technetium-tc-99m-sulfur-colloid and Neoplasms

The major role of nuclear medicine in clinical oncology is in tumor imaging, which includes evaluating specific organs or the entire body for the presence of tumor. Nuclear medicine studies have been used clinically in the initial evaluation of the tumor extent and in the subsequent management of the cancer patient to assess response to treatment, to detect early relapse, and to assist in making decisions concerning follow-up treatment. Technetium-99m macroaggregated albumin perfusion study for intraarterial chemotherapy has been helpful in monitoring the catheter tip, providing a map of regional perfusion at the capillary level (tumor vascularity), evaluating the degree of arteriovenous shunt in tumor bed, and optimizing division of the dose of chemotherapeutic agent when bilateral arterial catheters are used. Quantitative and serial radionuclide angiocardiography has been useful in assessing doxorubicin (Adriamycin, Adria Laboratories, Columbus, Ohio) toxicity, and 67Ga-citrate imaging has been used to monitor chemotherapy effect on lungs and kidneys. Radionuclide venography can demonstrate suspected thrombus, and the delineation of the vascular anatomy also allows proper placement of another catheter for continuous effective chemotherapy. Serial bone scans have been the primary modality to assess the response of bone metastasis to systemic therapy in breast cancer patients, and nuclear hepatic imaging may show tumor response, hepatocellular dysfunction, and cholecystitis related to chemotherapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Antineoplastic Agents; Bone and Bones; Bone Neoplasms; Chemotherapy, Cancer, Regional Perfusion; Doxorubicin; Gallium Radioisotopes; Heart Failure; Humans; Injections, Intra-Arterial; Kidney Diseases; Liver; Liver Diseases; Lung; Lung Diseases; Magnetic Resonance Spectroscopy; Neoplasms; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thrombophlebitis; Tomography, Emission-Computed

Topics: Breast Neoplasms; Colloids; Cost-Benefit Analysis; Female; Humans; Lymph Nodes; Mouth; Neoplasms; Radiopharmaceuticals; Sentinel Lymph Node; Sentinel Lymph Node Biopsy; Sulfur; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid

To report oncological cases (excluding those related to breast cancer) for which radioguided surgery has been used in combination with the Radioguided Occult Lesion Localization technique.. Radioguided surgery enables a surgeon to identify lesions or tissues that have been preoperatively marked with radioactive substances. The Radioguided Occult Lesion Localization technique has been widely used to identify the sentinel lymph node and occult lesions in patients with breast cancer. However, few studies have reported the use of this technique for non-breast cancer pathologies.. In all cases, injection of Technecium-99m sulfur colloid was performed, directly inside or near by the suspicious lesion, guided by ultrasound or computed tomography, up to 36 hours prior to the surgical procedure. Intraoperative lesion detection was carried out using a gamma-probe.. We report five oncology cases in which preoperative markings of the lesions were carried out using the Radioguided Occult Lesion Localization technique. The patients presented with the following: recurrence of renal cell carcinoma, cervical recurrence of papillary carcinoma of the thyroid, recurrence of retroperitoneal sarcoma, lesions of the popliteal fossa, and recurrence of rhabdomyosarcoma of a thigh. In each case, the lesions that were marked preoperatively were ultimately successfully excised.. Radioguided surgery has proven to be a safe and effective alternative for the management of oncology patients. The Radioguided Occult Lesion Localization technique can be useful in selected cases where suspect lesions may be difficult to identify intraoperatively, due to their dimensions or anatomical location. The procedure allows for more conservative excisions and reduces the surgery-related morbidity.

Topics: Adolescent; Adult; Female; Gamma Rays; Humans; Intraoperative Care; Male; Middle Aged; Neoplasms; Preoperative Care; Radionuclide Imaging; Radiopharmaceuticals; Surgery, Computer-Assisted; Technetium Tc 99m Sulfur Colloid; Ultrasonography, Interventional

LL1, a monoclonal antibody (MAb) to HLA Class-II-like antigen (li determinant) on the surface of B-lymphocytes, monocytes and histiocytes, was evaluated as an agent for bone marrow imaging. Six patients with diverse diseases (non-Hodgkin's lymphoma, n = 2; multiple myeloma, n = 1; polycythaemia vera, n = 1; lung cancer, n = 1; breast cancer, n = 1) were given low protein doses (< 1 mg) of 99Tcm (30 mCi) labelled Fab' of LL1. 99Tcm-sulphur colloid (SC) imaging was performed in three patients for comparison. Both planar and single photon emission tomographic images were acquired using Sopha gamma cameras. As early as 2 h post-MAb injection, excellent bone marrow images were achieved in all patients, demonstrating both normal or hyperproliferative marrow, as well as 'cold' bone marrow abnormalities such as radiation defects or cancer metastases. Similar to SC, relatively high uptake of LL1 was found in the liver and spleen. However, the bone marrow-to-liver and -spleen uptake ratios were approximately 19-fold higher (0.75 vs 0.04) and 6-fold higher (1.23 vs 0.22), respectively, with LL1 than with SC. The higher bone marrow uptake allowed clearly superior visualization of the thoracic spine when compared to SC. The mean T1/2 of blood and whole-body clearance were 0.4 and 66 h, respectively. The highest radiation absorbed doses (in cGy mCi-1) were observed in the spleen (0.47 +/- 0.24), kidneys (0.25 +/- 0.09) and liver (0.14 +/- 0.04). The bone marrow dose was only 0.05 +/- 0.02 cGy mCi-1. These results indicate that bone marrow imaging with 99Tcm-LL1 is feasible, and that LL1 may be a suitable alternative to SC because of better visualization of the lower thoracic spine. Potential applications include the improved detection of bone marrow metastases of solid tumours and the assessment of haematological disorders.

Topics: Animals; Antibodies, Monoclonal; Bone Marrow; Breast Neoplasms; Female; Humans; Lung Neoplasms; Lymphoma, Non-Hodgkin; Mice; Multiple Myeloma; Neoplasms; Polycythemia Vera; Radioimmunodetection; Technetium; Technetium Tc 99m Sulfur Colloid; Tissue Distribution; Tomography, Emission-Computed

The concentration of granulocyte-macrophage colonies in culture (CFU-c) in bone marrow cells was estimated, and bone marrow radionuclide scans were performed in a group of 15 cancer patients prior to bone marrow harvest for autologous transplantation. Preharvest CFU-c counts on iliac-crest bone marrow aspirates correlated very well with CFU-c counts from fresh and frozen-thawed bone marrows. Technetium-99m-sulfur colloid radionuclide scans showed that the distribution of total-body bone marrow and increased peripheral radionuclide uptake correlated with higher preharvest and harvest CFU-c counts. Bone marrow scan results were available in 1 h, whereas CFU-c counts took 14 days to obtain. Bone marrow scans may facilitate the clinical estimation of hemopoietic activity in patients under consideration for autologous bone marrow transplantation.

Topics: Bone Marrow; Breast Neoplasms; Carcinoma, Small Cell; Colony-Forming Units Assay; Hematopoiesis; Humans; Leukemia; Lung Neoplasms; Lymphoma; Male; Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Testicular Neoplasms

Two hundred six technetium-99m sulfur colloid bone marrow scans in 110 pediatrics patients were reviewed. The normal distribution of sulfur colloid in the lower extremities in various age groups was established. There was progressive loss of uptake with increasing age from less than two years to greater than ten years. Tumor replacement was seen as regions of decreased radioactivity, and the extent of the scan defect paralleled the response of the disease to therapy. Both chemotherapy and irradiation resulted in an extension of the Tc-99m SC to peripheral marrow sites. In irradiated areas, marrow scan defects were demonstrated and generally recovered normal activity by six months after the completion of therapy. Marrow scan abnormalities caused by tumor replacement were present in four patients despite normal bone scans and radiographs. Ultimate confirmation of tumor involvement was by needle aspiration or biopsy. Persistent marrow defects were seen in two patients with neuroblastoma who had remission of their disease: biopsy revealed myelofibrosis. Technetium-99m sulfur colloid bone marrow scanning is a sensitive monitor of altered marrow activity associated with pediatric hematologic or oncologic diseases.

Topics: Bone Marrow; Child; Child, Preschool; Hodgkin Disease; Humans; Lymphoma; Neoplasms; Neuroblastoma; Prospective Studies; Radionuclide Imaging; Reference Values; Sarcoma, Ewing; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Wilms Tumor

Topics: Humans; Lymph Nodes; Neoplasms; Radionuclide Imaging; Rhenium; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid