al. CANM Guidelines published in November 2018

"The best widely available agent for ventilation is 99mTc-Technegas, an aerosol of carbon nanoparticles (5-200 nm) generated in a high temperature furnace (Technegas Generator, Cyclomedica). Because of the very small particle size, this agent is distributed in the lungs almost like a gas and deposited in alveoli by diffusion, where they remain stable, thus providing the best possible images for ventilation SPECT."

Lung scintigraphy in COPD
Mortensen J, et al. Semin Nucl Med 2019; 49(1): 16-21

"V/Q scintigraphy is a valuable functional imaging biomarker in relation to several aspects of COPD. Disturbances in the distribution of ventilation and perfusion, which are pertinent to the pathophysiology of COPD, are directly visualized, particularly when using inert gases or Technegas as ventilation tracers while performing the scintigraphy as SPECT."

Role of medical and molecular imaging in COPD
Myc LA, et al. Clin Transl Med 2019; 8(1): 12

"3D ventilation/perfusion SPECT imaging procedures have been used to help diagnosis. COPD patients have also been evaluated using Technegas (99mTc-labelled carbon particles). Technegas has the potential to provide valuable information for the diagnosis of COPD as it has been demonstrated to correlate positively with spirometric lung function."

SPECT Ventilation imaging in asthma
Farrow CE, et al. Semin Nucl Med 2019; 49(1): 11-15

"Technegas as a SPECT ventilation agent has a key advantage as it remains fixed after inhalation, which allows imaging of upright ventilation distribution, analogous of pulmonary function tests."

Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease
Bajc M, et al. Int J of Chron Obstruct Pulmon Dis 2017; 12: 1579-1587

"V/Q SPECT, using Technegas as the ventilation imaging agent, could diagnose and grade severity of COPD and also estimate preserved lung function in 94 patients. Moreover, V/Q SPECT appears to be a unique tool to reveal the heterogeneity of COPD caused by pulmonary comorbidities such as pulmonary embolism, left heart failure, lung tumor and pneumonia."

V/Q SPECT – Normal Values for Lobar Function and Comparison With CT Volumes
Bailey DL, et al. Semin Nucl Med 2019; 49(1): 58-61

"An advantage of using Technegas as the ventilation agent and radiolabelled macro-aggregated albumin microspheres as the perfusion agent is that the deposition pattern is fixed upon administration and thus different patient postures can be studied and the effect of gravity and position determined, even though the scans must be acquired with the subject supine using conventional gamma camera SPECT/CT systems"

Radionuclide diagnosis of pulmonary embolism
Hess S, et al. Adv Exp Med Biol 2017; 906: 49-65

"Technetium-99m (99mTc-Technegas) is widely available and relatively inexpensive while Xenon-133 is less than ideal for SPECT imaging owing to its relatively low energy and suboptimal spatial resolution."