使用99mTc-DTPA定量测量肺沉积的挑战,这些99mTc-DTPA来自递送系统,递送时间非常不同。

Allan L Coates, Maria Green, Kitty Leung, Emily Louca, Markus Tservistas, Jeffrey Chan, Nancy Ribeiro, Martin Charron
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引用次数: 28

摘要

在定量气溶胶输送时,药物通常与放射性标签混合,如(99m)Tc-DTPA,其沉积被用作药物的代表。(99m)沉积在肺中的Tc-DTPA通过肺循环吸收和纤毛粘膜清除的结合被清除。如果管理不是即时的,则图像将不包括管理期间的清除,如果比较具有不同管理时间的设备,就会出现问题。然而,如果测量清除率,就有可能“纠正”在给药期间和计数之前发生的清除率的初始图像。五名成年男性在10分钟内从呼吸增强喷射雾化器(LC Plus)吸入含有(99m)Tc-DTPA的5ml溶液,并在2.5分钟内从振动膜装置(eFlow)吸入1.25 ml溶液。质量保证是放射性计数平衡(RCB),定义为雾化前减去后的总放射性差,除以预,并以百分比表示。衰减计算使用(57)Co洪水源(Macey和Marshall)。(99m)Tc-DTPA间隙的“校正”为LC Plus的0.91 +/- 0.04(平均+/- SD)和eFlow的0.96 +/- 0.02)。LC Plus的RCB为-0.6 +/- 3.5%,eFlow的RCB为-4.7 +/- 6.4%,这意味着可以接受的精度。对于LC Plus,肺沉积为充电剂量的15.9(13.4,18.4)%(平均值和95% CI),对于eFlow,肺沉积为32.0(29.0,35.0)%。该技术为定量平面成像提供了可接受的精度水平,并允许比较具有不同递送率的设备的递送。
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The challenges of quantitative measurement of lung deposition using 99mTc-DTPA from delivery systems with very different delivery times.

In quantifying aerosol delivery, the drug is often mixed with a radiolabel such as (99m)Tc-DTPA whose deposition is used as a proxy for the drug. (99m)Tc-DTPA deposited in the lung is cleared by a combination of absorption into the pulmonary circulation and mucociliary clearance. If administration is not instantaneous, the image will not include that clearance during administration, a problem raised if comparing devices with different administration times. However, if rates of clearance are measured, it will be possible to "correct" the initial image for the clearance that occurred during administration and before counting. Five adult males inhaled a 5-mL solution containing (99m)Tc-DTPA from a breath enhanced jet nebulizer (LC Plus)over the course of 10 min and a 1.25-mL solution from a vibrating membrane device (eFlow), which was delivered in 2.5 min. Quality assurance was the radioactivity count balance (RCB) defined as the difference in the total radioactivity pre-nebulization less post, divided by pre, and expressed as a percentage. Attenuation calculations used a (57)Co flood source (Macey and Marshall). The "correction" for the clearance of (99m)Tc-DTPA was 0.91 +/- 0.04 (mean +/- SD) for the LC Plus) and 0.96 +/- 0.02 for the eFlow). RCB was -0.6 +/- 3.5% for the LC Plus and -4.7 +/- 6.4% for the eFlow, implying acceptable accuracy. For the LC Plus, lung deposition was 15.9(13.4, 18.4)% (mean and 95% CI) of the charge dose, and for the eFlow it was 32.0(29.0, 35.0)%. This technique gave an acceptable level of accuracy for quantitative planar imaging and allowed the comparison of delivery from devices with very different rates of delivery.

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