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Radioaerosol Scintigraphy in Infants and Children Born to Mothers with HIV Disease

¹ From Depts of Radiology (P.O.A., M.J.F.)
² Pediatrics (R.B.M.), Columbia-Presbyterian Medical Center, 622 W 168th St, New York, NY 10032
³ Dept of Radiology, Univ of Southern California Medical Center (D.C.P.C.)
⁴ Dept of Radiology, Univ of California, Los Angeles Medical Center and School of Medicine (C.K.H.)
⁵ Dept of Radiology, Mount Sinai Medical Center and School of Medicine, New York (C.K.K.)
⁶ Dept of Radiology, Boston City Hospital, Mass (V.W.L.)
⁷ Dept of Radiology, Children's Hospital, Los Angeles, Calif (J.H.M.)
⁸ Dept of Radiology, Texas Children's Hospital, Houston (W.H.M.)
⁹ Div of Lung Diseases, National Heart, Lung and Blood Institute, Bethesda, Md (H.H.P.)
¹⁰ Dept of Biostatistics and Epidemiology, Cleveland Clinic, Ohio (A.S.)
¹¹ Div of Nuclear Medicine, Children's Hospital, Harvard Medical School, Boston, Mass (S.T.T.).

PURPOSE: To determine the usefulness of technetium 99m diethyltriaminepentacetic acid (DTPA) radioaerosol inhalation-clearance scintigraphy for early detection of pulmonary complications of human immunodeficiency virus (HIV) disease in children.

MATERIALS AND METHODS: A total of 301 studies were performed in 132 HIV-positive children (group 1; mean age, 46.6 months). In children born to HIV-positive mothers (group 2), 273 studies were performed in 160 children who eventually were proved to be HIV negative (mean age, 10.3 months), and 80 studies were performed in 47 HIV-positive children (mean age, 15.6 months). Radioaerosol studies were performed by using commercially available radioaerosol nebulizers. Pulmonary clearance half-time was measured by using conventional gamma camera computer systems. Radioaerosol results were correlated with indexes of pulmonary health and function.

RESULTS: The HIV-negative, group 2 children had a mean radioaerosol clearance half-time (58.1 minutes; 162 studies in 108 children) similar to that reported in healthy adults. Group 1 children with pulmonary involvement exhibited a faster mean clearance half-time (28.6 minutes) than did children without evidence of pulmonary involvement from either group 1 or group 2 (P < .05). A faster pulmonary clearance rate did not simply reflect the presence of chest disease that also was detectable on radiographs (P = .3).

CONCLUSION: Quantitative DTPA radioaerosol clearance studies may provide useful information about pulmonary involvement in selected children with HIV disease.

Index terms: Acquired immunodeficiency syndrome (AIDS), 60.2518 • Lung, diseases, 60.2518 • Lung, radionuclide studies, 60.12176 • Lung, ventilation