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

Topics: Antineoplastic Combined Chemotherapy Protocols; Chromium Compounds; Combined Modality Therapy; Female; Humans; Injections, Intraperitoneal; Neoplasm Staging; Ovarian Neoplasms; Palliative Care; Phosphates; Phosphorus Radioisotopes; Radiopharmaceuticals; Radiotherapy; Radiotherapy Dosage; Randomized Controlled Trials as Topic; Salvage Therapy; Technetium Tc 99m Sulfur Colloid

Topics: Antimony; Ascites; Breast Neoplasms; Colloids; Female; Gastrointestinal Neoplasms; Gold Colloid, Radioactive; Humans; Indium; Lung Neoplasms; Lymphoscintigraphy; Male; Melanoma; Mercury Radioisotopes; Methods; Neoplasm Staging; Organotechnetium Compounds; Ovarian Neoplasms; Phytic Acid; Prostatic Neoplasms; Radioisotopes; Sulfur; Technetium; Technetium Compounds; Technetium Tc 99m Sulfur Colloid

Significant variability in the pharmacokinetics and pharmacodynamics of PEGylated liposomal doxorubicin (PLD) exists. PLD undergoes clearance via the mononuclear phagocyte system (MPS). Technetium Tc 99m sulfur colloid (TSC) is approved for imaging MPS cells. We investigated TSC as a phenotypic probe of PLD pharmacokinetics and pharmacodynamics in women with epithelial ovarian cancer.. TSC 10 mCi IVP was administered and followed by dynamic planar and SPECT/CT imaging and blood pharmacokinetics sampling. PLD 30-40 mg/m(2) IV was administered with or without carboplatin, followed by plasma pharmacokinetics sampling.. There was a linear relationship between TSC clearance and encapsulated doxorubicin clearance (R(2) = 0.61, p = 0.02), particularly in patients receiving PLD alone (R(2) = 0.81, p = 0.04). There was a positive relationship (ρ = 0.81, p = 0.01) between maximum grade palmar-plantar erythrodysesthesia toxicity developed and estimated encapsulated doxorubicin concentration in hands.. TSC is a phenotypic probe for PLD pharmacokinetics and pharmacodynamics and may be used to individualize PLD therapy in ovarian cancer and for other nanoparticles in development.

Topics: Adult; Aged; Antibiotics, Antineoplastic; Carboplatin; Carcinoma, Ovarian Epithelial; Doxorubicin; Female; Hand-Foot Syndrome; Humans; Middle Aged; Neoplasms, Glandular and Epithelial; Ovarian Neoplasms; Phenotype; Polyethylene Glycols; Radiopharmaceuticals; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

This study addressed the technique of intraperitoneal distribution imaging (IDI). A literature search (MEDLINE database) revealed wide variations in IDI techniques without a basis for comparison. From April 1990 to September 1992, the authors studied 8 patients (age 43-65 years) with ovarian cancer. A total of 1000 ml of normal saline and 1 mCi of Tc-99m SC was infused intraperitoneally for IDI. In one patient loculation was observed, but only 250 ml of normal saline was infused with Tc-99m SC. A repeat study using our standard technique rendered free intraperitoneal distribution in this patient, as well as in the other seven cases. Some investigators recommend low volumes, but in our experience this produced the finding of pseudoloculation, which could change treatment inappropriately. Although the number of patients studied at our institution was small, administration of 1 liter intraperitoneally provided consistent IDI results.

Topics: Chromium Compounds; Female; Humans; Infusions, Parenteral; Middle Aged; Ovarian Neoplasms; Peritoneal Cavity; Phosphates; Phosphorus Radioisotopes; Radionuclide Imaging; Sodium Chloride; Technetium Tc 99m Sulfur Colloid; Tissue Distribution

This study was designed to evaluate the detection rate (DR) and sensitivity of sentinel lymph node (SLN) mapping in patients with endometrial cancer using TC99m colloid and blue dye and to evaluate the contribution of preoperative planar lymphoscintigraphy (PLSG) and SPECT/CT.. A retrospective analysis of patients who underwent SLN mapping as part of their primary surgery for endometrial cancer. Patients underwent preoperative PLSG and later with additional SPECT/CT. Intraoperative detection was performed using TC99m colloid and blue dye by cervical injections. SLNs were sent separately for pathologic evaluation with ultrastaging.. Fifty-three patients were included in this study. Successful preoperative mapping was achieved in 31 of 37 patients (84 %) who underwent SPECT/CT compared with only 30 of 45 patients (67 %) who underwent PLSG. SPECT/CT localizations of SLNs were anatomically accurate in 91 % of cases. Intraoperative DR of at least one SLN was 77 %, whilst the bilateral DR was 49 %. DR was significantly better using combined blue dye and TC99m colloid injections compared with blue dye alone: 81 versus 57 % for unilateral and 54 versus 28 % for bilateral mapping (P = 0.01, 0.009, respectively). Six cases of nodal metastasis were diagnosed: four by positive SLNs, and two cases were diagnosed using side-specific full dissection according to the SLN algorithm when SLN detection failed. There were no cases of false-negative results.. SLN detection using cervical injections of TC99m colloid and blue dye is feasible and sensitive for patients with endometrial cancer. SPECT/CT aids to accurate locating of the SLN.

Topics: Adenocarcinoma, Clear Cell; Adult; Aged; Aged, 80 and over; Carcinoma, Papillary; Cystadenocarcinoma, Serous; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Lymph Nodes; Lymphoscintigraphy; Male; Middle Aged; Neoplasm Grading; Neoplasm Staging; Ovarian Neoplasms; Prognosis; Radiopharmaceuticals; Retrospective Studies; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Diagnosis, Differential; Female; Humans; Middle Aged; Ovarian Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Splenectomy; Splenosis; Technetium Tc 99m Sulfur Colloid

A patient with postoperative Stage I ovarian carcinoma received 15 mCi of 32P-chromic phosphate suspension in normal saline intraperitoneally as part of her therapy. The following day, a portion of the infused radiopharmaceutical and normal saline had passed transdiaphragmatically into the patient's right pleural cavity. Thoracentesis removed as much fluid as possible and this fluid contained radioactive material. In the ensuing 4 yr, the patient has not manifested any detectable pleural or pulmonary abnormalities attributable to the radioactivity. Retrospective review of 100 consecutive patients receiving 32P-chromic phosphate intraperitoneal therapy resulted in 43 patients in whom the hemithoraces could be evaluated scintigraphically. Three of the 43 patients (7%) had right pleural fluid radioactivity. This is similar to the percentages reported in patients with cirrhosis with ascites in whom hepatic hydrothorax is identified.

Topics: Chromium Compounds; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Infusions, Parenteral; Middle Aged; Ovarian Neoplasms; Peritoneal Cavity; Phosphates; Phosphorus Radioisotopes; Pleura; Pleural Effusion; Technetium Tc 99m Sulfur Colloid; Time Factors; Tissue Distribution

Topics: Brachytherapy; Catheterization; Female; Humans; Intestine, Small; Ovarian Neoplasms; Phosphorus Radioisotopes; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon

A case of fatal radiation hepatitis occurring after treatment with 2200 rad given by the moving strip technique is presented. This fatality occurred in a 28-year-old woman with persistent ovarian carcinoma despite prolonged chemotherapy. Scans of the liver using computerized tomography, 99mTc sulfur colloid, and 99mTc diisopropyl iminodiacetic acid showed abnormalities only in sulfur colloid uptake and these resolved late in the course. Death was caused by progressive hepatic and renal failure. Postmortem examination showed changes typical of radiation hepatitis. Only 32 cases of radiation hepatitis have been previously reported and they are reviewed. The possible role of prolonged prior chemotherapy in enhancing sensitivity to radiotherapy is considered.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Autopsy; Cystadenocarcinoma; Female; Hepatitis; Humans; Hysterectomy; Ovarian Neoplasms; Radiation Injuries; Radionuclide Imaging; Radiotherapy; Radiotherapy Dosage; Technetium Tc 99m Sulfur Colloid

Topics: Ascites; Ascitic Fluid; Diaphragm; Female; Humans; Ovarian Neoplasms; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Lymphoscintigraphy is an easily performed noninvasive procedure that offers the potential to detect small numbers of ascitic tumor cells and early diaphragmatic tumor involvement. Moreover, it can be used to delineate and define abnormalities in lymph nodes that are not routinely visualized by bipedal contrast lymphangiography, ultrasound or computed tomography. Lymphoscintigraphy is recommended as an important investigative and adjunctive procedure in diagnosing gynecologic malignancies; there does not appear to be sufficient sensitivity and specificity to justify its routine clinical use.

Topics: Animals; Ascites; Breast; Female; Humans; Lymph Nodes; Mediastinum; Mice; Ovarian Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Uterine Cervical Neoplasms; Uterine Neoplasms

Seven patients received intraperitoneal chromic phosphate (32P) suspension in a 3-ml bolus with a saline flush, and another ten patients were given the suspension in a 500-ml infusion of normal saline. During the first six hours after administration, most 32P activity redistributed to the gravity-dependent portion of the peritoneal cavity. From 24 hours up to seven weeks after administration, activity distributions were fixed. Dispersions were heterogeneous in every patient, but the most marked examples of localized activity occurred in patients who had received bolus injections. We concluded that large-volume infusions and frequent changes in patient position for several hours following the infusion, contribute to improved dispersion of 32P suspension.

Topics: Chromium; Chromium Compounds; Female; Humans; Ovarian Neoplasms; Peritoneal Cavity; Phosphates; Posture; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Time Factors; Tissue Distribution

Topics: Brachytherapy; Colloids; Contrast Media; Female; Humans; Ovarian Neoplasms; Peritoneal Cavity; Phosphorus Radioisotopes; Radiography; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid