Performance and Feasibility of Therapeutic Vibrating Mesh Nebulizer for Ventilation Lung Scan

This study aimed to evaluate the performance of a therapeutic vibrating mesh-type nebulizer for the pulmonary delivery of radioaerosols for lung scintigraphy in healthy subjects. Six healthy subjects (mean age of 28.7 ± 6.2 y) inhaled 2 mL of Tc-99m diethylenetriaminepentaacetic acid (DTPA) and normal saline solution (20 mCi) via the therapeutic vibrating mesh nebulizer (DK010, DELBio, Taipei, Taiwan). The nebulizer’s mass median aerodynamic diameter (MMAD) is between 2.3 μm and 5.0 μm (3.47 ± 0.37 μm) and the nebulization rate is greater than 0.2 ml/min. Scintigraphy was performed to count radioaerosols in the regions of interest to determine the total and regional lung deposition and extrathoracic airway deposition of aerosols, penetration of aerosols, and radioactivity count balance. The total lung deposition of aerosols was 21.2 ± 5.2% (% ex-valve dose), 27.4 ± 8.0% (% ex-device dose) and 13.8 ± 4.1% (% initial dose) in nebulizer. The extrathoracic airway deposition was 4.8 ± 1.1%. The radioactivity count balance was 5.4 ± 3.0%. The ratio of outer vs inner lung deposition (O/I ratio, or penetration index) was 1.89 ± 0.55. The delivery efficiency and the penetration of aerosols to the peripheral lung achieved by the DELBio DK010 vibrating mesh-type nebulizer are similar to the commercialized jet-type nebulizers dedicated for radioaerosol lung scintigraphy nebulizer. The therapeutic vibrating mesh-type nebulizer (DELBio DK010) is feasible for radionuclide lung ventilation scintigraphy.

Relationship Between CRP, D-Dimer, D-Dimer/CRP with Clinical Probability and Diagnostic Value in Patients with Suspected Pulmonary Thoromboembolism

Objective: It was planned to investigate the diagnostic values for pulmonary thromboembolisym (PTE) by examining D-dimer, C-Reactive Protein (CRP), D-dimer/CRP ratio of patients who underwent computed tomography pulmonary angiography (CTPA) and/or lung scintigraphy with pre-diagnosis of pulmonary embolism. So it was thought that unnecessary computed tomograpy pulmonary Angiography could be reduced. Method: In our study, patients who were admitted to the chest diseases outpatient clinic and emergency department, who underwent CT pumonary Angiography and/or lung scintigraphy with a pre-diagnosis of pulmonary embolism, and who were simultaneously studied for D-dimer and CRP examinations were retrospectively evaluated. The efficiency and reliability of the Wells score and the combination of D-dimer, CRP and D-dimer/CRP ratio in the prediagnosis of pulmonary embolism were evaluated. Results: 46 of 79 patients with suspected pulmonary embolism included in our study were diagnosed with pulmonary thromboembolism with advanced tests. While the sensitivity and specificity of Wells score, D-dimer and CRP in diagnosing PTE were 41.3-100%, 91.3-27.3% and 84.7-42.4%, respectively, the cut off value of D-dimer/CRP ratio was 119.5. We found statistically significant higher D-dimer levels in patients with probable PTE according to Wells clinical scores. However, D-dimer/CRP ratio and CRP levels were statistically insignificant. Conclusion: In our study, D-dimer and CRP ratios were found to be significantly higher in patients with PTE, but D-dimer/CRP ratios were found to be less valuable in the diagnosis of PTE sensitivity and specificity.