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1.
Clin Nucl Med ; 41(3): 194-200, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26673241

RESUMEN

AIM: In patients with progressive, metastatic neuroendocrine tumors (NET), intra-arterial radionuclide infusions with high activities of In-[DTPA]-octreotide and more recently with non-carrier added (nca) Lu-[DOTA,Tyr]-octreotate have been performed with encouraging results. However, the affinity profiles (IC50) of these radiopeptides for human sst2 receptors are markedly different (In-[DTPA]-octreotide, 22 ± 3.6 nM and nca Lu-[DOTA,Tyr]-octreotate, 1.5 ± 4.0 nM). The total administered activity is determined by organ dose limits (kidneys and bone marrow), and our aim therefore was to compare and evaluate the therapeutic efficacy of both radiopeptides in metastatic NETs. METHODS: Thirty patients with gastroenteropancreatic (GEP) somatostatin-positive NETs with liver metastases confirmed on biopsy and In-pentetreotide scan were included. They were treated with In-[DTPA]-octreotide (n = 17) or nca Lu-[DOTA,Tyr]-octreotate (n = 13). Blood samples were collected 2, 4, 8, and 24 hours postadministration to calculate residence time in blood and in red marrow. The maximum percentage uptake in organs and tumors was estimated by region of interest analysis, and tumor dosimetry calculations were performed using OLINDA/EXM/ 1.0 software. RESULTS: ncaLu-[DOTA,Tyr3]-octreotate blood radioactivity, expressed as a percentage of the injected dose, was significantly lower than In-[DTPA]-octreotide (P < 0.05), as clearly depicted from the time-activity curves; the background-corrected tumor uptake was significantly higher than In-[DTPA]-octreotide but without any significant difference in other organs (spleen, kidneys, and liver). CONCLUSIONS: Using Lu-[DOTA,Tyr]-octreotate, a 3-fold higher absorbed dose to tumor tissue was achieved compared with In-[DTPA] octreotide. Residence time of nca Lu-[DOTA,Tyr]-octreotate results in a significantly higher absorbed dose to bone marrow compared with In-[DTPA]-octreotide. However, a drawback of In-[DTPA]-octreotide therapy is that the number of administrations would need to be almost doubled to achieve an equal therapeutic outcome as compared with Lu-[DOTA,Tyr]-octreotate.


Asunto(s)
Neoplasias Hepáticas/radioterapia , Tumores Neuroendocrinos/tratamiento farmacológico , Octreótido/análogos & derivados , Ácido Pentético/análogos & derivados , Radiofármacos/uso terapéutico , Adulto , Anciano , Femenino , Humanos , Neoplasias Hepáticas/secundario , Masculino , Tumores Neuroendocrinos/patología , Octreótido/administración & dosificación , Octreótido/efectos adversos , Octreótido/uso terapéutico , Ácido Pentético/administración & dosificación , Ácido Pentético/efectos adversos , Ácido Pentético/uso terapéutico , Radiofármacos/administración & dosificación , Radiofármacos/efectos adversos
2.
Q J Nucl Med Mol Imaging ; 56(6): 551-8, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23358409

RESUMEN

AIM: Aim of this study was to evaluate the effectiveness of non-carrier added (n. c. a.) [177Lu]DOTA-TATE in inoperable liver metastases, positive for sst2 receptor overexpression (verified by Octreoscan and confirmed by biopsy) due to neuroendocrine gastroenteropancreatic (GEP) tumors. [177Lu]DOTA-TATE has been infused after selective catheterization of the hepatic artery, minimising in parallel the toxicity of non-target tissues. METHODS: The dose per session administered to each patient (12 cases in total) was 7400 MBq (200 mCi). Repetitions did not exceed 6-fold with treatment intervals of 5-8 weeks. Response assessment was classified according to the therapeutic benefit. Absorbed doses delivered to metastases, kidneys and red marrow were calculated according to OLINDA 1.1 program and the derived values were correlated to the Response Evaluating Criteria in Solid Tumors (RECIST). CT/MRI scans were performed as baseline before, during and after the end of treatment and monthly ultrasound images for follow-up estimation and measurements. Toxicity (World Health Organization criteria) was measured using blood and urine tests of renal, hepatic and bone marrow function. RESULTS: None of the patients resulted complete response (0.0%); partial response was assessed in 8 (66.7%), disease stabilization in 3 (25%) and progressive disease in 1(8.3%). A 14-month median survival time was estimated for all patients, so far. Eight of 12 (66.7%) showed a mean target diameter shrinkage ranging from 33% to 45%. The organ average radiation dose estimation was found as follows: a) liver tumor 20.8 mGy/MBq; b) liver 0.14 mGy/MBq; c) kidneys 0.41 mGy/MBq; d) spleen 1.4 mGy/MBq; and f) bone marrow 0.022 mGy/MBq. The average absorbed dose per session to a tumor for a spherical mass of 20 g was estimated to be 20.8 mGy/MBq, depending on the histotype of the tumor. WHO toxicity grade 2 to 3 erythro-, leuko- and thrombo-cytopenia occurred in 9 (75%) cases observed about after the third session. CONCLUSION: In unresectable metastatic liver lesions positive for somatostatin receptors repeated, trans-hepatic high doses of [177Lu]DOTA-TATE resulted in a more than promising therapeutic outcome with a partial response in 75% of the treated patients. Given the loco-regional modality character of the administration technique, no nephro-toxicity has been so far observed whereas a remarkable myelotoxicity was noticed.


Asunto(s)
Neoplasias Intestinales/radioterapia , Neoplasias Intestinales/secundario , Neoplasias Hepáticas/radioterapia , Neoplasias Hepáticas/secundario , Tumores Neuroendocrinos/radioterapia , Tumores Neuroendocrinos/secundario , Octreótido/análogos & derivados , Compuestos Organometálicos/uso terapéutico , Neoplasias Pancreáticas/radioterapia , Neoplasias Pancreáticas/secundario , Neoplasias Gástricas/radioterapia , Neoplasias Gástricas/secundario , Adulto , Anciano , Femenino , Arteria Hepática , Humanos , Infusiones Intraarteriales , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Octreótido/uso terapéutico , Radiofármacos/uso terapéutico , Resultado del Tratamiento
3.
Q J Nucl Med Mol Imaging ; 55(1): 91-102, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21068716

RESUMEN

AIM: In this study, a new method has been used to predict pain response to (186)Re-HEDP therapy in patients suffering from painful osseous metastases, on the basis of a modified bone scan index and pre-therapy pain scoring. METHODS: Forty five patients received a total of 73 doses of (186)Re-HEDP during a period of pain relapse without extra-osseous disease progression. All patients were under stable regimen of zoledronic acid, far off other therapeutic manipulations. Imaging studies regarding a modified estimation of bone scan index, were applied; the value of the largest bony lesion (called mBSI), provided that it also corresponded to the most prominent site of osseous pain was taken into account, and a new semi-quantitative index called Double Product Value (DPV), equal to pre-therapy pain score times mBSI was entered in the result analyses, to investigate any possible correlations with response endpoints. RESULTS: Favourable response occurred in 35/47 evaluated therapeutic doses of (186)Re-HEDP (74.5%; excellent response in 12 doses, 25.5%). Responders had significantly lower DPV (3.4 ± 2.3 vs. 10.2 ± 6.2, P=0.0029, for non-responders). Patients with pre-therapy DPV 4, and also a longer median period of pain relief (respective mean values 5.9 versus 2.1 months, HR 2.82; P=0.0001). CONCLUSION: DPV, as developed and implemented in this study proved a valuable and reproducible pre-therapy tool for assessing degree and duration of pain response after (186)Re-HEDP therapy.


Asunto(s)
Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Ácido Etidrónico/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Renio/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/fisiopatología , Neoplasias de la Mama/fisiopatología , Neoplasias de la Mama/radioterapia , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Dolor/fisiopatología , Dolor/radioterapia , Dimensión del Dolor , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/fisiopatología , Neoplasias de la Próstata/radioterapia , Radioisótopos/uso terapéutico , Radiofármacos/uso terapéutico
5.
Radiat Prot Dosimetry ; 125(1-4): 403-6, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17223636

RESUMEN

According to the Euratom Directives (96/29, 97/43), the doses received by the workers as well as the family of patients and third persons during medical exposures, should conform to the dose constraint levels (DCLs), established by the authorities for each group in the context of optimisation. This study deals with the implementation of a radiation protection protocol, concerning the aforementioned group members for patients undergoing treatment with 111In-DTPA-D-Phe1-Octreotide, after intra-arterial infusion. It is shown that by applying this protocol the annual doses to the medical and technical staff are considerably reduced and remain below the established DCLs. Following the post-release behaviour instructions given to the patient, doses to the family and third persons may be kept lower than the corresponding DCLs provided by the National Regulations.


Asunto(s)
Familia , Cuerpo Médico , Exposición Profesional/análisis , Ácido Pentético/análogos & derivados , Monitoreo de Radiación/métodos , Protección Radiológica/métodos , Radiofármacos/análisis , Diseño de Equipo , Análisis de Falla de Equipo , Grecia , Internacionalidad , Ácido Pentético/análisis , Ácido Pentético/uso terapéutico , Dosis de Radiación , Radiofármacos/uso terapéutico , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
6.
Clin Imaging ; 25(4): 275-83, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11566091

RESUMEN

For pancreatic insulinomas, the treatment of choice is surgical excision, which when successful is curative. Intraoperative palpation combined with ultrasonography theoretically depict almost all tumors, however the accuracy of palpation is improved by the preoperative localization. All recent advances in imaging have improved the likelihood for curative surgical resection. Our purpose is to demonstrate the characteristics of all modalities, which may be used in the preoperative localization algorithm.


Asunto(s)
Algoritmos , Insulinoma/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Somatostatina/análogos & derivados , Angiografía/métodos , Gluconato de Calcio , Endosonografía , Humanos , Insulinoma/diagnóstico por imagen , Cuidados Intraoperatorios , Imagen por Resonancia Magnética , Neoplasias Pancreáticas/diagnóstico por imagen , Cuidados Preoperatorios , Cintigrafía , Receptores de Somatostatina/metabolismo , Tomografía Computarizada por Rayos X
7.
Anticancer Res ; 17(3B): 1593-7, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179200

RESUMEN

In-111 pentetreotide is a new radiolabelled [OctreoScan 111, Mallinckrodt Medical BV, Petten] somatostatin analog with high affinity to somatostatin receptors (SR). introduced for the in vivo imaging of SR positive tissues. In an attempt to evaluate its clinical usefulness for tissue characterization in malignancies without neuroendocrine expression in parallel with histological and radiological examinations, specific scintigraphy was performed on brain (6 cases), thyroid (6 cases) and breast (9 cases) tumors, and in lymphomas (9 cases) and melanomas (6 cases). A dose of 111MBq of In-111 pentetreotide was injected i.v. to each patient and scintimages at 6 and 22 hours (for comparison) p.i. were obtained. The primary lesion of the breast cancer population was imaged in all 9 cases as well as all the palpable axillary nodes in 4 cases. Three women with impalpable axillary lymph nodes scanned negative but had a positive biopsy. Both meningiomas were positive for SR scans: positive results were also obtained for the high grade astrocytoma and the craniopharyngioma: Two out of 6 patients with papillary thyroid cancer showed a marked radiotracer accumulation. Scintigraphy in all 5 lymphomas was positive for SR but did not detect the Tc-99m sulphur microcolloid [Lymphoscint, Solco, Basel, Suitzerland] imaged lymph nodes in 5 melanomectomized patients. When judging the imaging results of these non-neuroendocrine malignancies definite conclusions should not be drawn since the number of studied cases polymorph, was small for every cancer histotype; nevertheless SR scintigraphy does not seem to be reliable for tumor staging in non-neuroendocrine malignancies, but is more suitable for a tissue characterization and monitoring changes of SR expression during and after therapy.


Asunto(s)
Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Receptores de Somatostatina/análisis , Neoplasias Cutáneas/diagnóstico por imagen , Somatostatina/análogos & derivados , Neoplasias de la Tiroides/diagnóstico por imagen , Adolescente , Adulto , Neoplasias Encefálicas/patología , Neoplasias de la Mama/patología , Femenino , Humanos , Radioisótopos de Indio , Metástasis Linfática , Linfoma/patología , Imagen por Resonancia Magnética , Masculino , Melanoma/patología , Neoplasias Cutáneas/patología , Neoplasias de la Tiroides/patología , Tomografía Computarizada de Emisión
8.
Anticancer Res ; 17(3B): 1589-92, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179199

RESUMEN

Three radiolabelled substances, 111In-pentetreotide, 99mTc-(V)DMSA and 123I-MIBG with different kinetics but similar tumor seeking behavior, were i.v. injected to assess and correlate their clinical value in metastatic malignant pheochromocytomas (4 patients), stage III and IV neuroblastomas (7 patients) and medullary thyroid carcinomas (6 patients). All II pheochromocytoma/neuroblastoma patients received i.v. a dose of III MBq (3 mCi) of 123I-MIBG and 185 MBq (5 mCi) of 111In-pentetreotide, within approximately weeks each other. Furthermore, in 4 of these patients as well as in all medullary thyroid carcinoma patients 111 MBq (3 mCi) of 99mTc-(V)DMSA were applied i.v. I week prior to the pentetreotide/mlBG scans. Four patients (malignant pheochromocytoma) with a total of 7 foci showing MIBG accumulation had 3 sites with pentetreotide and 1 site with (V)DMSA uptake, while in 7 patients (neuroblastora) with 15 foci showing MIBG accumulation 10 sites had detectable pentetreotide and 3 sites detectable (V)DMSA. Of the three radiotracers, 111In-pentetreotide used for somatostatin receptor identification holds promise mainly in cases where foci imaged with 123I-MIBG are negative. 111In-pentetreotide is unlikely to replace 123I-MIBG as a first-line routine diagnostic scintigraphic modality; compared to pentetreotide or MIBG, (V)DMSA seems to be highly sensitive only in medullary thyroid carcinomas.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Carcinoma Medular/diagnóstico por imagen , Yodobencenos , Neuroblastoma/diagnóstico por imagen , Compuestos de Organotecnecio , Feocromocitoma/diagnóstico por imagen , Somatostatina/análogos & derivados , Succímero , Neoplasias de la Tiroides/diagnóstico por imagen , 3-Yodobencilguanidina , Adolescente , Neoplasias de las Glándulas Suprarrenales/patología , Adulto , Biopsia , Carcinoma Medular/patología , Niño , Femenino , Humanos , Radioisótopos de Indio , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neuroblastoma/patología , Feocromocitoma/patología , Ácido Dimercaptosuccínico de Tecnecio Tc 99m , Neoplasias de la Tiroides/patología , Tomografía Computarizada de Emisión
9.
Anticancer Res ; 17(3B): 1615-8, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179204

RESUMEN

Although bone scintigraphy using Tc-99m labelled diphosphonates is a highly sensitive modality for the detection of of the extent of secondary skeletal malignancies, it is often not sufficient since possible bone marrow participation cannot be imaged We make a preliminary report on the usefulness of bone marrow immunoscintigraphy in the follow-up of patients with skeletal metastases due to breast and prostate cancer in parallel with the interpretation of conventional Tc-99m MDP bone scans. Approximately 7 to 9 months after radionuclide therapy both Tc-99m MDP [Hellenic Nuclear Research Center "Democritos". Aghia Paraskevi, Attikil and Tc-99m Anti-Granulocyte BW 250/183 [CIS Bio International, Gif sur Yvette, France] bone scans were performed on 2 prostate cancer patients and 5 women with breast cancer with disseminated bone metastases. Bone scans preceded bone marrow scans. Bone marrow defects were concordant with cortical scans in 4 cases, while they were larger in 4 sites compared to -MDP scan. Four sites in the ribs, shown on -MDP scan could not be detected on antigranulocyte scans. Bone cortex and marrow combined imaging of osseous metastases using different radiotracers increases the information on the real extent of skeletal involvement; the scintigraphic data obtained are valuable for the further decision making for the best possible management of unexpected myelosuppressive side effects as well as the follow-up of the treated cancer patients.


Asunto(s)
Médula Ósea/diagnóstico por imagen , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Próstata/diagnóstico por imagen , Medronato de Tecnecio Tc 99m , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Neoplasias de la Mama/radioterapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/radioterapia , Radioinmunodetección/métodos , Reproducibilidad de los Resultados
10.
Anticancer Res ; 17(3B): 1667-9, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179215

RESUMEN

The purpose of lymphoscintigraphy in patients with melanoma before surgery is to image the lymphatic drainage net and particularly to detect the sentinel node; the purpose of immunolymphoscintigraphy after surgery is to map the lymphatic drainage and to detect a possible spead of the malignancy towards the lymph nodes surrounding the surgical field or more distal regions. The aim of the present study was to assess the sensitivity of a two-phase procedure with Tc-99m-Iabelled agents for exploring possible spread of melanoma after thorough resection of the primary lesion. Seven melanomectomized patients were enrolled into the study. The melanomas were situated on the head, back, arm and buttock of these patients. Intracutaneous lymphoscintigraphy with Tc-99m sulphur microcolloid [Lymphoscint, Solco, Basel, Switzerland] and i.v. immunoscrintigraphy with Tc-99m-antimelanoma antibody [Tecnemab-K-I, Sorin Biomedica Spa, Saluggia, Italy] at a dosage of 55 MBq and 740 MBq respectively, were performed in 13 patients to define possible infiltration of lymph nodes after surgery with a time interval of 1 week between the two examinations. Tc-99s sulphur microcolloid preceded the Tc-99m anti-melanoma antibody scan. The scintigrams were evaluated by three experienced nuclear physicians. The method detected 3 out of 16 suspicious nodes as malignant. Combined two-phase technique improves the diagnostic and staging accuracy of cutaneous melanoma affected population and appears extremely useful in the surgical confrontation of the lymphatic spead.


Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Metástasis Linfática/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Azufre Coloidal Tecnecio Tc 99m , Tecnecio , Adulto , Femenino , Humanos , Escisión del Ganglio Linfático , Sistema Linfático , Masculino , Melanoma/patología , Melanoma/cirugía , Persona de Mediana Edad , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Radioinmunodetección/métodos , Reproducibilidad de los Resultados , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía
11.
Anticancer Res ; 17(3B): 1699-704, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179222

RESUMEN

Prostate carcinoma is the most commonly associated with osseous metastases malignancy in males. The lesions, being usually of a mixed sclerotic/lytic variety and less often of the pure sclerotic type, need to be treated by a bone seeking radioactive element with an as low as possible radiobiological burden on the surrounding (peritumoral) tissues. Rhenium-186-HEDP was used to treat these osseous metastatic lesions due to its bone seeking kinetics attractive radiochemical properties. Of a total of 16 prostate cancer patients. 3 experiment loss of pain, 8 experienced obvious and 2 some improvement. No change was observed in 3 patients. Ten patients manifested a flare syndrome increasing pain approximately 2 to 6 days, after Re-186-HEDP i.v. application. Six patients showed a definite and 9 a slight decrease in platelet levels and absolute number of polymorphonuclear white blood cells, up to fourth week following treatment. One patient underwent a whole blood transfusion and in 2 peripheral neuropathy was observed lasting about 9 to 12 days. Re-186-HEDP appears to be a promising new metal ion complex for the palliation of painful bone metastases in prostate cancer. Compared to Sr-89 therapy, it shows a longer analgetic efficacy and has the advantage of emitting gamma rays, a fact which facilitates dosimetric calculations.


Asunto(s)
Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Ácido Etidrónico/uso terapéutico , Neoplasias de la Próstata/radioterapia , Renio/uso terapéutico , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/fisiopatología , Humanos , Masculino , Compuestos Organometálicos , Dimensión del Dolor , Dolor Intratable , Cuidados Paliativos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/fisiopatología , Radioisótopos , Cintigrafía , Medronato de Tecnecio Tc 99m
12.
Anticancer Res ; 17(3B): 1713-8, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179224

RESUMEN

BACKGROUND: There have been no major advances in the systemic detection of renal cell carcinoma (RCC) and its unpredictable metastases. Surgery, thus, remains the mainstay of the curative treatment for the localized disease. The propose of the present study has been to systemically detect and treat advanced RCC respectively with Ga-67 and Y-90 radiopharmaceuticals containing tumour-affine species. PATIENTS AND METHODS: Thirty-three RCC patients were imaged with Tc-99m-MDP and then with Ga-67 citrate solution in order to detect RCC and its metastases. Yttrium-90 citrate solution, containing the radionuclide species chromatographically and electrophoretically identical to those in RCC-affine Ga-67 solution, was administered i.v. for systemic therapy of advanced RCC. Total-body distribution of Y-90 was studied with a gamma-camera equipped with an ultra-high-sensitivity collimator. The efficacy of the therapy was studied by the clinical condition of the patient and by the total-body scintigraphic imaging with Tc-99m-MDP and with Ga-67 citrate solution. RESULTS: Ga-67 detects RCC bone metastases better than Tc-99m-MDP. Systemic therapy of RCC metastasized to bones, lung and brain was obtained with RCC-affine Y-90 citrate solution. CONCLUSIONS: Third group metal radionuclides, Ga-67 and Y-90, detect and treat advanced RCC.


Asunto(s)
Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Renales/radioterapia , Citratos/uso terapéutico , Radioisótopos de Galio/uso terapéutico , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/radioterapia , Compuestos Organometálicos/uso terapéutico , Radioisótopos de Itrio/uso terapéutico , Adulto , Anciano , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Carcinoma de Células Renales/patología , Femenino , Humanos , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Medronato de Tecnecio Tc 99m , Tomografía Computarizada de Emisión
13.
Anticancer Res ; 17(3B): 1731-4, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179226

RESUMEN

BACKGROUND: Androgen deprivation therapy remains so far the mainstay of advanced prostate cancer treatment. Although it improves the quality of life of the patient for some time, the disease progresses and soon it becomes hormonally unresponsive. The object of our research has been to find a systemic therapy for prostate cancer patients whose disease no longer responds to hormone therapy, radiation therapy, chemotherapy and immunotherapy. PATIENTS AND METHODS: Thirty-one advanced prostate cancer patients with intense bone metastasis pain, bed ridden, and with permanent urinary catheter were first examined with Ga-67 and then treated with Y-90 solutions which were chromatographically and electrophoretically analysed for the presence of both cationic and anionic species of the radionuclide. The quality of life and prostate specific antigen (PSA values) values were followed for testing the success of the therapy. RESULTS: Prostate cancer-affine Y-90 cured the advanced prostate cancer patients who regained their normal life. The uptake of the radionuclide in the primary cancer and its metastases responsible for the treatment has been confirmed by scintigraphy. CONCLUSIONS: Prostate cancer-affine Y-90 solution, containing stable cationic and anionic species of the radionuclide, is effective in the cure of advanced prostate cancer patients.


Asunto(s)
Radioisótopos de Galio/uso terapéutico , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/radioterapia , Radioisótopos de Itrio , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Dolor , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/patología , Calidad de Vida , Cintigrafía , Tomografía Computarizada por Rayos X , Cateterismo Urinario
14.
Anticancer Res ; 17(3B): 1767-72, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179232

RESUMEN

The efficacy and toxicity of treatment with 1400 +/- 100 MBq of Re-186-HEDP were evaluated in women with osseous metastatic breast cancer. The follow-up period was fourteen weeks. The efficacy of treatment was assessed by a) a pain and performance questionnaire that patients were asked to complete daily and b) a CT scan comparison of a randomly preselected osseous lesion before and 30 weeks after Re-186-HEDP i.v. application. The response to treatment was also evaluated by using the Kamofsky Index. Two out of fourteen women (14%) experienced loss of pain, 6 experienced obvious and 2 some improvement. No change was observed in 4 patients. Five patients manifested a flare response to treatment, with increase in pain within the first, 4 to 5 days after Re-186-HEDP administration. Five patients showed a decrease in platelet levels and absolute number of polymorphonuclear blood transfusion; no neurologic side effects were observed. Re-186-HEDP appears to be a useful new radiopharmaceutical for pain palliation induced by osseous metastases due to breast cancer. Compared to Sr-89 chloride efficacy, it provides longer-lasting analgesia, and when needed it can be reinjected with less risk due to its improved physico- and radiochemical properties.


Asunto(s)
Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Neoplasias de la Mama/radioterapia , Ácido Etidrónico/uso terapéutico , Dolor Intratable , Renio/uso terapéutico , Adulto , Analgesia/métodos , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/fisiopatología , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/fisiopatología , Ácido Etidrónico/efectos adversos , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Compuestos Organometálicos , Osteólisis , Cuidados Paliativos , Radioisótopos , Renio/efectos adversos , Medición de Riesgo , Estroncio/efectos adversos , Estroncio/uso terapéutico , Medronato de Tecnecio Tc 99m , Tomografía Computarizada de Emisión
15.
Anticancer Res ; 17(3B): 1779-81, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179234

RESUMEN

In bone scintigraphy extraosseous uptake of the radiopharmaceutical (TcO4-, pertechnetate) is a common finding when the stomach is abnormally observed; this may be due to the instability of the radiopharmaceutical leading to free pertechnetate within this organ. The same explanation might be inculpate rhenium 186-HEDP, due to its similarity to Tc-99m MDP's sphysicochemical properties and behavior, as both radioisotopes are Group VII metals /1/ and are labelling the same ligand (a diphosphonate moiety). We report on 186Re-HEDP uptake in the stomach in two patients with osseous metastases because of prostate and breast cancer respectively out of a series of 52 cancer affected individuals, treated with 186Re-HEDP. The thorough clinical and laboratory investigation of both patients assessed that this extraosseous radio-rhenium accumulation was multifactorial with the main cause being a disturbance of body fluid acid-balance, favoring calcium and phosphate ion precipitation and leading to 186Re-HEDP extraosseous uptake.


Asunto(s)
Neoplasias Óseas/metabolismo , Huesos/diagnóstico por imagen , Neoplasias de la Mama/radioterapia , Ácido Etidrónico/farmacocinética , Ácido Etidrónico/uso terapéutico , Neoplasias de la Próstata/radioterapia , Renio/farmacocinética , Renio/uso terapéutico , Estómago/diagnóstico por imagen , Neoplasias Óseas/diagnóstico por imagen , Huesos/metabolismo , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Femenino , Humanos , Masculino , Compuestos Organometálicos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Radiofármacos , Medronato de Tecnecio Tc 99m , Tomografía Computarizada de Emisión
16.
Anticancer Res ; 17(3B): 1841-4, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9179242

RESUMEN

Thallium-201 with a half-life of 73 hours, decays by electron capture and as a consequence emits numerous Auger electrons. When it localises in the cell nucleus it causes enhanced biological effects. Technetium-99m with a half-life of 6 hours, radiates gamma rays and the side effects are not as significant. Tl-201 and Tc-99m labelled with SESTAMIBI are used for the SPECT perfusion image of the heart. In this study the tissue of interest are the testes which, after irradiation, can develop stochastic effects: both somatic (cancer) and hereditary. The activities of the radiopharmaceuticals used in common practice (30 mCi of Tc-99m and 3 mCi of Tl-201) cause different probabilities for the induction of stochastic effects in the testes. The probabilities are about 30 times higher for Tl-201 than for Tc-99m. These results, in combination with the fact that the higher activity of Tc-99m yields better images within shorter time, must make the clinician carefully assess the choice of the radiopharmaceutical to be used for the studies of the heart, especially for patients of reproductive age.


Asunto(s)
Corazón/diagnóstico por imagen , Neoplasias Inducidas por Radiación/epidemiología , Tecnecio Tc 99m Sestamibi/farmacocinética , Neoplasias Testiculares/epidemiología , Testículo/efectos de la radiación , Radioisótopos de Talio/farmacocinética , Tomografía Computarizada de Emisión de Fotón Único , Semivida , Humanos , Masculino , Neoplasias Inducidas por Radiación/etiología , Neoplasias Inducidas por Radiación/mortalidad , Neoplasias Testiculares/etiología , Neoplasias Testiculares/mortalidad , Distribución Tisular
17.
Hybridoma ; 16(1): 133-7, 1997 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9085140

RESUMEN

Somatostatin receptors (SR) are surface markers characterizing not only APUDomas associated with neuroendocrine identities but also malignancies without neuroendocrine expression. Recently, the somatostatin analog pentetreotide was labeled with In-111 (OctreoScan 111, Mallinckrodt Medical BV, Petten, Holland) and introduced for the in vivo visualization in man of SR-positive tissues. In the present report, SR-specific scintigraphy is evaluated as a clinical tool for tissue characterization in correlation with histological and radiological examinations. Scintigraphy was focused and performed in cancer types without neuroendocrine tissue expression such as brain (n = 6) and breast tumors (n = 9) and lymphomas (n = 5). Scintigraphy was performed for comparison at 6 and 22 h after i.v. application of 111 MBq (3 mCi) of In-111-Pentetreotide. In the breast cancer group, the primary tumor was visualized in all 9 women as well as in all 4 cases with palpable axillary lymph nodes. Three women with a negative axillary node scan and impalpable nodes had positive biopsy. In two cases, mediastinal lymph node involvement was observed. So far the role of SR-positive breast cancer (BC) scans remains unknown. It is tempting to speculate that in resected women who are histologically and scintigraphically SR positive, it might be of value in the early detection of symptom-free recurrences. High densities of SR were present within both meningiomas, the high-grade astrocytoma and the craniopharyngioma. Differentiation of low- and high-grade astrocytomas could not be successfully achieved because both grades showed intense radioactivity uptake, even though high-grade tumors lack SR. The latter might be due to the damaged blood-brain barrier and the poor radioactivity washout observed in high-grade astrocytomas. All five lymphomas could be detected due to the presence of activated lymphocytes and macrophages that express SR at a sufficient density. In conclusion, SR scintigraphy in non-neuroendocrine malignancies does not seem to be reliable for an initial tumor staging but rather more suitable for a tissue characterization and extremely useful for monitoring changes of SR expression after treatment.


Asunto(s)
Radioisótopos de Indio , Neoplasias/diagnóstico por imagen , Receptores de Somatostatina/metabolismo , Somatostatina/análogos & derivados , Adolescente , Adulto , Anciano , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Carcinoma Neuroendocrino/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Humanos , Radioisótopos de Indio/metabolismo , Neoplasias Pulmonares/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Cintigrafía , Somatostatina/metabolismo
18.
Nuklearmedizin ; 34(5): 207-14, 1995 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-7479096

RESUMEN

After demonstrating that the application form 87Y-NTA-EDTMP-Ca is superior to the so far used citrate form of yttrium especially regarding the tumour/liver and tumour/bone ratios, the relationships between the concentrations of the components in the 87Y-NTA-EDTMP-Ca mixture and the 87Y biokinetics were investigated in tumour-bearing mice. The increase of the EDTMP and Ca2+ concentrations by several orders of magnitude caused no significant changes of tumour radioactivity but a clear radioactivity decrease in the liver, spleen and bone, respectively. The increase of the NTA concentration led also to a radioactivity decrease in all organs and tissues investigated. A significant radioactivity reduction in the tumour could be observed only after administration of rather high NTA amounts. Considerations of the tumour/background ratios depending on different compositions of the injection mixture showed the possibility of optimizing radionuclide biodistribution.


Asunto(s)
Neoplasias Mamarias Experimentales/metabolismo , Melanoma Experimental/metabolismo , Radioisótopos de Itrio/farmacocinética , Animales , Calcio/farmacología , Femenino , Neoplasias Mamarias Experimentales/diagnóstico por imagen , Melanoma Experimental/diagnóstico por imagen , Ratones , Ratones Endogámicos , Cintigrafía , Valores de Referencia , Distribución Tisular
19.
Nuklearmedizin ; 34(1): 32-9, 1995 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-7724362

RESUMEN

Differences of yttrium biokinetics after application to male tumor-bearing mice of 87Y-citrate were studied in comparison to a 87Y-NTA-EDTMP-Ca mixture after variation of both the manner of application (intraperitoneal vs. intratumoral) and the tumor type (mamma carcinoma vs. melanoma). The application of 87Y as NTA-EDTMP-Ca preparation led--in comparison to the citrate form applied so far--to a similar radionuclide tumor accumulation and distinctly lower extratumoral radioactivities in liver, spleen and skeleton with clearly more favorable tumor/background ratios. Melanomas showed a significantly higher radioactivity accumulation (factor 2-3) after injection of 87Y-NTA-EDTMP-Ca than mamma carcinomas. Intratumoral application led to high initial radioactivities in the tumors. Radioactivity concentrations which are comparable with those after intraperitoneal application were achieved within 4 h after intratumoral application. The application of the EDTMP-containing mixture promises in comparison to the traditional citrate form higher radiation doses in the tumor related to the whole-body radiation exposure. The consequences for a possible tumor therapy will be further investigated.


Asunto(s)
Citratos , Neoplasias Mamarias Experimentales/diagnóstico por imagen , Melanoma Experimental/diagnóstico por imagen , Compuestos Organometálicos , Radioisótopos de Itrio/farmacocinética , Animales , Calcio/metabolismo , Citratos/farmacocinética , Cinética , Masculino , Neoplasias Mamarias Experimentales/metabolismo , Melanoma Experimental/metabolismo , Ratones , Ratones Endogámicos , Compuestos Organometálicos/farmacocinética , Cintigrafía , Distribución Tisular
20.
Nuklearmedizin ; 32(2): 99-105, 1993 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-8479937

RESUMEN

169Yb complexes with known biokinetics in tumour-bearing mice up to 48 h p.i. were injected into healthy mice to study the radionuclide biodistribution in various organs and tissues for 672 h after injection, in order to obtain reliable biokinetic data in an animal model, not affected by tumour-growth, as a basis for the calculation of biological half-life and dose distribution. The results demonstrated the existence of at least two components with different biological half-lives in the organs and tissues investigated. The effective half-lives of these components decreased with increasing stability of the complexes administered. The effective half-life of the fast component was a few hours and that of the slow one between about 200 and 800 h.


Asunto(s)
Citratos/farmacocinética , Ácido Edético/análogos & derivados , Ácido Nitrilotriacético/farmacocinética , Radioisótopos/farmacocinética , Iterbio/farmacocinética , Animales , Citratos/administración & dosificación , Ácido Cítrico , Ácido Edético/administración & dosificación , Ácido Edético/farmacocinética , Inyecciones Intravenosas , Masculino , Ratones , Ratones Endogámicos , Ácido Nitrilotriacético/administración & dosificación , Radioisótopos/administración & dosificación , Factores de Tiempo , Distribución Tisular , Iterbio/administración & dosificación
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