Annals of Nuclear Medicine

, Volume 17, Issue 6, pp 435–438 | Cite as

Usefulness of technetium-99m hexamethylpropylene amine oxime lung scan to detect inhalation lung injury of patients with pulmonary symptoms/signs but negative chest radiograph and pulmonary function test findings after a fire accident—a preliminary report

  • Yu-Chien Shiau
  • Feng-Yuan Liu
  • Jeffrey J. P. Tsai
  • Jhi-Joung Wang
  • Shung-Tai Ho
  • Albert Kao
Original Articles


Objective: In this study, we employed technetium-99m hexamethylpropylene amine oxime (99mTc HMPAO) lung scan to detect inhalation lung injury of patients after a fire accident.Methods: Ten healthy men for controls and 10 male patients with pulmonary symptoms/signs from a fire accident were enrolled in this study for comparison.99mTc HMPAO lung scan was performed in each control and patient, as well as the degree of pulmonary vascular endothelium damage was represented as lung/liver uptake ratios (L/L ratio). All of the controls and patients had no smoking histories. None of the controls and patients had positive findings of plain chest radiograph (CXR) and pulmonary function test (PFT).Results: The results showed that significantly higher L/L ratio in the 10 patients (0.53±0.07) than in the 10 controls (0.30±0.07) (the p value<0.05). Using a cut-off value of 0.40, all of the 10 patients had abnormally increased L/L ratios.Conclusions: We conclude that99mTc HMPAO lung scan has the potential to be a sensitive, objective and noninvasive method to detect inhalation lung injury of patients with pulmonary symptoms/signs but negative CXR and PFT findings after a fire accident.

Key words

technetium-99m hexamethylpropylene amine oxime inhalation lung injury fire accident 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fein A, Leff A, Hopewell PC. Pathophysiology and management of the complications resulting from fire and the inhaled products of combustion.Crit Care Med 1980; 8: 94–98.PubMedCrossRefGoogle Scholar
  2. 2.
    Peitzman AB, Shires GT, III, Corbett WA, Curreri PW, Shires GT. Measurement of lung water in inhalation 1981; 90: 305–312.PubMedGoogle Scholar
  3. 3.
    Kimmel EC, Still KR. Acute lung injury, acute respiratory distress syndrome and inhalation injury: an overview.Drug Chem Toxicol 1999; 22: 91–128.PubMedCrossRefGoogle Scholar
  4. 4.
    Eaton RJ, Senior RM, Pierce JA. Aspects of respiratory care pertinent to the radiologist.Radio Clin N Amer 1973; 2: 93–107.Google Scholar
  5. 5.
    Lin WY, Kao CH, Wang SJ. Detection of acute inhalation injury in fire victims by means of technetium-99m DTPA radioaerosol inhalation lung scintigraphy.Eur J Nucl Med 1997; 24: 125–129.PubMedCrossRefGoogle Scholar
  6. 6.
    Wittram C, Kenny JB. The admission chest radiograph after acute inhalation injury and burn.Br J Radiol 1994; 67: 751–754.PubMedCrossRefGoogle Scholar
  7. 7.
    Niden AH, Mishkin FS. Diffuse infiltrative lung disease. In:Pulmonary nuclear medicine—techniques in diagnosis of lung disease, Atkins HL (ed), New Yor; Marcel Dekker Inc., 1984; 167–200.Google Scholar
  8. 8.
    Shih CM, Shiau YC, Wang JJ, Ho ST, Kao A. Increased lung uptake of technetium-99m hexamethylpropylene amine oxime in systemic lupus erythematosus.Respiration 2002; 69: 143–147.PubMedCrossRefGoogle Scholar
  9. 9.
    Tocino IM. Chest radiology and other imaging techniques. In:The lung in rheumatic disease, Cannon GW, Zimmerman GA (eds), New York; Marcel Dekker Inc., 1990: 81–116.Google Scholar
  10. 10.
    Owada K, Uwantono E, Takeda H. Investigation of myocardial and pulmonary uptake of Tc-99m-HMPAO in the patients with cardiac diseases (abstract).KAKU IGAKU (Jpn J Nucl Med) 1993; 30: 960.Google Scholar
  11. 11.
    Shih WJ, Gruenwald F, Biersack HJ, Berger R, Brandenburg S, Coupal J, et al. Tc-99m HMPAO diffuse pulmonary uptake demonstrated in cigarette smokers.Clin Nucl Med 1991; 16: 668–672.PubMedCrossRefGoogle Scholar
  12. 12.
    Touya JJ, Rahimian J, Grubbs DE, Corbus HF, Bennett LR. A noninvasive procedure forin vivo assay of a lung amine endothelial receptor.J Nucl Med 1985; 26: 1302–1307.PubMedGoogle Scholar
  13. 13.
    Suga K, Uchisako H, Nishigauchi K, Shimizu K, Kume N, Yamada N, et al. Technetium-99m-HMPAO as a marker of chemical and irradiation lung injury: experimental and clinical investigations.J Nucl Med 1994; 35: 1520–1527.PubMedGoogle Scholar

Copyright information

© Springer 2003

Authors and Affiliations

  • Yu-Chien Shiau
    • 1
  • Feng-Yuan Liu
    • 1
  • Jeffrey J. P. Tsai
    • 2
  • Jhi-Joung Wang
    • 3
  • Shung-Tai Ho
    • 4
  • Albert Kao
    • 5
  1. 1.Department of Nuclear MedicineFar Eastern Memorial HospitalTaipeiTaiwan
  2. 2.Graduate Institute of BioinformaticsTaichung Healthcare and Management UniversityTaichungTaiwan
  3. 3.Department of Medical ResearchChi-Mei Medical CenterTainanTaiwan
  4. 4.School of MedicineNational Defense Medical CenterTaipeiTaiwan
  5. 5.Department of Medical ResearchChina Medical University HospitalTaichungTaiwan

Personalised recommendations