Gallium lung scintigraphy in amiodarone pulmonary toxicity

Journal Article · Wed Jun 01 00:00:00 EDT 1988 · Chest; (United States)

DOI:https://doi.org/10.1378/chest.93.6.1126· OSTI ID:6973800

Zhu, Y Y; Botvinick, E; Dae, M; Golden, J; Hattner, R; Scheinman, M

We sought to assess the role of gallium-67 lung scintigrams in the evaluation of amiodarone pulmonary toxicity. Images and laboratory studies were evaluated in 54 patients who had chest radiographs and scintigraphic studies during amiodarone treatment of more than one month's duration among 561 patients receiving the medication for refractory arrhythmias. There were 22 patients with pulmonary symptoms and clinical evidence of amiodarone pulmonary toxicity (group 1); 19 patients had other causes for pulmonary symptoms (group 2); and 21 patients were without symptoms or other clinical evidence of pulmonary toxicity (group 3). There was no difference among groups in treatment duration or total amiodarone dose. Symptomatic presentation could not differentiate between group 1 and group 2 patients. However, radiographic findings of isolated pulmonary congestion or a normal radiograph in the presence of symptoms made amiodarone toxicity unlikely, while the appearance of new, dense radiographic infiltrates--often in a nodular distribution--were more frequent among group 1 patients (p less than 0.01). During symptomatic periods, 18 of 22 group 1 patients had abnormal gallium lung uptake, while four revealed more subtle serial changes but there was only one abnormal scintigram among symptomatic group 2 patients. Nonspecific radiographic abnormalities in patients with pulmonary symptoms on amiodarone therapy were rarely attributed to toxicity in the presence of a normal scintigram. One group 3 patient developed scintigraphic abnormalities early during amiodarone treatment, suggesting toxicity in the presence of a normal chest x-ray examination. Comparison of radiographic and scintigraphic studies performed during symptoms with those performed prior to symptom development best indicated the diagnosis, while comparison with later images assessed the efficacy of treatment.

• Research Organization: Univ. of California, San Francisco (USA)
• OSTI ID: 6973800
• Journal Information: Chest; (United States), Vol. 93:6
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
LUNGS
BIOMEDICAL RADIOGRAPHY
SCINTISCANNING
VASODILATORS
TOXICITY
GALLIUM 67
PATIENTS
SYMPTOMS
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR AGENTS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
GALLIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
RESPIRATORY SYSTEM
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