Correlation of 18F-sodium fluoride uptake and radiodensity in extraosseous metastases of medullary thyroid carcinoma.

Objective: Although 18F-sodium fluoride (18F-NaF) uptake is frequently observed in extraosseous metastases of medullary thyroid carcinoma (MTC) with calcification, itcan also occur in metastatic sites without visible calcium deposition, leading to the hypothesis that visually undetectable calcium accumulation may be responsible for this uptake. The aim of this study was to indirectly support this hypothesis by analyzing the correlation between the degree of 18F-NaF uptake and radiodensity in extraosseous MTC metastases, since calcium deposition can increase attenuation even when not visually detectable. Subjects and methods: Extraosseous metastatic lesions of 15 patients with MTC were evaluated using 18F-NaF positron-emission tomography (PET)/computed tomography (CT)and segmented by levels of standardized uptake value (SUV). The correlation between mean SUV and mean Hounsfield unit (HU) values was assessed for the entire group of segments and for two subgroups with different mean HU values. Results: Very high correlations were observed between mean SUV and mean HU values for both the entire group of segments and the subgroup with a mean HU value greater than 130 (p = 0.92 and p = 0.95, respectively; p < 0.01). High correlation (p = 0.71) was also observed in the subgroup with mean HU values ranging from 20 to 130 (p < 0.01). Conclusion: The findings of the present study suggest that there is an association between 18F-NaF uptake and calcium deposition in extraosseous metastasesof MTC, supporting the hypothesis that visually undetectable calcium accumulation may be responsible for 18F-NaF uptake in regions without visible calcium deposition.

Experimental evaluation of brain spect using d,1 -HMPAO99mTc in dogs. Anatomo-physiological implications / Avaliação experimental de "spect" cerebral mediante utilização do d,1 - HMPAO 99mTc em cães. Considerações anátomo-fisiológicas

Technetium-99m-d,1-hexamethylpropyleamine oxime (99mTc-HMPAO) is an important radiopharmaceutical used for both brain SPECT imaging and "in vitro" labelling of white blood cells. An increasing utilization of this radiopharmaceutical for studies of several neurologic and psychiatric diseases in humans, lead us to the preparation of the kits of HMPAO to be labeled with technetium-99m. This paper presents animal experimental studies with d,l-HMPAO99mTc prepared from liofilized kits developed in our laboratories and also comparison to those commercially available. The brain scans have been done initially in rabbits, however better results were obtained with dogs. Six mongrel dogs clinically qualited as normals, were used in order to get scintigraphic brain pictures and washout curves of region of interest (ROIs). The value of experimental studies in animals and the considerable reduction in price of the so obtained radiopharmaceutical, have shown the viability of such procedure in the clinical practice as well in the veterinary clinic of small animals. By the other side, the perfusion of d,l-HMPAO99mTc showed that such a product concentrates at the same time in the cerebral area and nasal fossa, showing evidence of similar structures as the hemato encephalic barrier, also in the nasal area.

O d,1 - Hexametilpropileno oxima marcado com o tecnécio-99m(99mTc-HMPAO) é um importante radiofármaco usado tanto para imagens tomográficas cerebrais quanto na marcação in vitro" de leucócitos. A crescente utilização deste radiofármaco no estudo de doenças neurológicas no homem levou-nos à obtenção de "kits" de HMPAO para ser marcado pelo tecnécio-99m. Neste trabalho apresentamos o estudo experimental efetuado com "kits" liofilizados de d,1 HMPAO99mTc desenvolvidos em nossos laboratórios, comparando inclusive com aqueles encontrados no comércio. As imagens cerebrais inicialmente foram feitas em coelhos, entretanto os melhores resultados foram obtidos em cães. Assim, selecionaram-se seis cães sem raça definida, considerados clinicamente normais para obtenção das imagens cintilográficas do cérebro e o washout das regiões de interesse (ROls). Os estudos experimentais em animais e a considerável redução do custo do radiofármaco mostrou-nos a possibilidade da utilização destes exames na clínica veterinária, especialmente de pequenos animais. Por outro lado, a perfusão do d,l HMPAO99mTc mostra que a concentração do radiofármaco se faz ao mesmo tempo na região do cérebro e nas fossas nasais, demonstrando a existência de estruturas iguais às da barreira hemo-encefálica nesta última região.