COMPARISON OF TC-99M APCITIDE SCINTIGRAPHY WITH CT ANGIOGRAPHY IN INTERMEDIATE PROBABILITY OF PULMONARY EMBOLI BY PIOPED CRITERIA USING PULMONARY ANGIOGRAPHY AS A GOLD STANDARD.

Authors

  • Supatporn TEPMONGKOL Divisions of Nuclear Medicine
  • Somjai WANGSUPHACHART Diagnostic Radiology.
  • Sukalaya LERDLUM Department of Radiology: Department of Internal Medicine
  • Chanchai SITTIPUNT Department of Radiology: Department of Internal Medicine
  • Wasan UDAYACHALERM Chulalongkorn Cardiac Center, Faculty of Medicine, Chulalongkorn University

Keywords:

Pulmonary embolism, GPIIB/IIIA receptor, scintigraphy, helical CT, pulmonary angiography

Abstract

Objectives: Ventilation-perfusion (V/Q) lung scintigraphy has been considered to be the first-line investigation for suspected pulmonary thromboembolism (PTE). An intermediate probability finding is problematic. Further investigation is needed to confirm or exclude clots. This study was aimed to evaluate the role of Tc-99m apcitide to diagnose PTE and to compare the diagnostic efficiency with CT angiography (CTA) and pulmonary angiography (PAgram).
Design: Prospective study comparing efficiency of Tc-99m apcitide scintigraphy and CTA to diagnose acute PTE by using PAgram as a gold standard.
Setting: Patients in tertiary care hospital (King Chulalongkorn Memorial Hospital)
Participants: Six out of eightteen patients with intermediate probability for PTE by V/Q lung scintigraphy.
Results: Six patients were studied by Tc-99m apcitide (planar and SPECT) scintigraphy and CTA. Four of these had PAgram. Only one positive planar Tc-99m apcitide study were observed. Three out of four patients had concordant results of SPECT Tc-99m apcitide with PAgram. In one patient with negative Tc-99m apcitide, CTA and PAgram were diagnosed to be pulmonary infarction. For 2 patients in whom PAgram were not performed, Tc-99m apcitide agreed with CTA. Tc-99m apcitide had more positive lesions than CTA and PAgram in 2 patients.
Conclusion: Tc-99m apcitide scintigraphy is a promising mean to detect active clots in PTE. It has a potential to detect more active clots than CTA.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Delen JE, Alpert JS. Natural history of pulmonary emboli. Prog Cardiovasc Dis 1975; 17: 259-270

Alpert JS, Smith R, Carlson J, et al. Mortality in patients treated for pulmonary embolism. JAMA 1976; 236: 1477-1480

Worsley DF, Alavi A. Comprehensive analysis of the results of the PIOPED study. J Nucl Med 1995; 36: 2380-2387

Taillefer R, Edell S, Innes G, et al. Acute thromboscintigraphy with (99m)Tcapcitide: results of the phase 3 multicenter clinical trial comparing 99mTc-apcitide scintigraphy with contrast venography for imaging acute DVT. Multicenter Trial Investigators. J Nucl Med 2000; 41: 1214- 1216 .

Muto P, Lastoria S, Varella P, et al. Detecting deep venous thrombosis with Technetium-99m-labeled synthetic peptide P280. J Nucl Med 1995; 36: 1384-1391

WeinP. Opinion response to acute pulmonary embolism: The role of computed tomographic imaging. J Thorac Imaging 1997; 12: 86-89

Mayo JR, Remy-Jardin MJ, Muller NL, et al. Pulmonary embolism: prospective comparison of spiral CT with ventilationperfusion scintigraphy. Radiology 1997; 205: 447-452

Kauczor HU, Heussel CP, Thelen M. Update on diagnostic strategies of pulmonary embolism. Eur Radiol 1999; 9: 262- 215

AcutectTM Prescribing Information

Becker RC. Antiplatelet therapy. Science&Medicine 1996; July/August: 12- 21

Lister-James J, Knight LC, Maurer AH, et al. Thrombus imaging with a technetium-99m-labeled, activated platelet receptor-binding peptide. J Nucl Med 1996; 37: 775-781

Dodd LR, Krishnamurthy GT, Kreis JM, et al. Detection of acute deep venous thrombosis (DVT) by scintigraphy with Tc-99m P280, a synthetic peptide that binds to glycoprotein IIb/IIIa receptors on activated platelets [abstract]. J Nucl Med 1996; 37(5S): 95P-96P

Weiland FL, Obranovich GT, Vande Streek PR, etal. Technetium-99m P280 labeled peptide in the detection and localization of deep vein thrombosis: a prospective study in 32 cases [abstract]. J Nuc l Med 1996; 37(5S): 294P

Taillefer R. Therasse E, Turpin §, et al. Comparison of early and delayed scintigraphy with 99mTc-Apcitide and correlation with contrast-enhanced venography in detection of acute deep vein thrombosis. J Nucl Med 1999; 40: 2029-2035

Lastoria S, Muto P, Varella P, et al. Localization of human brain tumors by Tc-99m labelled P-280 synthetic peptide. J Nucl Med 1994; 35: 97P

Goodman LR, Curtin JJ, Mewissen MW, etal. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. Am J Radiol 1995; 164: 1369-1374

Otmani A, Tribouilloy C, Leborgne L, et al. Diagnostic value of echocardiography and thoracic spiral CT angiography in the diagnosis of acute pulmonary embolism. Ann Cardiol Angeiol 1998; 47: 707-715

Downloads

Published

2023-04-15

How to Cite

1.
TEPMONGKOL S, WANGSUPHACHART S, LERDLUM S, SITTIPUNT C, UDAYACHALERM W. COMPARISON OF TC-99M APCITIDE SCINTIGRAPHY WITH CT ANGIOGRAPHY IN INTERMEDIATE PROBABILITY OF PULMONARY EMBOLI BY PIOPED CRITERIA USING PULMONARY ANGIOGRAPHY AS A GOLD STANDARD. ASEAN J Radiol [Internet]. 2023 Apr. 15 [cited 2024 Dec. 4];8(3):185-92. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/610

Issue

Vol. 8 No. 3 (2002): September-December

Section

Original Article

License

Copyright (c) 2023 The ASEAN Journal of Radiology

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Disclosure Forms and Copyright Agreements
All authors listed on the manuscript must complete both the electronic copyright agreement. (in the case of acceptance)

Most read articles by the same author(s)