Document Detail


Pulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP).
MedLine Citation:
PMID:  11713353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clearance of inhaled technetium 99m-labelled diethylenetriamine penta-acetic acid ((99m)Tc-DTPA) from the lungs is a potential indicator of disease progression in patients with idiopathic pulmonary fibrosis (IPF). METHODS: We prospectively analysed the usefulness of this technique for predicting survival in 106 non-smoking patients with usual interstitial pneumonia (UIP) pattern IPF diagnosed by high resolution CT (HRCT) scanning or histological examination (M/F 65/41, mean (SD) age 61 (11) years). DTPA clearance was analysed according to both mono-exponential and bi-exponential models. Half times for the fast (t(0.5)F) and slow (t(0.5)S) components of clearance, the percentage contribution of the fast component (fF), and half time for mono-exponential approximation to the early part of the clearance curve (t(0.5)) were calculated. RESULTS: The patients had substantially faster t(0.5) (mean 23.9 (9.6) minutes) than normal values (>45 minutes). Thirty seven patients (35%) died during follow up (median 15 months). Univariate Cox regression analysis identified significant predictors of survival as age, forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), total lung capacity (TLC), % predicted TLC, carbon monoxide transfer factor (TLCO), % predicted TLCO, arterial oxygen tension (PaO(2)), oxygen saturation, t(0.5)F, and HRCT fibrosis score. Multiple stepwise Cox regression analysis identified t(0.5)F (p=0.03, hazard ratio 0.747, 95% CI 0.578 to 0.964), % predicted TLC (p=0.02, hazard ratio 0.976, 95% CI 0.956 to 0.995), % predicted TLCO (p=0.003, hazard ratio 0.960, 95% CI 0.935 to 0.986), and age (p=0.003, hazard ratio 1.062, 95% CI 1.021 to 1.104) as independent predictors of survival. CONCLUSION: These data suggest that (99m)Tc-DTPA clearance t(0.5)F measurement may predict survival in patients with UIP pattern IPF.
Authors:
N Mogulkoc; M H Brutsche; P W Bishop; B Murby; M S Greaves; A W Horrocks; M Wilson; C McCullough; M Prescott; J J Egan;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thorax     Volume:  56     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-11-19     Completed Date:  2001-12-28     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  916-23     Citation Subset:  IM    
Affiliation:
North West Lung Research Centre, South Manchester University Hospitals, NHS Trust, UK. 1000046.1102@compuserve.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Bronchoalveolar Lavage Fluid / cytology
Female
Humans
Male
Metabolic Clearance Rate
Middle Aged
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Pulmonary Fibrosis / metabolism*
Radiopharmaceuticals / pharmacokinetics*
Regression Analysis
Respiratory Function Tests
Survival Analysis
Technetium Tc 99m Pentetate / pharmacokinetics*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 65454-61-7/Technetium Tc 99m Pentetate
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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