290 Trakia Journal of Sciences, Vol. 12, Suppl. 1, 2014 Trakia Journal of Sciences, Vol. 12, Suppl. 1, pp 290-294, 2014 Copyright © 2014 Trakia University Available online at: http://www.uni-sz.bg ISSN 1313-7050 (print) ISSN 1313-3551 (online) LUNG PERFUSION SCINTIGRAPHY IN PULMONARY METASTASES N. Georgieva 1* , E. Obretenov 2 , G. Kalaydjiev 3 , K. Peeva 4 1 Department of Nuclear Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria 2 Clinic of Thoracic Surgery, University Hospital, Stara Zagora, Bulgaria 3 Clinic of Thoracic Surgery, National Oncology Hospital, Sofia, Bulgaria 4 Department of Social Medicine and Health Management, Medical Faculty, Trakia University, Stara Zagora, Bulgaria ABSTRACT The lungs are one of the common metastatic places for different carcinomas with other primary localization when there is generalization of the process. Lung perfusion scintigraphy is a valuable method for detection of the changes in lung perfusion at metastatic process. We have performed lung perfusion scintigraphy on 19 patients, 8 women and 11 men, in the range of 36 -68 years of age with single or multiple metastases in the lungs from carcinomas with other primary localization. Perfusion changes vary from impaired at different extent perfusion in small zone encompassing parts of one or several segments in one of the lungs to perfusion defect and in some cases to distent mediastinum. Perfusion indices, independently of the metastases localization in the lungs were mean = 46,92%, SD = 11,87%. The single metastases in the lungs cause predominantly oval zone of impaired perfusion. The involvement of one or the two hili and the distent mediastinum are indirect sign for advanced metastatic process or presence of multiple metastases. Metastases in the left lung more often induce greater changes in perfusion indices. Key words: lung perfusion scintigraphy, pulmonary metastases INTRODUCTION The lungs are one of the common metastatic places for different carcinomas with other primary localization when there is generalization of the process. Lung perfusion scintigraphy is a valuable method for detection of the changes in lung perfusion at metastatic process, for determination of functional operability when the metastasis could be operated on. MATERIALS AND METHODS We have performed lung perfusion scintigraphy on 19 patients, 8 women and 11 men, in the range of 36 -68 years of age with single or multiple metastases in the lungs from carcinomas with other primary localization. In one of the female patients the metastasis in the lungs is operated on. _________________________ *Correspondence to: Nina Georgieva, Department of Nuclear Medicine, Medical Faculty, 11 Armeyska str ,6003 Stara Zagora, Bulgaria, e-mail: ngeorgieva21@yahoo.com Lung perfusion scintigraphy was performed in all patients with 99m Tc- human albumin microspheres with a particle size of 23-45μm (kit Sferotec – Sorin Biomedica-Italy). The injection was applied in supine position, intravenously in bolus, 1ml at an activity of 55-74MBq. The period of examination was between the 15 th min and the 2 nd hour after injection, at anterior, posterior, lateral and 45° detection, perfusion indices from 6 fields in front and posterior projection were calculated (Picker Dyna Camera 4 Scintillation Camera System – Picker Corporation Nuclear and Ultrasound, USA). RESULTS Pulmonary metastases are searched in 14 patients. In 4 of the patients there has been suspicion of primary tumor in the lungs. In one patient with operated colon carcinoma was suspected second localization of carcinoma in the lungs which intra- operatively is proven as metastasis of the primary carcinoma. The distribution of the patients by diagnosis is shown in Table 1: