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Semin Nucl Med. 2019 Jan;49(1):11-15. doi: 10.1053/j.semnuclmed.2018.10.007. Epub 2018 Nov 20.

SPECT Ventilation Imaging in Asthma.

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Airway Imaging and Physiology Group, The Woolcock Institute of Medical Research, Glebe NSW 2037; Northern Clinical School, Faculty of Medicine & Health, University of SydneyNSW 2006. Electronic address:
Airway Imaging and Physiology Group, The Woolcock Institute of Medical Research, Glebe NSW 2037; Department of Respiratory Medicine, Royal North Shore Hospital, Pacific Highway, St Leonards NSW 2065.


Uneven distribution of ventilation, or ventilation heterogeneity, has been observed in asthma for over 60 years using multiple breath nitrogen washout (MBNW) studies. Ventilation heterogeneity has been known to predict airway hyperresponsiveness (the ability of the airways to constrict too easily and by too much) in asthma, which is a core physiological characteristic of this disease. SPECT ventilation imaging allows topographical analysis of changes in ventilation distribution. Technegas as a SPECT ventilation agent has a key advantage as it remains fixed after inhalation, which allows imaging of upright ventilation distribution, analogous of pulmonary function tests. Recent studies using Technegas ventilation SPECT have shown spatial imaging markers also relate to airway hyperresponsiveness in asthma, and are predicted by a MBNW index of peripheral ventilation heterogeneity. It has also been shown that low-ventilation regions induced by bronchoconstriction were also related to peripheral ventilation heterogeneity. Furthermore, this suggests that the function of peripheral airways may determine the topographical pattern of airway narrowing with a more widespread distribution of narrowing. SPECT ventilation adds spatial characterisation information and it should be included in research protocols to enhance the understanding of complex physiological mechanisms in asthma.

[Indexed for MEDLINE]

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