phosphorus-radioisotopes and Astrocytoma

Multi-modal MR-PET-EEG data acquisition in simultaneous mode confers a number of advantages at 3 T and 9.4 T. The three modalities complement each other well; structural-functional imaging being the domain of MRI, molecular imaging with specific tracers is the strength of PET, and EEG provides a temporal dimension where the other two modalities are weak. The utility of hybrid MR-PET at 3 T in a clinical setting is presented and critically discussed. The potential problems and the putative gains to be accrued from hybrid imaging at 9.4 T, with examples from the human brain, are outlined. Steps on the road to 9.4 T multi-modal MR-PET-EEG are also illustrated. From an MR perspective, the potential for ultra-high resolution structural imaging is discussed and example images of the cerebellum with an isotropic resolution of 320 μm are presented, setting the stage for hybrid imaging at ultra-high field. Further, metabolic imaging is discussed and high-resolution images of the sodium distribution are presented. Examples of tumour imaging on a 3 T MR-PET system are presented and discussed. Finally, the perspectives for multi-modal imaging are discussed based on two on-going studies, the first comparing MR and PET methods for the measurement of perfusion and the second which looks at tumour delineation based on MRI contrasts but the knowledge of tumour extent is based on simultaneously acquired PET data.

Topics: Algorithms; Animals; Astrocytoma; Brain Chemistry; Brain Neoplasms; Cerebellum; Cerebrovascular Circulation; Electroencephalography; Electromagnetic Fields; Humans; Magnetic Resonance Imaging; Neuroimaging; Oxygen Radioisotopes; Phosphorus Radioisotopes; Positron-Emission Tomography; Sodium; Sodium Radioisotopes; Tomography Scanners, X-Ray Computed

In the past, we have clinically evaluated radiolabelled antibodies in Hodgkin's disease and hepatocellular cancer. Increased tumour pressure, reduced vascularity and poor diffusion has limited significant radiolabelled antibody tumour dose deposition. Using intratumoural infusion of macroaggregated albumin to blockade exiting vasculature followed by colloidal chromic 32Phosphorous, we have been able to achieve 75% to 100% tumour dose deposition by interstitial tumour infusion under computerised tomographic guidance. Phase I studies in a variety of solid tumours indicate extremely high doses may be achieved without toxicity (i.e. non-resectable pancreas 900,000 cGy to 1.7 million cGy) with tumour control and remission. This is a review of those studies and how the technique was applied.

Topics: Astrocytoma; Brachytherapy; Brain Neoplasms; Carcinoma, Hepatocellular; Carcinoma, Small Cell; Chemoembolization, Therapeutic; Chromium; Colloids; Dexamethasone; Head and Neck Neoplasms; Hodgkin Disease; Humans; Injections, Intralesional; Liver Neoplasms; Lung Neoplasms; Pancreatic Neoplasms; Phosphorus Radioisotopes; Radiography, Interventional; Radioimmunotherapy; Radiotherapy Dosage; Remission Induction; Serum Albumin; Tomography, X-Ray Computed

The authors investigated the outcome of stereotactic biopsy and radiotherapy in 35 consecutive adult patients with nonanaplastic, nonpilocytic astrocytomas who were diagnosed between 1982 and 1992. The median patient age at presentation was 32 years. All received fractionated external-beam radiation therapy (median dose 56 Gy) as the initial management strategy. Additional treatment in two patients included intracavitary irradiation with colloidal phosphorus-32. Six patients (17%) had documented tumor progression during the follow-up interval and died. Three others died of causes unrelated to their tumor. Median survival after stereotactic biopsy and irradiation was 118 months (9.8 years). Median survival from the time of onset of neurological symptoms was 148 months (12.3 years). Only three patients required delayed cytoreductive surgery. The outcome of brain astrocytomas, although improved because of earlier diagnosis and therapy, does not substantiate this tumor as having benign behavior; early recognition with neuroimaging, immediate histological diagnosis via stereotactic biopsy, and initial fractionated radiation therapy may provide the potential for longer survival for patients with low-grade astrocytomas. The majority of such surviving patients have a satisfactory quality of life, which is manifested by prolonged normal functional and employment status. The survival data reported in this prospective Phase I-II clinical trial suggest that stereotactic biopsy and radiation therapy are appropriate initial management strategies for astrocytomas.

Topics: Adolescent; Adult; Astrocytoma; Biopsy; Brachytherapy; Brain Neoplasms; Child; Combined Modality Therapy; Craniotomy; Female; Follow-Up Studies; Humans; Karnofsky Performance Status; Magnetic Resonance Imaging; Male; Middle Aged; Phosphorus Radioisotopes; Quality of Life; Radiotherapy, Adjuvant; Stereotaxic Techniques; Survival Analysis

(32)P is a pure beta-emitter that has a depth of penetration of 2-3 mm and can be useful in the treatment of cystic lesions. Its effectiveness in the treatment of a selected brain tumor is illustrated here.

Topics: Astrocytoma; Basal Ganglia; Biopsy; Brachytherapy; Brain Neoplasms; Child; Colloids; Female; Follow-Up Studies; Humans; Instillation, Drug; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Phosphorus Radioisotopes; Radiotherapy Planning, Computer-Assisted

The authors report on 40 brain tumor patients treated with CT-guided stereotactic injection of 198Au and 32P. Among the 40 cases were astrocytoma in 23 cases, craniopharyngioma in 9, meningioma in 4, pituitary adenoma in 2, and pinealoma and metastatic carcinoma each in 1 case. The tumors were all located in deep or important areas of the brain which were difficult to deal with by conventional operation. 62 injections of colloidal isotopes were performed, and all were successful. No major adverse effects or complications occurred on follow-up of 6-12 months, 28 patients were improved in their clinical symptoms, and CT scanning showed that the tumor sizes were diminished. The effective rate is 70%.

Topics: Adenoma; Adult; Astrocytoma; Brain Neoplasms; Craniopharyngioma; Female; Gold Radioisotopes; Humans; Male; Meningeal Neoplasms; Meningioma; Phosphorus Radioisotopes; Pinealoma; Pituitary Neoplasms; Radiosurgery; Stereotaxic Techniques; Tomography, X-Ray Computed

140 patients with brain tumor were treated by CT-guided stereotactic injections of radionuclides, such as Aurum-198 (198 Au), Phosphorus-32 (32 P) and Yttrium-90 (90Y). Of these patients aged from 3 to 67 years (average 37), 64 were male and 76 female. Astrocytoma was found in 75 patients, craniopharyngioma in 46, metastatic carcinoma in 7, meningioma in 5, germinoma in 4 and pituitary adenoma in 3. The tumors were located in the deep part or functionally critical area of the brain. After 267 times of injection of colloidal isotopes, no major adverse effects or complications occurred. Follow-up for 6 to 48 months showed improvement in symptoms in 104 (74.3%) patients and CT scanning showed the diminished tumors.

Topics: Adolescent; Adult; Aged; Astrocytoma; Brachytherapy; Brain Neoplasms; Child; Child, Preschool; Craniopharyngioma; Female; Glioblastoma; Gold Radioisotopes; Humans; Male; Middle Aged; Phosphorus Radioisotopes; Stereotaxic Techniques; Tomography, X-Ray Computed; Yttrium Radioisotopes

We describe a procedure of preparing [32P]phosphotyrosyl histones with minimal contamination by 32P-labeled lipids; the latter was usually found to be mixed with the phosphoproteins when the cell membrane-enriched fraction of A-431 cells was used as a source of tyrosine kinase. The phosphatase activities previously found to be associated with the plasma membranes of a human astrocytoma were resolved using purified [32P]phosphotyrosyl histones and [32P]phosphatidylinositol phosphate. In comparison with the phosphotyrosyl protein phosphatase, the phosphatidylinositol phosphate phosphatase activity is more active over a broad range of pH values, and its activity is inhibited by fluoride, zinc chloride, and lower concentrations of vanadate.

Topics: Animals; Astrocytoma; Cell Membrane; Histones; Humans; Hydrogen-Ion Concentration; Hydrolysis; Kinetics; Mice; Phosphoprotein Phosphatases; Phosphoric Monoester Hydrolases; Phosphorus Radioisotopes; Protein Tyrosine Phosphatases

Cyst formation by astrocytomas can cause progressive neurological deficit and can necessitate multiple surgical procedures. Before the advent of computed tomography (CT) preoperative diagnosis of cystic astrocytomas was difficult and stereotactic management of these lesions was limited. CT-guided stereotaxy provides a safe approach to all cystic astrocytomas including brain stem lesions. Based upon the experience of intracavitary radiation of craniopharyngioma cysts, the authors treated nine patients presenting with cystic astrocytomas utilizing colloidal chromium phosphorus 32 (32P). Control of cyst formation was achieved in eight patients. Our preliminary data suggest that intracavitary 32P may provide a significant adjunctive therapy in the management of cystic astrocytomas.

Topics: Adolescent; Adult; Aged; Astrocytoma; Brain Neoplasms; Child; Female; Humans; Male; Middle Aged; Phosphorus Radioisotopes; Stereotaxic Techniques

Ten patients with intracranial cystic tumors underwent stereotactic intracavitary irradiation using 32P colloidal chromic phosphate. Accurate dosimetry (25,000-30,000 rad to the cast wall) was achieved by volume estimation using computed tomography. Between 1 and 15 months after surgery both craniopharyngioma and astrocytoma cysts regressed. Neurological, visual, and endocrinological deficits either stabilized or improved. Intracavitary irradiation should be the primary method of treating solitary cystic tumors of the brain.

Topics: Adolescent; Adult; Aged; Astrocytoma; Brain Neoplasms; Cerebral Ventricle Neoplasms; Child; Child, Preschool; Chromium; Chromium Compounds; Colloids; Craniopharyngioma; Cysts; Female; Humans; Male; Middle Aged; Phosphates; Phosphorus Radioisotopes; Pituitary Neoplasms; Stereotaxic Techniques

A 41-year-old man had a 6 x 6 x 5-disk diameter amelanotic tumor in the posterior fundus. The clinical and fluorescein angiographic appearance suggested a benign retinal vascular tumor, although amelanotic choroidal melanoma and retinoblastoma were diagnostic possibilities. An incisional 48-hour radioactive phosphorus (32P) uptake test was performed and the result showed an increased uptake over the tumor mass of 100% as compared to the control quadrants. The globe was enucleated and the pathologic diagnosis was isolated astrocytic glioma of the retina with minimal, if any, malignant potential. The highly developed vascular system of the tumor probably contributed to the false-positive test result.

Topics: Adult; Astrocytoma; Diagnostic Errors; Eye Neoplasms; False Positive Reactions; Fluorescein Angiography; Humans; Male; Ophthalmoscopy; Phosphorus Radioisotopes; Photomicrography; Retina

Topics: Ammonium Sulfate; Animals; Astrocytoma; Cations, Divalent; Cattle; Chromatography, DEAE-Cellulose; Chromatography, Gel; Clone Cells; Cyclic AMP; Evaluation Studies as Topic; Hydrogen-Ion Concentration; Hydroxyapatites; Iron; Lanthanum; Methods; Muscles; Phosphorus Radioisotopes; Protein Binding; Protein Kinase Inhibitors; Rats; Ribonucleotides; Sodium Chloride; Time Factors; Tritium

Cerebrospinal fluid (CSF) contains two groups of proteins that bind tightly to DNA and to polyriboguanylic acid, respectively. In certain diseases the amounts of a given nucleic acid bound by a constant volume of CSF may increase, while in others the amount of such proteins may be reduced. Binding of polyriboguanylic acid increased in CSF samples from patients with brain tumors, stroke, multiple sclerosis, and communicating hydrocephalus, but it significantly decreased in CSF samples from patients with obstructive hydrocephalus. These increases may or may not be proportional to the rise in total CSF proteins characteristic for these diseases. Elevated binding of DNA was observed in samples from patients with hydrocephalus, epilepsy, and cortical atrophy. The technique described may be applicable to the diagnosis of a variety of diseases of the central nervous system.

Topics: Alcoholism; Astrocytoma; Brain Diseases; Brain Injuries; Brain Neoplasms; Carcinoma; Cerebrospinal Fluid Proteins; Cerebrovascular Disorders; Child, Preschool; DNA; Epilepsy; Female; Guanine Nucleotides; Headache; Humans; Hydrocephalus; Meningioma; Middle Aged; Multiple Sclerosis; Neurilemmoma; Phosphorus Radioisotopes; Polynucleotides; Protein Binding; Schizophrenia; Tritium