technetium-tc-99m-exametazime and Sarcoma

Blood flow measurements were made in 28 patients with soft tissue sarcoma of the extremities to investigate the prognostic significance of tumour vascularity. Four patients with benign tumours also underwent blood flow measurement. Mean and maximum tumour blood flow was calculated from technetium-99m hexamethyl-propyleneamineoxime uptake measured using single photon emission computed tomography (SPECT), tumour volume measured from SPECT transaxial image reconstructions and cardiac output assessed with Doppler ultrasonography. Twenty-seven malignant lesions and one benign tumour showed increased uptake of isotope relative to surrounding tissues. Mean sarcoma blood flow varied between 1 and 33 ml per 100 ml tumour per min, and maximum flow between 5 and 57 ml per 100 ml per min. Fourteen patients developed progressive disease during the first year of follow-up. Eight of 11 patients with a high isotope uptake ratio, eight of 12 with a high mean blood flow and eight of 14 with a high maximum blood flow relative to the respective medians for the series showed disease progression.

Topics: Adult; Aged; Aged, 80 and over; Blood Flow Velocity; Disease Progression; Female; Follow-Up Studies; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Sarcoma; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Tumor perfusion and oxygenation status have been suggested as factors which may influence treatment outcome in cancer patients. Nuclear medicine assays of tumor perfusion [99mTc-hexamethylpropylenamine oxime (HMPAO)] and tumor hypoxia [123I-iodoazomycin arabinoside (IAZA)] have recently been developed and described. We report on measurements of perfusion and oxygenation status of 27 tumors in 22 patients using these probes. An inverse correlation between tumor uptake of HMPAO and IAZA was measured (p < 0.05), with severe perfusion deficit usually associated with an increased uptake of the hypoxic marker. This trend was observed for limited stage small-cell lung carcinoma, squamous-cell carcinoma of the head and neck, soft-tissue sarcoma, brain metastases from small-cell lung carcinoma and adenocarcinoma of the prostate as a group, but not for glioblastoma multiforme. Whereas each imaging agent can yield information about the physiological status of tumor and normal tissue, the information resulting from their combined use could be important in cancer therapy.

Topics: Brain Neoplasms; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cell Hypoxia; Female; Glioblastoma; Head and Neck Neoplasms; Humans; Iodine Radioisotopes; Lung Neoplasms; Male; Nitroimidazoles; Organotechnetium Compounds; Oximes; Sarcoma; Soft Tissue Neoplasms; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Blood flow patterns have been studied in 28 patients with soft tissue sarcoma (29 tumours) using 99mTc-labelled hexamethyl propyleneamineoxime with planar views of the tumour-bearing region. Tumour:background ratios ranged from 1.13 to 6.60 (mean 2.74) and maximum:minimum tumour ratios (between peripheries and centres of tumours) ranged from 1.34 to 32.0 (mean 4.70). In eight of 29 tumours (seven of which were involving the trunk) the tumour could not be identified. This study demonstrates that the blood supply to soft tissue sarcomas is generally greater than that to adjacent normal tissues and that tumour centres are relatively underperfused compared with the tumour periphery. In this heterogeneous series there was no clear-cut relationship between blood flow and histological grade or type.

Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Regional Blood Flow; Sarcoma; Soft Tissue Neoplasms; Technetium Tc 99m Exametazime