Pulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP).

2.50
Hdl Handle:
http://hdl.handle.net/10541/84078
Title:
Pulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP).
Authors:
Mogulkoc, N; Brutsche, M H; Bishop, P W; Murby, Brian; Greaves, M S; Horrocks, A W; Wilson, M; McCullough, C; Prescott, M; Egan, J J
Abstract:
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.
Affiliation:
North West Lung Research Centre, South Manchester University Hospitals, NHS Trust, UK. 1000046.1102@compuserve.com
Citation:
Pulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP). 2001, 56 (12):916-23 Thorax
Journal:
Thorax
Issue Date:
Dec-2001
URI:
http://hdl.handle.net/10541/84078
DOI:
10.1136/thorax.56.12.916
PubMed ID:
11713353
Type:
Article
Language:
en
ISSN:
0040-6376
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMogulkoc, Nen
dc.contributor.authorBrutsche, M Hen
dc.contributor.authorBishop, P Wen
dc.contributor.authorMurby, Brianen
dc.contributor.authorGreaves, M Sen
dc.contributor.authorHorrocks, A Wen
dc.contributor.authorWilson, Men
dc.contributor.authorMcCullough, Cen
dc.contributor.authorPrescott, Men
dc.contributor.authorEgan, J Jen
dc.date.accessioned2009-10-12T15:56:17Z-
dc.date.available2009-10-12T15:56:17Z-
dc.date.issued2001-12-
dc.identifier.citationPulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP). 2001, 56 (12):916-23 Thoraxen
dc.identifier.issn0040-6376-
dc.identifier.pmid11713353-
dc.identifier.doi10.1136/thorax.56.12.916-
dc.identifier.urihttp://hdl.handle.net/10541/84078-
dc.description.abstractBACKGROUND: 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.en
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshBronchoalveolar Lavage Fluid-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMetabolic Clearance Rate-
dc.subject.meshMiddle Aged-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshPrognosis-
dc.subject.meshProportional Hazards Models-
dc.subject.meshProspective Studies-
dc.subject.meshPulmonary Fibrosis-
dc.subject.meshRadiopharmaceuticals-
dc.subject.meshRegression Analysis-
dc.subject.meshRespiratory Function Tests-
dc.subject.meshSurvival Analysis-
dc.subject.meshTechnetium Tc 99m Pentetate-
dc.titlePulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP).en
dc.typeArticleen
dc.contributor.departmentNorth West Lung Research Centre, South Manchester University Hospitals, NHS Trust, UK. 1000046.1102@compuserve.comen
dc.identifier.journalThoraxen

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