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Tc-99m macro aggregated albumin scintigraphy - indications other than pulmonary embolism: A pictorial essay.

Gandhi SJ, Babu S, Subramanyam P, Shanmuga Sundaram P - Indian J Nucl Med (2013)

Bottom Line: Commercially available TechneScan LyoMAA cold kit from Mallinckrodt Medical B.V., Holland was used.Acquisition protocols for different indications are described in this article.It can provide useful clinical information in other indications, which we try to highlight in this article.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine and PETCT, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

ABSTRACT

Introduction: Tc-99m macro aggregated albumin (MAA) is synonymous for lung perfusion scintigraphy and is part of the study in the evaluation of pulmonary thromboembolism. We wanted to highlight the utilities of Tc-99m MAA other than pulmonary embolism as a pictorial assay.

Materials and methods: Patients referred for Tc-99m MAA scintigraphy under various indications were included in this pictorial essay. Commercially available TechneScan LyoMAA cold kit from Mallinckrodt Medical B.V., Holland was used. Acquisition protocols for different indications are described in this article. Different clinical indications (e.g., pulmonary artery stenosis, hepatopulmonary syndrome, FEV1 calculation in lung surgery planning, selective internal radiation therapy planning, venography for deep venous thrombosis, left to right cardiac shunts, etc.) where Tc-99m MAA scintigraphy was asked for; how it helped in different clinical scenarios and how it can be used clinically is explained with unique and interesting case examples and images. We also reviewed the literature to look for certain remote indications of MAA imaging for the sake of completion like - (shunt scintigraphy, peritoneopleural communication, etc.).

Conclusion: Tc-99m MAA is a very useful radiopharmaceutical, which can be used for many other indications apart from the commonly used indication of lung perfusion scan in pulmonary embolism. It can provide useful clinical information in other indications, which we try to highlight in this article.

No MeSH data available.


Related in: MedlinePlus

Lung perfusion scan showing left anteromedial basal segmental lung perfusion defect
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Figure 15: Lung perfusion scan showing left anteromedial basal segmental lung perfusion defect

Mentions: A 21-year-old male patient with sudden onset dyspnea was referred for ventilation perfusion scan to look for pulmonary embolism. In view of the acute presentation and no risk factors, a simultaneous venography study using Tc MAA was scheduled. Tc-99m MAA was injected simultaneously through bilateral pedal veins as part of pulmonary perfusion scan to look for deep vein thrombosis. Whole body images showed significant collateral vessels with associated anteromedial basal segmental lung perfusion defect in the left lung [Figures 15 and 16]. Later doppler study of bilateral lower limbs confirmed subacute thrombus involving left iliac and left common femoral veins.


Tc-99m macro aggregated albumin scintigraphy - indications other than pulmonary embolism: A pictorial essay.

Gandhi SJ, Babu S, Subramanyam P, Shanmuga Sundaram P - Indian J Nucl Med (2013)

Lung perfusion scan showing left anteromedial basal segmental lung perfusion defect
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3822414&req=5

Figure 15: Lung perfusion scan showing left anteromedial basal segmental lung perfusion defect
Mentions: A 21-year-old male patient with sudden onset dyspnea was referred for ventilation perfusion scan to look for pulmonary embolism. In view of the acute presentation and no risk factors, a simultaneous venography study using Tc MAA was scheduled. Tc-99m MAA was injected simultaneously through bilateral pedal veins as part of pulmonary perfusion scan to look for deep vein thrombosis. Whole body images showed significant collateral vessels with associated anteromedial basal segmental lung perfusion defect in the left lung [Figures 15 and 16]. Later doppler study of bilateral lower limbs confirmed subacute thrombus involving left iliac and left common femoral veins.

Bottom Line: Commercially available TechneScan LyoMAA cold kit from Mallinckrodt Medical B.V., Holland was used.Acquisition protocols for different indications are described in this article.It can provide useful clinical information in other indications, which we try to highlight in this article.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine and PETCT, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

ABSTRACT

Introduction: Tc-99m macro aggregated albumin (MAA) is synonymous for lung perfusion scintigraphy and is part of the study in the evaluation of pulmonary thromboembolism. We wanted to highlight the utilities of Tc-99m MAA other than pulmonary embolism as a pictorial assay.

Materials and methods: Patients referred for Tc-99m MAA scintigraphy under various indications were included in this pictorial essay. Commercially available TechneScan LyoMAA cold kit from Mallinckrodt Medical B.V., Holland was used. Acquisition protocols for different indications are described in this article. Different clinical indications (e.g., pulmonary artery stenosis, hepatopulmonary syndrome, FEV1 calculation in lung surgery planning, selective internal radiation therapy planning, venography for deep venous thrombosis, left to right cardiac shunts, etc.) where Tc-99m MAA scintigraphy was asked for; how it helped in different clinical scenarios and how it can be used clinically is explained with unique and interesting case examples and images. We also reviewed the literature to look for certain remote indications of MAA imaging for the sake of completion like - (shunt scintigraphy, peritoneopleural communication, etc.).

Conclusion: Tc-99m MAA is a very useful radiopharmaceutical, which can be used for many other indications apart from the commonly used indication of lung perfusion scan in pulmonary embolism. It can provide useful clinical information in other indications, which we try to highlight in this article.

No MeSH data available.


Related in: MedlinePlus