A case of recurrent cholangitis after bile duct injury during laparoscopic cholecystectomy: Value of scintigraphy with Tc-99m GSA and hepatobiliary scintigraphy for indication of lobectomy

A 39-year-old woman with acute cholecystitis and gallstones underwent laparoscopic cholecystectomy. She suffered from recurrent episodes of cholangitis due to injury of the major bile ducts during laparoscopic cholecystectomy. Hepatobiliary scintigraphy with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan was performed. Although normal bile excretion was found from the left hepatic duct to the percutaneous transhepatic biliary drainage (PTBD) tube, excretion from the right hepatic lobe was prolonged. Scintigraphy with Tc-99m diethylenetriaminepentaacetic acid-galactosyl human serum albumin demonstrated atrophy of the right hepatic lobe and enlargement of the left hepatic lobe. Cholangiography via the PTBD tube revealed complete obstruction of the left hepatico-jejunal anastomosis and could not enhance the right intrahepatic bile duct. A right hepatic lobectomy was performed because of the atrophy, glissonitis and the absence of an appropriate bile duct for reconstruction. Postoperatively she was active and exhibited no evidence of recurrent cholangitis.     

99Tcm-MIBI SPECT-CT同机图像融合技术在乳腺肿瘤显像及淋巴结转移判断中的应用

目的 探讨99Tcm-MIBI SPECT-CT同机图像融合技术对于乳腺肿瘤显像及淋巴结转移判断的临床应用价值.方法 对80例女性乳腺肿块患者行99Tcm-MlBI乳腺及腋窝淋巴结平面显像及99Tcm-MIBI SPECT-CT显像.所有患者均有手术后病理检查结果做对照.结果 80例患者中SPECT-CT融合图像对乳腺癌诊断的灵敏度88.2%(45/51),高于平面显像的82.4%(42/51).两者差异有统计学意义(P<0.05).SPECT-CT融合图像对原发性乳腺癌诊断的特异度、准确度分别为93.1%(26/29)、90%(71/80),均高于平面显像的79.3%(23/29)、81.3%(65/80).平面显像检测腋淋巴结的灵敏度77.2%(17/22),特异度86.2%(25/29),准确度82.4%(42/51),SPECT-CT融合图像检测腋淋巴结的灵敏度81.8%(18/22),特异度89.7%(26/29),准确度86.3%(44/51).两者比较差异无统计学意义(P0.05).结论 SPECT-CT图像融合显像技术在乳腺癌诊断的灵敏度、特异度和准确度均高于平面显像.在乳腺癌腋窝淋巴结转移探测方面SPECT/CT图像融合与平面显像相似.     

Predictors of a positive baseline bone scan in breast cancer

The aim of this retrospective study was to determine the predictors of a positive bone scan in female patients with breast carcinoma. The participants were 126 females with newly diagnosed breast carcinoma and a baseline bone scan. Patients who had started treatment before their bone scan were excluded. Bone scans were assessed as ‘no metastases’ or ‘definite skeletal metastases’ without knowledge of the patient's predictor variables. Those with ‘possible metastases’ were correlated with other available imaging and clinical information, and recategorized as ‘no metastases’ or ‘definite skeletal metastases’. Results were compared with predictor variables. Significant predictors were increasing age, a higher histopathological grading and positive progesterone receptor status following a forward-stepwise logistic regression analysis. Axillary nodal status, tumour size and oestrogen receptor status did not correlate with a positive bone scan. Not every patient needs a staging bone scan. This study is important because it predicts the need for baseline scintigraphy for specific patients in whom skeletal metastases are more likely to be present or to develop. The findings are particularly valuable in times of worldwide resource scarcity and evolving surgical practice.     

叶酸受体介导99mTc标记c-erbB2癌基因反义寡核苷酸的乳腺癌细胞摄取率

目的研究叶酸受体介导的99mTc标记c-erbB2癌基因反义寡核苷酸乳腺癌细胞的摄取率.方法用双功能鳌合剂次已酰双半胱氨酸(EC)连接15mer寡脱氧核苷酸(ODN)和叶酸(FA),形成ODN-EC-FA,用99mTc标记,形成99mTc-ODN-FA.同样的方法不加叶酸,形成99mTc-ODN.加2μCi的99mTc-ODN-FA和99mTc-ODN到107cell/瓶对数生长期乳腺癌细胞MDA-MB-231,分别于20、40、60、120、180、240分钟测定细胞的摄取率.结果乳腺癌细胞对99mTc-ODN-FA的摄取率明显高于99mTc-ODN.结论叶酸配体与受体的特异结合使寡核苷酸的乳腺癌细胞摄取率明显增加.     

Synthesis and biological characterization of 99mTc(I) tricarbonyl cysteine complex,a potential diagnostic for assessment of renal function

Cysteine containing three functional groups, i.e. a carboxyl, sulfhydryl, and amino group, has been labelled with ^99mTc(I) tricarbonyl precursor ( 2 ) in order to study the renal characteristics of the resulting ^99mTc(I) tricarbonyl cysteine ( 3 ) versus the reference ^99mTc‐MAG₃ ( 1 ). The ^99mTc(I) tricarbonyl cysteine ( 3 ) was prepared in good yields and characterized by HPLC, eletrophoresis, and eletrospray mass spectrometry. The plasma protein binding rate of ^99mTc(I) tricarbonyl cysteine ( 3 ) was about 70 to 80%, and similar to that of ¹³¹I‐OIH (70%) but lower than that of ^99mTc‐MAG₃ (90%). The T_1/2 of ^99mTc(I) tricarbonyl cysteine (4.30±0.79 min) in the kidney was higher than the one of ^99mTc‐MAG₃ (2.43±0.70 min). The static image of ^99mTc(I) tricarbonyl cysteine at 5 min post injection showed high concentrated activity in the kidney. And in the 15, 30 min post injection images, most activity appeared in the bladder without a residue in other organs. The ^99mTc(I) tricarbonyl cysteine exhibited biological behavior comparable to ^99mTc‐MAG₃ and it is expected to have diagnostic potential for imaging renal function in nuclear medicine. Copyright © 2004 John Wiley & Sons, Ltd.     

On the 99mTc‐labeling of isoniazid with different 99mTc cores

Recent advances in the chemistry of radiolabeling with ^99mTc such as use of the ^99mTc tricarbonyl and ^99mTc–HYNIC cores have revived interest in ^99mTc‐labeling of small biomolecules and further investigation as potential radiopharmaceuticals. Isoniazid, a drug commonly used for treatment of tuberculosis, has been chosen for the present study. Three distinct strategies were utilized to radiolabel isoniazid with ^99mTc. In the direct labeling protocol, the hydrazino amide functional group of isoniazid was used for ^99mTc‐labeling in the HYNIC sense using tricine and EDDA as co‐ligands. The other strategies of ^99mTc‐labeling involved the derivatization of isoniazid to its N, N‐diacetic acid derivative, which in turn was either used as a tridentate ligand for labeling with the [^99mTc(CO)₃(H₂O)₃]⁺ synthon or directly labeled by the conventional route wherein ^99mTc is in the +3 oxidation state. The complexes prepared in >95% yields were characterized by paper chromatography, thin layer chromatography and HPLC. Comparison of the three approaches showed that maximum specific activity and stability was obtained in the ^99mTc–isoniazid derivative synthesized via the tricarbonyl method. However, in vitro cell‐binding studies indicated that none of the ^99mTc–isoniazid complexes prepared had any appreciable uptake in Mycobacterium tuberculosis. Copyright © 2005 John Wiley & Sons, Ltd.     

Synthesis of S‐thiomethyl DMSA and S‐thiomethyl ECD,radiolabelling with technetium‐99m and biological evaluation

Protection of the thiolate function of dimercaptosuccinic acid (DMSA) and ethylenedi‐l ‐cysteine diethyl ester (ECD) by S‐thiomethylation allowed automatic deprotection during technetium‐99m (^99mTc) radiolabelling by direct reduction with stannous chloride dihydrate. Protection of the free thiolate group increased the stability of the ligands as well as deprotection during complexation, which resulted in the desired radiopharmaceuticals. The complexes obtained from the protected ligands were chromatographically (HPLC) and biologically compared with the corresponding ^99mTc complexes of the unprotected ligands. The results suggest that the aforementioned method of protection by S‐thiomethylation could be utilized for the development of single‐vial DMSA and ECD kit. Copyright © 2012 John Wiley & Sons, Ltd.     

Preparation and first biological evaluation of novel Re-188/Tc-99m peptide conjugates with substance-P

IntroductionNew ¹⁸⁸Re and ^99mTc peptide conjugates with substance- P (SP) were prepared and biologically evaluated. The radiopharmaceuticals have been labelled with the [M≡N]²⁺ (M=^99mTc, ¹⁸⁸Re) core using a combination of π-donor tridentate and π-acceptor monodentate ancillary ligands.MethodsThe new radiopharmaceuticals have been prepared through a two-step reaction by simultaneous addition of the tridentate and monodentate ligands to a vial containing a preformed [M≡N]²⁺ core. The tridentate ligand was formed by linking two cysteine residues to the terminal arginine of the undecapeptide SP, whereas the monodentate ligand was a tertiary phosphine. The preparation of the corresponding Re-188 derivative required developing a more complex chemical procedure to obtain the [Re≡N]²⁺ core in satisfactory yields. Characterization of the resulting products was obtained by chromatographic methods. Biological evaluation was performed for both Tc-99m and Re-188 derivatives by in-vitro studies on isolated cells expressing NK1-receptors. In-vivo imaging in mice was carried out using a small-animal YAP(S)PET tomograph.ConclusionNew Tc-99m and Re-188 peptide radiopharmaceuticals with SP have been prepared in high-yield and with high-specific activity. Both Tc-99m and Re-188 peptide radioconjugates exhibit high affinity for NK1 receptors, thus giving further evidence to the empirical rule that structurally related Tc-99m and Re-188 radiopharmaceuticals exhibit identical biological properties.     

细胞黏附分子CD99在人髓母细胞瘤中的表达及意义

目的 探讨细胞黏附分子CD99在人髓母细胞瘤组织中的表达特点及其临床意义。方法 采用免疫组化法检测107例髓母细胞瘤及15例瘤旁正常脑组织标本中CD99的表达。所有病人均随访至死亡或截止至2013年12月，随访时间为12~80个月，利用Kaplan-Meier生存曲线进行生存分析。结果 髓母细胞瘤CD99阳性表达率（57.94%，62/107）明显高于瘤周正常脑组织（0%，0/15；P<0.05）。CD99的表达水平与病人性别、年龄、肿瘤的病理组织学分型和分子亚型均无明显相关性（P>0.05）。CD99的高表达与髓母细胞瘤病人的预后呈显著负相关（P<0.05）。结论 CD99高表达与髓母细胞瘤预后显著相关，可作为预后判断的指标及治疗髓母细胞瘤潜在的新靶点。     

乳腺专用伽马显像中99Tcm-甲氧基异丁基异腈的摄取与乳腺浸润性导管癌患者临床病理特征的关系

目的分析乳腺浸润性导管癌患者的临床病理特征与乳腺专用伽玛显像(BSGI)中⁹⁹Tc^m-甲氧基异丁基异腈(MIBI)摄取之间的关系。 方法回顾性分析2014年3月至2018年3月就诊于威海市立医院行BSGI检查、未接受新辅助治疗及穿刺活组织检查及术前无肿瘤远处转移的浸润性导管癌患者244例的临床资料。分析患者的BSGI数据，计算病灶的放射性计数与正常组织的比值(T/N)，从而评估肿瘤对⁹⁹Tc^m-MIBI的摄取量。T/N为偏态分布数据，用M(P₂₅～P₇₅)表示。用Wilcoxon秩和检验分析患者临床病理特征与T/N之间的关系，用多元线性回归模型分析患者临床病理特征对T/N的影响。 结果全部244例患者BSGI中的T/N范围为1.0～7.5。Wilcoxon秩和检验结果显示T/N与T分期、N分期、组织学分级及Ki67表达有关(Z＝－6.852、5.198、－3.931，P均<0.001；Z＝－3.059, P＝0.002)，而与ER、PR、HER-2、P53、EGFR表达及三阴性乳腺癌无关(Z＝ －0.730、－1.526、－1.137、－1.175、－1.224、－1.556, P均>0.050)。多元线性回归分析表明T分期及N分期是T/N的影响因素(t＝5.100, 95%CI：0.414～0.935, P<0.001；t＝ 2.819, 95%CI：0.118～0.668, P＝0.005)。 结论乳腺浸润性导管癌的T分期和N分期可能影响BSGI中肿瘤对⁹⁹Tc^m-MIBI的摄取，因此，可以通过术前测定BSGI的T/N，对肿瘤的恶性程度进行初步评估。