RESUMO
The usefulness of 123I-epidepride as a single photon emission computed tomography (SPECT) scan D2 receptor ligand was examined in vivo in 13 medicated patients with schizophrenia and age- and sex-matched normal controls. To establish the effect of endogenous dopamine on 123I-epidepride binding, 4 of the 13 controls also received 20 mg D-amphetamine. The results showed that 123I-epidepride had high specific binding to the striatum in both patients with schizophrenia and normal controls. There was a trend for the total striatal binding of medicated patients with schizophrenia, as measured by total basal ganglia: frontal cortex (TBG:FC) ratios, to be less than the binding of controls (P = 0.053). This trend confirms previous work showing that antipsychotic medication decreases the number of D2 receptors available for binding to the radioligand. Interestingly, there was also a significant relationship between 123I-epidepride binding ratios and global functioning scales (Global Assessment of Functioning scale [GAF]) for schizophrenia (r = 0.56, P = 0.045), although there was no such relationship with the Brief Psychiatric Rating Scale (BPRS). In addition, our results showed that amphetamine-induced dopamine release did not alter 123I-epidepride binding, confirming the high specific binding of 123I-epidepride to the D2 receptor. We conclude that 123I-epidepride appears to be a very useful SPECT ligand for imaging the D2 receptor.
Assuntos
Benzamidas/farmacocinética , Sítios de Ligação , Corpo Estriado/diagnóstico por imagem , Pirrolidinas/farmacocinética , Receptores de Dopamina D2/fisiologia , Esquizofrenia/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Anfetamina/administração & dosagem , Anfetamina/farmacologia , Gânglios da Base/diagnóstico por imagem , Gânglios da Base/efeitos dos fármacos , Gânglios da Base/metabolismo , Benzamidas/metabolismo , Sítios de Ligação/efeitos dos fármacos , Estimulantes do Sistema Nervoso Central/farmacologia , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/efeitos dos fármacos , Lobo Frontal/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pirrolidinas/metabolismo , Receptores de Dopamina D2/efeitos dos fármacos , Receptores de Dopamina D2/metabolismo , Esquizofrenia/metabolismoRESUMO
Fifty-three women with clinical evidence of adenocarcinoma of the breast were studied with technetium-99m labelled monoclonal antibody (MAb) 170H.82 at protein doses of 1, 2 and 4 mg. An overall per lesion efficacy of 83.5% sensitivity and 97.7% positive predictive value was obtained. Efficacy appears higher in lesions restricted to the breast and local regional disease than systemic metastases. For the 2 mg dose the breast/local regional disease efficacy was 90% sensitivity and 90.2% positive predictive value. The biodistribution of this MAb was best represented by a two-compartment model with a distribution-phase half-life of 4.0+/-1.4 h, followed by an elimination-phase half-life of 39.6+/-6.6 h. In all six patients studied, the critical organ was the kidney, with a mean radiation absorbed dose of 37+/-6.9 mGy/GBq. The accuracy of this imaging technique allows the development of diagnostic strategies for the routine use of the compound in patients with breast cancer.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Radioimunodetecção , Tecnécio , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Doses de Radiação , Sensibilidade e Especificidade , Distribuição TecidualRESUMO
The monoclonal antibody (MoAb) 174H.64 (Truscint SQ, Biomira Inc.) is a murine-derived MoAb reacting with an extracellular surface component of the cytoskeletal matrix ectopically expressed on squamous-cell carcinoma cell-surface membranes. A chimeric form of this MoAb has also been produced by genetically modifying the Fc portion of the MoAb by the insertion of a human Fc fragment. During this process the isotype was altered from an IgG1 (murine) to an IgG3 (chimeric). Pilot and phase I/II clinical trials of the murine and chimeric 99mTc-labelled 174H.64 MoAbs have been undertaken at selected European and North American sites. As part of this evaluation serum, urine and image data were collected at specific time intervals and used to obtain a kinetic model to describe the in vivo distribution of the MoAbs. A two-compartment model of the form: C(t) = C1 e-lambda 1t + Cz e-lambda zt was found to best describe the serum distribution of radioactivity of both the murine and chimeric MoAbs. The initial distribution half-lives were 2.9 +/- 0.7 hours and 2.7 +/- 0.2 hours, and the terminal elimination half-lives were 17.6 +/- 3.8 hours and 22.5 +/- 1.3 hours for the murine and chimeric MoAbs, respectively. No significant difference was found between the kinetic model parameters of two MoAbs at the 95% level. Assuming a similar clinical efficacy, these MoAbs could then be used interchangeably, with the chimeric MoAb offering potential advantages in reducing HAMA response.