A comparison of the Economics of xenon 127, xenon 133 and krypton 81m for routine ventilation imaging of the lungs

Abstract

We have compared the cost of providing routine lung ventilation scintigraphy using 127Xe with other radioactive gases in 100 patients. The physical properties of 127Xe permit a logical imaging sequence where a ventilation study is only carried out if indicated by perfusion scintigraphy which is performed first. With 133Xe, all patients must be ventilated prospectively, or a preselection carried out based on radiographic appearances at the time of imaging. This results in a greater number of ventilation studies than with 127Xe. Despite the greater cost per study of 127Xe, the overall cost of providing a routine diagnostic service with this gas is no more than that of using 133Xe in selected patients. The cost of ventilating all patients prospectively with 133Xe is considerably greater than using 127Xe only when indicated by abnormal perfusion images. If ventilation imaging is to be available at all times, either isotope of xenon costs very much less than 81Krm. We conclude that 127Xe is the radiopharmaceutical of choice for routine lung ventilation scintigraphy.