Technegas Functional Lung Imaging
Technegas™ is an ultra-fine dispersion of Technetium-labelled carbon, produced by heating Technetium-99m in a carbon crucible for a few seconds at 2,750 degrees Celsius1. The resultant gas-like Technegas™, thus produced in a Technegas generator, is a dispersion of nanosized (average size 30-60nm) pure carbon platelets of hexagonal shape fully encapsulating Technetium metal crystals2. The small size and hydrophobic properties together confirm ideal characteristics for gas-like behaviour and alveoli deposition into the lungs2-3. TECHNEGASTM penetrates to the sub-segmental areas of the lung and is trapped by surfactant in the alveolar walls4.
Once inhaled by the patient suspected of having a pulmonary embolism (PE), the patient is then imaged under a gamma camera in the ventilation part of a ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) scan3. Generated into a mobile generator, Technegas™, used in the ventilation part of the V/Q scan, is cost-effective, simple to perform and accurate5. With the uptake in SPECT imaging, V/Q SPECT results with Technegas™ can be argued to be superior to planar imaging and computed tomography (CT) when comparing sensitivity, accuracy and negative predictive value6-7.
Of significant interest, when compared to CT, is the low radiation dose imparted by V/Q SPECT imaging8. This is important in all patients but particularly in young women with proliferating breast tissue9.
” Lung scintigraphy has a superior sensitivity combined with adequate specificity and low rate of non-diagnostic tests. The low radiation dose, the possibility to quantify the degree of embolism and to use the test for follow-up of treatment of embolism and its feasibility in very sick patients, contribute to the priority of lung scintigraphy over Computed Tomographic Pulmonary Angiography ” 10
Table 1: Diagnostic ability of V/Q SPECT/CT7, V/Q SPECT7, CTPA7 and V/Q Planar6 to detect PE
(adapted from Reinartz et al, 2004 6 and from Hess and al, 2016 7 )
” With the advent of SPECT and SPECT/CT technology, significant improvements in ventilation-perfusion imaging have been made, not only in our ability to resolve subtle heterogeneity in ventilation and perfusion distributions but also in providing relative quantification of ventilation and perfusion11 “
As a result of these technical improvements, advanced quantitative V/Q SPECT/CT with Technegas™ could be used as a tool for pre-operative evaluation, monitoring disease progression and following-up treatment response12-13 in a range of conditions whereas functional imaging of alveolar spaces are required, including for:
Chronic Thromboembolic Pulmonary Hypertension
Chronic Obstructive Pulmonary Disease
Pre-operative quantification of lung function
Radiotherapy treatment planning
To learn more about Technegas™ clinical capabilities, visit our clinical page
Benefits of TechnegasTM V/Q SPECT
Sensitivity, specificity and accuracy at least equivalent to CTPA5 giving the clinician interpretative confidence in diagnosing PE event at subsegmental levels6,14.
The gas-like behaviour of Technegas™ coupled with the ideal energy of Tc-99m gives excellent penetration to peripheral areas3,15. Images may be acquired in multiple projections facilitating image interpretation16 .
V/Q SPECT with Technegas™ has 27 to 36 times less radiation dose to the patient breast as compared with CTPA8.
Quick and simple:
Rapid and easy administration of Technegas™ 15 (3-4 breaths only) allowing accurate and quick decisions even in case of lung obstructive disease16.
Minimal exclusion criteria:
Technegas™ may be administered to almost all patients including patients with renal impairment17, iodinated contrast allergy17 and chronic lung obstruction disease18. Technegas™ should be also favoured in young women of child-bearing age8,16 and in pregnant women8-9.
Because Technegas™ is easy to breath, it aids patients’ comfort and compliance.
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- Fawdry RM, et al. Initial experience with Technegas – a new ventilation agent. Australas Radiol 1988; 32(2): 232-238
- Senden TJ, et al. The physical and chemical nature of Technegas. J Nucl Med 1997; 38: 1327-1333
- Roach PJ, Schembri GP and Bailey DL. V/Q scanning using SPECT and SPECT/CT. J Nucl Med 2013; 54: 1588-1596
- Mortensen J and Gutte H. SPECT/CT and pulmonary embolism. Eur J Nucl Med Mol Imaging 2014; 41(Suppl1): 81-90
- Roach PJ, Bailey DL, Harris BE. Enhancing lung scintigraphy with single-photon emission computed tomography. Semin Nucl Med 2008; 38: 441–449
- Reinartz P, et al. Tomographic imaging in the diagnosis of pulmonary embolism: A comparison between V/Q lung scintigraphy in SPECT technique and multislice spiral CT. J Nucl Med 2004; 45: 1501-1508
- Hess S, et al. State-of-the-Art Imaging in Pulmonary Embolism: Ventilation/Perfusion Single-Photon Emission Computed Tomography versus Computed Tomography Angiography — Controversies, Results, and Recommendations from a Systematic Review. Semin Thromb Hemost 2016; 42: 833–845
- Isidoro J, et al. Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Phys Med 2017; 41: 93-96
- Bajc et al. V/P SPECT as a diagnostic tool for pregnant women with suspected pulmonary embolism. Eur J Nucl Mol Imaging 2015; 42: 1325-1330
- Bajc et al. Comparison of ventilation/perfusion scintigraphy and helical CT for diagnosis of pulmonary embolism; strategy using clinical data and ancillary findings. Clin Physiol Funct Imaging 2002; 22(6): 392-397
- Elojeimy S, et al. Overview of the novel and improved pulmonary ventilation-perfusion imaging applications in the era of SPECT/CT. AJR Am J Roentgenol 2016; 207(6): 1307-1315
- Inmai T, et al. Clinical evaluation of 99mTc-Technegas SPECT in thoracoscopic lung volume reduction surgery in patients with pulmonary emphysema. Ann Nucl Med 2000; 14(4): 263-269
- Hsu K, et al. Endoscopic lung volume reduction in COPD: improvements in gas transfer capacity are associated with improvements in ventilation and perfusion matching. J Bronchology Interv Pulmonol 2018; 25(1): 48-53
- Grüning T, et al. Three-year experience with VQ SPECT for diagnosing pulmonary embolism: diagnostic performance. Clin Imaging 2014; 38(6): 831-835
- Bajc M and Jonson B. Ventilation/perfusion SPECT for diagnosis of pulmonary embolism and other diseases. Int J Mol Imaging 2011; 682949
- Hess S and Madsen PH. Radionuclide diagnosis of pulmonary embolism. Adv Exp Med Biol 2017; 906: 49-65
- Miles S, et al. A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism. Chest 2009; 136: 1546-1553
- Nasr A, Lindqvist A and Bajc M. 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. EC Pulmonology and Respiratory Medicine 2017; 4(3): 85-91
- Sánchez-Crespo A, et al. A technique for lung ventilation-perfusion SPECT in neonates and infants. Nucl Med Commun 2008; 29(2): 173-177
Pending market authorisation – not yet available for use
Ultralute is a revolutionary innovation that allows Nuclear Medicine departments to increase the productivity of their Tc-99m generator. It does this by allowing you to elute any amount of activity in approximately 2ml. By increasing the concentration of Tc-99m from an elution, the decay profile and the growth of Tc-99m from a Mo-99m/Tc 99m generator can be better utilised.