technetium-tc-99m-medronate and Colorectal-Neoplasms

Selective Internal Radiation Therapy (SIRT) is a new and effective locoregional anticancer therapy for colorectal cancer patients with liver metastases. Markers for prediction of therapy response and prognosis are needed for the individual management of those patients undergoing SIRT.. Blood samples were prospectively and consecutively taken from 49 colorectal cancer patients with extensive hepatic metastases before, three, six, 24 and 48 h after SIRT to analyze the concentrations of nucleosomes and further laboratory parameters, and to compare them with the response to therapy regularly determined 3 months after therapy and with overall survival.. Circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), carcinoembryonic antigen (CEA), C-reactive protein (CRP) and various liver markers increased already 24 h after SIRT. Pretherapeutical levels of CYFRA 21-1, CEA, cancer antigen 19-9 (CA 19-9), asparate-aminotransferase (AST) and lactate dehydrogenase (LDH) as well as 24 h values of nucleosomes were significantly higher in patients suffering from disease progression (N = 35) than in non-progressive patients (N = 14). Concerning overall survival, CEA, CA 19-9, CYFRA 21-1, CRP, LDH, AST, choline esterase (CHE), gamma-glutamyl-transferase, alkaline phosphatase, and amylase (all 0 h, 24 h) and nucleosomes (24 h) were found to be prognostic relevant markers in univariate analyses. In multivariate Cox-Regression analysis, the best prognostic model was obtained for the combination of CRP and AST. When 24 h values were additionally included, nucleosomes (24 h) further improved the existing model.. Panels of biochemical markers are helpful to stratify pretherapeutically colorectal cancer patients for SIR-therapy and to early estimate the response to SIR-therapy.

Topics: Adult; Aged; Biomarkers, Tumor; Cohort Studies; Colorectal Neoplasms; Female; Humans; Kaplan-Meier Estimate; Liver Neoplasms; Male; Middle Aged; Multivariate Analysis; Nucleosomes; Predictive Value of Tests; Prognosis; Prospective Studies; Radiopharmaceuticals; Survival Analysis; Technetium Tc 99m Medronate

The aim of the study was to determine the value of radioisotope bone scans in the preoperative staging of patients with hepatopancreatobiliary (HPB) cancer.. Bone scanning was performed as part of a routine staging protocol in 402 consecutive patients with HPB cancer over a period of 5 years. Patients with positive bone scans underwent coned radiography, computed tomography with review on bone windows, or a bone biopsy. Bone scans were reviewed along with staging investigations, surgical and histological findings. Patients were followed for a minimum of 6 months.. There were 171 patients with colorectal liver metastases, 106 with suspected pancreatic cancer, 47 with hepatocellular cancer, 52 with gallbladder cancer or cholangiocarcinoma, and 26 with other types of HPB cancer. Bone scans were negative in 377 patients (93.8 per cent) and positive in 25 patients (6.2 per cent). Of the 25 positive scans, 16 were falsely positive as a result of degenerative bone disease. Of nine patients with a true-positive bone scan, four had locally irresectable disease and four distant metastases. In only one patient did the bone scan result alone influence the decision to resect the HPB cancer. Overall sensitivity was 100 per cent, specificity 95.9 per cent, positive predictive value 36.0 per cent and negative predictive value 100 per cent.. Bone scanning should not be included in the routine staging protocol for HPB cancer.

Topics: Aged; Biopsy, Needle; Bone Neoplasms; Cholangiocarcinoma; Colorectal Neoplasms; Female; Gallbladder Neoplasms; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Staging; Pancreatic Neoplasms; Preoperative Care; Prospective Studies; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, Spiral Computed

Extrarenal uptake of Tc-99m DMSA is not seen very often. It has previously been described in metastatic disease and was mainly attributed to the presence of V-DMSA in the injected solution. We report a clinical case of incidental visualization of metastatic bone disease of the colon in a patient with renal failure. This could be the result of not only the presence of V-DMSA, but also the renal failure and the atypia of the lesions.

Topics: Aged; Bone Neoplasms; Colorectal Neoplasms; Humans; Incidental Findings; Kidney; Male; Radionuclide Imaging; Radiopharmaceuticals; Renal Insufficiency; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

Topics: Aged; Cicatrix; Colorectal Neoplasms; Dermatologic Surgical Procedures; Diagnosis, Differential; Humans; Laparotomy; Male; Radionuclide Imaging; Radiopharmaceuticals; Skin; Spinal Osteophytosis; Technetium Tc 99m Medronate; Wound Healing

A method of superimposing computed tomography (CT) and immunoscintigraphic (IS) single photon emission tomography (SPET) slices is presented and has been applied to 10 patients with suspected cancer recurrence. IS was performed with carcinoembryonic antigen (CEA)-specific indium-111 monoclonal antibodies (MoAbs) in 5 patients with colorectal cancer, and with OC125 111In-MoAbs in 5 patients with ovarian cancer. All patients had an abnormal CT image result in the pelvis, which was interpreted 5 times as recurrence, once as doubtful and four times as scar fibrosis. Recurrence was subsequently proven in all patients. Bone scintigraphy (BS) SPET was recorded at the same time as IS. No special technique was used during BS, IS or CT acquisition. CT images were fed into a computer using a CCD camera. Using the internal anatomical landmarks provided by the pelvic bone structures seen on CT and BS, an operator had to select corresponding fiducial points, which were used by the software to register the images. The final results were CT-BS and CT-IS superimposed images. CT-BS images were used for quality control. In all patients, the inspection of CT-BS and CT-IS showed that the registration process is accurate and assists in the co-interpretation of CT and IS images.

Topics: Colorectal Neoplasms; Female; Humans; Indium Radioisotopes; Neoplasm Recurrence, Local; Ovarian Neoplasms; Radioimmunodetection; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Combining the volume rendering and bicolour visualization techniques is proposed as an aid in interpreting single photon emission tomography (SPET) immunoscintigraphy (IS) recorded simultaneously with SPET bone landmarking (BL). The combination helps in localizing abnormal monoclonal uptake and in differentiating it from a physiological radioactivity distribution. The so-called rendered images (RIs) are obtained in both IS and BL studies according to a depth- weighted maximum activity projection algorithm. Fused BL and IS RIs are constructed by a simple, pixel by pixel addition. They are displayed using a bicolour grey-red scale, which makes it possible to visualize both studies by a transparency effect. This method was applied to patients suspected of suffering colorectal or ovarian cancer recurrences, in whom monoclonal antibodies against carcinoembryonic antigen, B72-3 or OC125 labelled with indium-111 were used.

Topics: Bone and Bones; Colorectal Neoplasms; Female; Humans; Indium Radioisotopes; Neoplasm Recurrence, Local; Ovarian Neoplasms; Radioimmunodetection; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon