R&D

At its core, Cyclopharm is a company built on innovation, from the original Technegas in 1986 through to Ultralute. Cyclopharm continues to innovate in these niche areas.

We are currently working on a number of initiatives around the globe and will update those here soon.

Guidelines

Research studies

Chronic thromboembolic pulmonary hypertension: detection, medical and surgical treatment approach, and current outcomes 01/05/2016
First Author: Poch, DS, Last Author: Auger, WR

V/Q remains the most widely sensitive test for the detection of chronic thromboembolic pulmonary hypertension (CTEPH). The combination of an abnormal V/Q scan and confirmatory digital substraction pulmonary angiography (DSPA) is the current gold standard for the detection of CTEPH and for operability assessment respectively. Although previous studies showed a wide gap between the sensitivity of V/Q (96%) and CTPA (51%), CTPA imaging has advanced with recent study showing that CTPA had a sensitivity of 92% in 114 consecutive patients being evaluated for CTEPH. Nonetheless, the simplicity of interpretation inherent with a V/Q scan along with the difficulties to recognise findings of CTEPH on CTPA makes perfusion scan the ideal screening study in the evaluation of patients for CTEPH.

Heart Fail Rev 2016; 21(3): 309-322

A review of imaging modalities in pulmonary hypertension 01/04/2017
First Author: Ascha, ML, Last Author: Tonelli, AR

V/Q scan is the imaging modality of choice for screening patients with suspected chronich tromboembolic pulmonary hypertension (CTEPH) due to its high sensitivity. Imaging in CTEPH reveals perfusion defects with normal ventilation. A normal or low-probability V/Q effectively excludes CTEPH with a sensitivity of 90-100% compared to CTPA yielding a sensitivity of 50-98%. Despite the high sensitivity and experts recommendations, V/Q scan for detecting CTEPH patients is still underutilized. Efforts should be tailored to increase its use in clinical setup as V/Q do not require iodine contrast and have less radiation exposure compared to CTPA.

Ann Thorac Med 2017; 12(2): 61-73

Estimation of regional lung function in interstitial pulmonary disease using Technegas and Tc99m-macroaggregated albumin single-photon emission tomography 01/12/1998
First Author: Sasaki, Y, Last Author: Narita, N

This study highlight that quantitative V/Q SPECT (Technegas + 99m-Tc-MAA) is considered to be an effective means to evaluate the progression and pathology of interstitial pulmonary disease and to detect early impairment of lung function.

Eur J Nucl Med 1998; 25(12): 1623-1629

Current status of ventilation-perfusion scintigraphy for suspected pulmonary embolism 01/03/2017
First Author: Metter, D.F, Last Author: Freeman, LM

Ventilation imaging is most often performed in conjunction with lung perfusion to characterize perfusion defects as a matched, mismatched or reverse mismatched. The optimal tracer for ventilation studies is Technegas, an ultra fine dispersion of 99mTc-labeled carbon. Despite that Technegas is not approved for use in the United States, it is used in 79% of ventilation imaging studies performed in Canada and is also commonly used in Europe. Its main advantage is greater percentage deposition in the alveolar spaces and less undesirable adherence to the central airways, compared with droplet radioaerosols.

AJR Am J Roentgenol 2017; 208(3): 489-494

Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease 01/05/2017
First Author: Bajc, M, Last Author: He, XY

V/Q SPECT, using Technegas as the ventilation imaging agent, could diagnose and grade severity of COPD and also estimate preserved lung function in 94 patients. Moreover, V/Q SPECT appears to be a unique tool to reveal the heterogeneity of COPD caused by pulmonary comorbidities such as pulmonary embolism, left heart failure, lung tumor and pneumonia. The characteristics of these comorbidities suggest their significant impact in symptoms, their influence on prognosis and their response to treatment.

Int J of Chron Obstruct Pulmon Dis 2017; 12: 1579-1587

Radionuclide diagnosis of pulmonary embolism 01/01/2017
First Author: Hess, S, Last Author: Madsen, PH

Among the traditional imaging modalities for diagnosing pulmonary embolism (PE), the choice has narrowed to V/Q scan and CTPA. However, V/Q scan is preferred over CTPA for follow-up of PE particularly in young women in order to avoid the excessive breast radiation exposure associated with CTPA.

Adv Exp Med Biol 2017; 906: 49-65

The Economic Value of Hybrid Single-Photon Emission Computed Tomography with Computed Tomography Imaging in Pulmonary Embolism Diagnosis 01/06/2017
First Author: Toney, LK, Last Author: Palli, SR

Compared to the currently available scanning technologies for diagnosing suspected PE, SPECT/CT appears to confer superior economic value, primarily via improved sensitivity and specificity and low non-diagnostic rates. In turn, the improved diagnostic accuracy accords this modality the lowest ratio of expenses attributable to potentially avoidable complications, misdiagnosis and underdiagnosis.

Acad Emerg Med 2017; [Epub ahead of print]

State-of-the-Art Imaging in pulmonary embolism: ventilation-perfusion single photon emission computed tomography versus computed tomography angiography – Controversies, Results, and Recommendations from a Systematic Review 01/10/2016
First Author: Hess, S, Last Author: Madsen, PH

V/Q SPECT-CT should be considered the first-line modality in most clinical setting based on overall better diagnositic performance. The use of V/Q SPECT-CT also allows differential diagnosis of other lung diseases than pulmonary embolism or chronic thromboembolic pulmonary hypertension (CTEPH).

Semin Thromb Hemost 2016; 42(8): 833-845

SPECT-CT/VQ versus CTPA for diagnosing pulmonary embolus and other lung pathology: Pre-existing lung disease should not be a contraindication 01/08/2016
First Author: Bhatia, KD, Last Author: Emmett, L

Pre-existing lung disease should not be a relative contraindication to the use of V/Q SPECT-CT. This modality has a sensitivity of 100% and specificity of 94% with lower radiation doses compared to CTPA

J Med Imaging Radiat Oncol 2016; 60(4): 492-497

Reproducibility of lobar perfusion and ventilation quantification using a SPECT/CT segmentation software in lung cancer patients 01/04/2017
First Author: Provost, K, Last Author: Lord, M

Quantification of regional lung perfusion and ventilation using a SPECT/CT-based lung segmentation software is highly reproducible. This three-dimensional method yields statistically significant differences in measurements for right lung lobes when compared to planar scintigraphy. We recommend that SPECT/CT based quantification be used for all lung cancer patients undergoing pre-therapy evaluation of regional lung function.

J Nucl Med Technol 2017; [Epub ahead of print]