phosphorus-radioisotopes and Kidney-Neoplasms

Infusional brachytherapy for treatment of neoplasms, with colloidal 32P has been used to treat various tumors in the pancreas, liver, brain, lung, and head and neck. In performing such treatments, anatomical verification of the location of the administered 32P from the image obtained by Bremsstrahlung SPECT alone is not possible due to the lack of internal landmarks, since the radionuclide is distributed only in the tumor and does not usually accumulate in the normal organs. The purpose of this study was to provide a practical three-dimensional approach for image fusion between Bremsstrahlung SPECT and CT.. The tumors in four cancer patients were injected directly with 32P under CT guidance. A Bremsstrahlung SPECT study using 99mTc backscatter sources to obtain the body contour was then performed. SPECT images were used to generate the skin contours using a threshold detection method. A three-dimensional surface was generated from these contours using a tiling program and fused with a corresponding CT surface generated from a CT scan in the same patient through an iterative surface-fitting algorithm. The three-dimensional surface of the region of high-activity, corresponding to the infused tumor, was then generated using the Bremsstrahlung SPECT data by mapping the iso-count surfaces through a computer program. The three-dimensional image of the organ then was fused with the registered CT-SPECT datasets.. The accuracy of fit measured as the mean distance between the SPECT and CT surfaces was in the range of 3-4 mm.. The anatomical co-registration of Bremsstrahlung SPECT with CT images using the outer surface-fitting algorithm is a reliable tool. This correlation permits direct anatomic confirmation of the region of the 32P activity distribution with the anatomic site selected for injection.

Topics: Algorithms; Brachytherapy; Humans; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Pancreatic Neoplasms; Phosphorus Radioisotopes; Radiotherapy Planning, Computer-Assisted; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Ochratoxin A (OTA), a natural contaminant of mouldy food and feed, is suspected of being one of the etiological agents responsible for Balkan endemic nephropathy (BEN) and the associated urinary tract tumours. We have previously shown that ochratoxin A is genotoxic as expressed by DNA single-strand breaks. DNA-OTA adducts have been detected in various mouse organs after ochratoxin A treatment. Tumorous tissues from three kidneys and five bladders of Bulgarian patients undergoing surgery for cancer and from three non-malignant kidneys collected from French subjects were analysed for DNA adducts. Several adducts with the same RF values as those obtained from mouse kidney after treatment with OTA (one major and some minor adducts) were detected, mainly in kidney but also in bladder tissues from Bulgaria. No adducts were detected in French kidney tissues. These results provide new evidence of the possible role of OTA in the development of tumours of the urinary tract in Bulgaria.

Topics: Animals; Balkan Nephropathy; Bulgaria; DNA; DNA Damage; DNA, Neoplasm; Humans; Kidney; Kidney Neoplasms; Mice; Ochratoxins; Phosphorus Radioisotopes; Urinary Bladder Neoplasms

The synthetic estrogen diethylstilbestrol (DES), a known human carcinogen, induces renal carcinoma in male Syrian hamsters within 6 months after s.c. implantation. Tumor formation could be evoked by its hormonal properties or by a reactive genotoxic metabolite binding to DNA, but previous attempts to detect adducts have failed. In the present study, kidney DNA of male Syrian hamsters, treated with s.c. DES implants to induce renal carcinoma, was analyzed for the presence of DES-induced adducts using 32P-postlabeling assay. Covalently-modified DNA nucleotides were detected in the kidneys after chronic DES treatment, but not in kidneys of untreated hamsters, or in liver or tumor tissue of DES-treated animals. This report demonstrates for the first time the ability of an estrogen to give rise to covalent DNA modification in vivo specifically in the target organ of carcinogenesis. DES-induced covalent DNA adducts are taken as evidence for tumor initiation by DES via damage to cellular macromolecules, in addition to tumor-promotional effects described previously.

Topics: Adenosine Triphosphate; Animals; Carcinogens; Cricetinae; Diethylstilbestrol; DNA; DNA Repair; Kidney; Kidney Neoplasms; Liver; Male; Mesocricetus; Phosphorus Radioisotopes

10 kidneys bearing adenocarcinoma (hypernephroma), 1 ureteric tumour, 2 Wilms' tumour from patients undergoing nephrectomy, and normal human and animal kidneys were preserved and later tested to see whether normothermic blood perfusion restored glomerular filtration, oxygen consumption, and energy metabolism, as monitored by 31P nuclear magnetic resonance (NMR). NMR spectra of normal human kidney and of renal tumours were characteristic of kidney in other species (rat, rabbit, and dog), with six principal resonances assigned to adenosine monophosphate, inorganic phosphate (Pi), glycerophosphoryl choline, gamma, alpha, and beta adenosine triphosphate and an intrarenal pH 7.0-7.2. 7 out of 9 hypernephromas and 1 of the 2 Wilms' tumours produced an additional resonance at +4.2 ppm. This peak was absent from all normal kidney spectra and may represent Pi in a specific and highly acidic environment (pH 6.1-6.5) found in actively metabolising human tumours. Furthermore, in 1 tumour (out of 5 tested) the +4.2 ppm peak rose rapidly after the addition of chemotherapeutic agents to the perfusing blood. This observation may indicate drug sensitivity of this one tumour. The results suggest that 31P NMR imaging may be used to monitor therapeutic response during regional perfusion of malignant tumours in man.

Topics: Animals; Antineoplastic Agents; Chemotherapy, Cancer, Regional Perfusion; Dogs; Drug Therapy, Combination; Energy Metabolism; Humans; Kidney; Kidney Neoplasms; Magnetic Resonance Spectroscopy; Phosphates; Phosphorus Radioisotopes; Renal Circulation

In the urological department of the Wilhelminenspital altogether 22 patients with incurable bone pains in metastasizing carcinoma were treated with radioisotopes between 1976 and 1980. 32P and 89Sr were used in a dosage of 3 times 3 mCi and once 1 mCi. A reaction to the therapy could be proved in 46%, in 23% the success could be estimated as very good. Clinic and therapy were discussed with the help of own cases and literature.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Carcinoma; Female; Humans; Kidney Neoplasms; Male; Neoplasm Staging; Palliative Care; Phosphorus Radioisotopes; Prostatic Neoplasms; Strontium Radioisotopes

Arterial vascular occlusion of hypernephromas may be performed by obstructiing the tumor vascular tree with the injection of ferromagnetic silicone microspheres. The powerful superconducting electromagnet confines the embolized iron-silicone compound to the neoplastic target organ. Radioactive material may or may not be added to the iron-silicone compound to give local direct radioactive radiation therapy to the tumor area. In experimental dogs up to 70,000 rad of beta radiation from the P32 source had been delivered homogeneously within the kidney when mixed with the ferrosilicone. This technique may well be used in cases in which a major operation is contraindicated or when preoperative necrosis of the tumor is advisable. Since the entire procedure can be done with the patient under local anesthesia in a radiology department it may be a valuable new technique in the future management of urological tumors, unilateral renal hypertension, solitary kidney pathology and so forth. Ferrosilicone material has not been found to be toxic. The application of a powerful superconducting electromagnet to the technique provides a means of confining the embolized iron-silicone compound to the target organ.

Topics: Adenocarcinoma; Animals; Catheterization; Dogs; Embolism; Evaluation Studies as Topic; Femoral Artery; Humans; Injections, Intra-Arterial; Iron; Kidney; Kidney Neoplasms; Magnetics; Microspheres; Necrosis; Phosphorus Radioisotopes; Renal Artery; Silicones

Three hundred and three cases of polycythaemia vera were treated between 1949 and 1961 using radioactive phosphorus, the minimum follow-up for the patients in the group being 12 years and the maximum 24 years. Two hundred and thirty three patients died, the median duration of survival after the first treatment with phosphorus being 10 years (i.e. 12 years after the diagnosis was made). 59 patients died of the vascular complications of polycythaemia, 76 of leukaemia or myelofibrosis. The total number of deaths due to vascular complications up to the tenth year exceeded the total number of deaths due to haematological complications (leukaemia or myeloid metaplasia). At the end of the 11th year the opposite was true. From the ninth year onwards, acute leukaemia and myelofibrosis represent more than 40 p.cent of deaths of known cause and the annual probability of death from a haematological cause for the surviving patients increases regularly until the fifteenth year when it reaches approximately 5 p.cent of the patients at risk. However the median survival of patients dying from acute leukaemia or myeloid splenomegaly is slightly longer than that of patients dying from other causes, this confirming that these disorders would appear to represent the terminal phase in the course of polycythaemia vera.

Topics: Acute Disease; Aged; Female; Follow-Up Studies; Hemorrhage; Humans; Kidney Neoplasms; Leukemia; Male; Middle Aged; Phosphorus Radioisotopes; Polycythemia Vera; Primary Myelofibrosis; Splenomegaly; Thrombosis