99mTc-MIBI Lung Scintigraphy in the Assessment of
Pulmonary Involvement in Interstitial Lung Disease and Its
Comparison With Pulmonary Function Tests and
High-Resolution Computed Tomography
Abstract: The differentiation of active inflammatory processes from
an inactive form of the disease is of great value in the management of
interstitial lung disease (ILD). The aim of this investigation was to
assess the efficacy of 99mTc-methoxy-isobutyl-isonitrile (99mTc-
MIBI) scans in distinguishing the severity of the disease compared
to radiological and clinical parameters.
In total, 19 known cases of ILD were included in this study and were
followed up for 1 year. Five patients without lung disease were
considered as the control group. The patients underwent pulmonary
function tests (PFTs) and high-resolution computed tomography scans,
followed by 99mTc-MIBI scanning. The 99mTc-MIBI scans were
analyzed either qualitatively (subjectively) or semiquantitatively.
All 19 ILD patients demonstrated a strong increase in 99mTc-MIBI
uptake in the lungs compared to the control group. The 99mTc-MIBI
scan scores were higher in the patient group in both the early phase
(0.24[0.19–0.31] vs 0.11[0.10–0.15], P<0.05) and the delayed phase
(0.15[0.09–0.27] vs 0.04[0.01–0.09], P<0.05) compared with the
control group. A positive correlation was detected between the
99mTc-MIBI scan and the high-resolution computed tomography
(HRCT) scores (Spearman’s correlation coefficient ¼ 0.65, P<0.02)
in the early phase but not in the delayed phase in patients (P>0.14). The
99mTc-MIBI scan scores were not significantly correlated with the PFT
findings (P>0.05). In total, 5 patients died and 14 patients were still
alive over the 1-year follow-up period. There was also a significant
difference between the uptake intensity of 99mTc-MIBI and the
outcome in the early phase (dead: 0.32[0.29–0.43] vs alive:
0.21[0.18–0.24], P<0.05) and delayed phase (dead: 0.27[0.22–0.28]
vs alive: 0.10[0.07–0.19], P<0.05).
The washout rate was �40 min starting from 20 min up to 60 min
and this rate was significantly different in our 2 study groups (ILD:
46.61[15.61–50.39] vs NL: 70.91[27.09–116.36], P¼0.04).
The present study demonstrated that 99mTc-MIBI lung scans might
distinguish the severity of pulmonary involvement in early views, which
were well correlated with HRCT findings. These results also revealed
that 99mTc-MIBI lung scans might be used as a complement to other
diagnostic and clinical examinations in terms of functional information
in ILD; however, further investigations are strongly require