technetium-tc-99m-gluceptate and Adenocarcinoma

A newly developed single photon emission computed tomography (SPECT) method was used to measure noninvasively the concentration of labeled drugs in human lung tumors. The validity of the method was established by the high correlation (r = .92) between in vivo SPECT measurement of the concentration of glucoheptonate labeled with technetium-99m and in vitro measurement of the concentration of the drug in specimens of nine of the same tumors obtained at surgery. The in vivo concentration of intravenously injected bleomycin labeled with cobalt-57 was measured over time in 14 human lung tumors. Significant differences were found in the uptake of bleomycin by the tumors, even those with the same histologic characteristics, when the concentration over time, the tumor/blood ratio at 30 minutes, and the tumor cumulative concentration were measured in vivo. Since the drug concentration in the blood was not related to the concentration in the tumor (r = .54), uptake of chemotherapeutic drugs should be measured in each patient individually.

Topics: Adenocarcinoma; Bleomycin; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cobalt Radioisotopes; Humans; Lung; Lung Neoplasms; Organotechnetium Compounds; Sugar Acids; Technetium; Time Factors; Tomography, Emission-Computed

Fifty-two patients with proven primary lung cancer who were referred for mediastinoscopy were prospectively studied with Tc-99m glucoheptonate and Ga-67 citrate thoracic scintigraphy. Primary lung tumors concentrated Ga-67 in 92% of cases, compared to 88% for Tc-99m glucoheptonate. Mediastinoscopy confirmed the presence of mediastinal metastases in 23 patients. The sensitivity of Tc-99m glucoheptonate and Ga-67 scans for mediastinal involvement detection is respectively 52% and 83%, for a specificity of 100% (Tc-99m glucoheptonate) and 88% (Ga-67). Twenty-nine patients underwent thoracotomy after a negative mediastinoscopy. Hilar metastatic involvement was present in eight patients. The sensitivity and the specificity for detection of hilar involvement were respectively 63% and 95% for Tc-99m glucoheptonate and 88% and 78% for Ga-67. Although more specific than Ga-67 scan, Tc-99m glucoheptonate thoracic imaging cannot be recommended in the staging of lung cancer because of its low sensitivity in the detection of intrathoracic metastatic spread of primary lung carcinoma.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma; Gallium Radioisotopes; Humans; Lung Neoplasms; Lymphatic Metastasis; Mediastinal Neoplasms; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Thorax

We prospectively studied technetium-99m glucoheptonate (Tc-GHA) uptake in 58 patients with newly diagnosed lung cancer and in 20 patients with pulmonary inflammatory disease or metastatic carcinoma. Fifty-three (91%) primary tumors accumulated Tc-GHA: squamous cell 20/22, adenocarcinoma 7/7, large cell 10/11, and small cell 16/18. Intensity of tumor uptake was greatest in small-cell cancer. Supraclavicular metastases were detected in two patients. Fourteen patients with mediastinal evaluation by Tc-GHA imaging and trispiral tomography underwent mediastinoscopy or thoracotomy. Five of ten patients with negative mediastinum by tomography and Tc-GHA imaging showed metastases by biopsy (false-negative Tc-GHA). Less intense accumulation of Tc-GHA was observed in 18/20 cases of pulmonary inflammatory disease or pulmonary metastases. Although Tc-GHA accumulates by an unknown mechanism in primary lung cancer, we cannot recommend its use in detecting mediastinal spread of lung cancer due to its unacceptably high false-negative rate.

Topics: Adenocarcinoma; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Histoplasmosis; Humans; Lung Diseases; Lung Neoplasms; Mediastinal Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium

Single photon emission computerized tomography (SPECT) was done on two patients with suspected renal masses. Nuclear scintigraphy was equivocal on two tumors readily identified by SPECT. Single photon tomography is cost effective and increases the reliability of nuclear scintigraphy.

Topics: Adenocarcinoma; Adenoma; Adult; Aged; Humans; Kidney; Kidney Neoplasms; Male; Organotechnetium Compounds; Sugar Acids; Technetium; Tomography, Emission-Computed; Ultrasonography

Sixty-three patients aged 21-80 yr were examined. Tc-99m glucoheptonate (Tc-GH) scintigraphy was performed in 32 patients: 26 with primary lung carcinoma; six with metastases in lung, mediastinum, and pleura from carcinomas elsewhere; eight with benign pulmonary diseases; and 23 without known pulmonary disease. Tc-GH accumulated in 23 of 26 primary pulmonary carcinomas as active foci. The specificity of Tc-GH scans for neoplasm detection was higher than that of chest radiographs. The visualization of malignant tumors was much better in the late Tc-GH images (5-6 hr) than in the early (1 hr). Metastases from other carcinomas were positive in four of six patients, but they were considerably better detected in the radiographs, except in one patient with metastatic hepatocellular carcinoma. Neoplasms or their metastases in the hilar and mediastinal regions were better detected in the Tc-GH scans than in the chest radiographs. Only one of eight benign lung processes was visualized (as a weak diffuse accumulation of Tc-GH in hilar scar formation), and 23 patients without pulmonary disease had no pathological foci.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Humans; Lung Diseases; Lung Neoplasms; Mediastinal Neoplasms; Middle Aged; Organotechnetium Compounds; Pleural Neoplasms; Radionuclide Imaging; Sugar Acids; Technetium