Lymphoscintigraphy: a comparison of 99Tc(m) antimony sulphide colloid and 99Tc(m) stannous phytate.

In vitro comparison of 99Tc(m) antimony sulphide colloid and 99Tc(m) stannous phytate as well as in vivo studies in six rabbits and seven patients indicate disparity in the colloidal properties and localization of these two agents. The variability in lymphatic uptake and the relatively poor quality of scintigraphic images following interstitial injection of 99Tc(m) stannous phytate, when compared with 99Tc(m) antimony sulphide colloid, provide evidence of the unsuitability of this agent for lymphoscintigraphy. Maintenance of the diagnostic quality of the lymphoscintigraphic image and adherence to interpretive criteria already established therefore preclude the routine use of 99Tc(m) stannous phytate for interstitial lymphoscintigraphy.     

A convenient method for the preparation of 99mTc(V)dimercaptosuccinic acid (99mTc(V)-DMSA)

Tc(IV)-DMSA for kidney scintigraphy has been prepared in acidic solution. Once the labeling is done in basic solution, upon addition of a small amount of NaHCO3, a mixture of 3-4 other DMSA-complexes is formed, presumably containing Tc(V). Kidney uptake in male adult rats of the 99mTc(V)-DMSA is 1.6% injected dose/g (4.9%/total organ) compared to 16.4% injected dose/g (resp. 50.3%/total organ) for 99mTc(IV)-DMSA.     

In vitro adsorption of 99Tc(m)-MIBI, 99Tc(m)-tetrofosmin, 99Tc(m)-furifosmin and 99Tc(m)O4- onto tubes

Adsorption of radiopharmaceuticals onto disposable syringes has been reported to amount to levels of almost 50%. Data on adsorption of radiopharmaceuticals onto materials used for in vitro studies are extremely limited. We assessed the extent of adsorption of 99Tc(m) hexakis(2-methoxyisobutylisonitrile) (99Tc(m)-MIBI), 99Tc(m)-tetrofosmin, 99Tc(m)-furifosmin and 99Tc(m)O4 onto tubes used for in vitro measurement of cellular uptake of these radiopharmaceuticals. The influence on adsorption of different incubation media, temperature and time of incubation was evaluated. Total (not corrected for adsorption) uptake was compared with corrected, net cellular uptake in SK-BR-3, MCF-7 and liposarcoma cell lines. Values of adsorption ranging from 0.94+/-0.13% to 7.07+/-0.46% were found. The extent of adsorption of all the radiopharmaceuticals varied with the type of incubation medium and the incubation temperature. With 99Tc(m)-furifosmin, adsorption was dependent on the incubation time as well on the incubation temperature and some of the incubation media investigated. Our findings indicate that systematic investigations to evaluate the adsorption of radiopharmaceuticals onto materials used during in vitro studies of cellular uptake should be considered a mandatory aspect of quality control.     

Tc-99m(V)-DMSA in wound infection after closure of an ileostomy

We present a 71-year-old man who underwent closure of an ileostomy and had a fever seven days post surgery. Both Tc-99m(V)-dimercaptosuccinic acid (DMSA) and gallium-67 citrate scans showed increased tracer accumulation in the right lower quadrant of the abdomen. Tc-99m(V)-DMSA scintigraphy can be a rapid alternative tool in the detection of wound infection in patients after ileostomy closure.     

In vitro evaluation of canine leukocytes radiolabeled in whole blood with (99m)Tc stannous colloid

INTRODUCTION: Technetium-99m stannous colloid ((99m)TcSnC)-labeled leukocytes are used to investigate a variety of inflammatory diseases in human medicine. The present study investigates the in vitro behavior of canine leukocytes labeled in whole blood with (99m)TcSnC. METHODS: Blood samples from 10 healthy dogs were labeled with (99m)TcSnC using a standard procedure. The distribution of radioactivity among blood components (plasma, leukocyte layers and erythrocytes) was measured following separation of the radiolabeled samples across Histopaque density gradients. Phagocytic function of labeled and unlabeled leukocytes was estimated using zymosan particles. Labeling retention by leukocytes was determined at 1, 3, 4 and 7 h postlabeling. RESULTS: The mean+/-standard error percentage of radioactivity associated with plasma, erythrocyte and leukocyte fractions was 2.0+/-0.21%, 55.5+/-0.60% and 42.5+/-0.54%, respectively (the last comprising 70.2+/-0.83% in polymorphonuclear leukocytes and 29.8+/-0.83% in mononuclear leukocytes). Labeled canine leukocytes had a phagocytic activity of 91.3+/-0.28% (control, 91.7+/-0.26%). The radiolabeled canine leukocytes retained 94.1+/-0.30% of radioactivity at 7 h postlabeling. CONCLUSIONS: Radiolabeling of canine leukocytes in whole blood with (99m)TcSnC has minor adverse effect on their phagocytic function. The radiolabeled canine leukocytes retained a large percentage of radioactivity for at least 7 h postlabeling.     

Direct 99m Tc labeling of Herceptin (trastuzumab) by 99m Tc(I) tricarbonyl ion.

By simply incubating Herceptin (trastuzumab) with [99m Tc(CO)3(OH2)3]+ ion in saline, a significant yield of 99m Tc-labeled trastuzumab was found to be achievable. The effective labeling may be based on that trastuzumab is inherent with endogenous histidine group to which 99m Tc(I) tricarbonyl ion can be strongly bound. For practical 99m Tc labeling processing, trastuzumab was purified beforehand from the commercial product, Herceptin (Genentech) via size exclusion chromatography to remove the excipient, alpha-histidine and a high-labeled yield could be obtained by incubating the purified trastuzumab with [99m Tc(CO)3(OH2)3]+. Retention of bioactivity of the 99m Tc(I)-labeled trastuzumab was validated using a cell binding test.     

Positive imaging of cardiomyopathy with99mTc(V)-DMSA

A case of histologically proven dilated cardiomyopathy and a case of clinically diagnosed cardiomyopathy (cardiac amyloidosis was strongly suspected but was not confirmed) were examined with 99mTc(V)-dimercaptosuccinic acid (DMSA). 99mTc(V)-DMSA accumulation in the damaged myocardium was clearly demonstrated. These results suggested the possibility that 99mTc(V)-DMSA could be used as a positive agent for cardiomyopathy.     

Use of (99m)Tc from a commercial (99)Mo/(99m)Tc generator as yield tracer for the determination of (99)Tc at low levels.

The concentrations of (99)Tc and impurity radionuclides in the (99m)Tc tracer solution obtained from a commercial (99)Mo/(99m)Tc generator were measured by gamma spectrometry and liquid scintillation counting. (99)Mo and (103)Ru were found in the (99m)Tc eluate. A simple separation using two extra alumina cartridges was investigated to purify the eluate to obtain a suitable (99m)Tc tracer with low (99)Tc concentration. The activity ratio of (99)Tc/(99m)Tc in the prepared (99m)Tc solution is lower than 15 x 10(-9), which is higher than the theoretical ratio of less than 10 x 10(-9). The possible reason is discussed. The (99)Tc in the 20 kBq spiked (99m)Tc tracer was found to be less than 0.3 mBq, which is lower than the detection limit of the radiometric method used for environmental samples. The purified (99m)Tc eluate is used as yield tracer for the determination of low levels of (99)Tc in environmental samples.     

Pentavalent technetium-99m (V)-DMSA uptake in a pheochromocytoma in a patient with Sipple's syndrome

This case report describes 99mTc(V)-dimercaptosuccinic acid (DMSA) accumulation in a pheochromocytoma in a patient with Sipple's syndrome. Scintigraphy with 99mTc(V)-DMSA demonstrated uptake in medullary carcinoma of the thyroid gland (MCT). Iodine-131 metaiodobenzylguanidine (MIBG) scintigraphy showed the bilateral pheochromocytomas but did not demonstrate uptake in the MCT.     

Technetium-99m radiopharmaceutical preparation by surface adsorbed stannous ions

A method of producing technetium-99m (99mTc) radiopharmaceuticals is described, where reduction of pertechnetate occurs through stannous ions adsorbed on the surface of an infusion catheter. This leads to radiopharmaceuticals containing microgram quantities of stannous ions and that, therefore, results in minimal blood-pool labeling and essentially the elimination of tin colloids. Other advantages of the method include a reduction in quantities of ligand required and the possibility to mass produce the "tinned" catheters as technetium "reduction" kits. A wide variety of 99mTc radiopharmaceuticals have been prepared in high yield. Excellent biodistribution in several of these is demonstrated.     

Imaging of abdominal infection using 99m Tc stannous fluoride colloid labelled leukocytes

Radiolabelling of leukocytes using labelled phagocytosed technetium-99m (99mTc) colloidal radiopharmaceuticals has been reported as a method for imaging infection. This in vivo study compares the use of leukocytes labelled using 99mTc stannous fluoride colloid with leukocytes labelled using indium-111 (111In) oxinate. A total of 26 patients (10 male, 16 female; mean age 52 years, range 23-88 years) referred for the investigation of possible infection were studied using both leukocyte labelling methods simultaneously. Images were acquired 4h and 24h after re-injection of the labelled cells. The images were evaluated qualitatively by two nuclear medicine physicians. The results show a high degree of concordance between the techniques: 11 of the 28 images showed a focus of leukocyte accumulation with both techniques at 24h, and 13 out of 28 showed a normal appearance at 24h with both methods. In four cases the results were discordant; the 99mTc stannous fluoride colloid labelled leukocytes gave a false positive appearance at 24h in three patients and a false negative in one. In conclusion, colloid labelling of leukocytes offers a sensitive method for the detection of infective foci coupled with the high resolution imaging offered by 99mTc. It has the advantage over other in vitro labelling methods of being a simpler, non-labour-intensive procedure employing whole blood, and its use should be considered by departments that have limited facilities for in vitro leukocyte labelling.     

Determination of the oxidation state of Tc in 99Tc(Sn)EHDP, 99mTc(Sn)EHDP, 99Tc(Sn)MDP and 99mTc(Sn)MDP complexes. Characterization of Tc(III)-, Tc(IV)- and Tc(V)EHDP complexes

The oxidation state of complexed Tc was determined, by performing paper and thin-layer chromatography during potentiometric titrations. Both titrations of Sn(II) with TcO₄⁻ and of TcO₄⁻ with Sn(II) were performed at pH 2.5, 7.0 and 12.0. Differences were found in the number of electrons transferred to 1 mol of TcO₄⁻, n, in the titration solutions at the end point of a direct and a reversed titration. The oxidation state of Tc changes during a titration with the titration degree. It was possible to obtain almost pure Tc(III)-, Tc(IV)- and Tc(V)EHDP complexes, depending on the pH, titration mode and titration degree. These TcEHDP complexes were analyzed by u.v./vis spectrometry, anion-exchange HPLC on Aminex A-28, gel chromatography on Biogel P₄ and extraction with oxine in chloroform. The spectra of the pure Tc(III), Tc(IV) and Tc(V) species were calculated. Adsorption of these complexes on calcium phosphate increased in the order Tc(V) < Tc(IV) < Tc(III). From the chromatographic characterizations it was concluded that in the ^99mTc(Sn)EHDP bone scanning agent Tc is tetravalent. An analogous (though less elaborate) investigation was performed on the Tc(Sn)MDP complex.     

Evaluation of [(99m)Tc] liposomes as lymphoscintigraphic agents: comparison with [(99m)Tc] sulfur colloid and [(99m)Tc] human serum albumin

This study investigates the use of [(99m)Tc] liposomes for the detection of sentinel lymph nodes. A variety of [(99m)Tc] liposome formulations were compared with common lymphoscintigraphic agents including [(99m)Tc] regular-sulfur colloid (SC), [(99m)Tc] 0.22 microfiltered-SC, [(99m)Tc] reduced heating time 0.22 microfiltered-SC, and [(99m)Tc] human serum albumin (HSA) in rabbits. Images were acquired for the first 60 minutes and at 24 hours, followed by tissue biodistribution study. All agents except [(99m)Tc] regular SC demonstrated good migration from the injection site. Agents were retained in the popliteal node at 24 hours to varying degrees as follows: both [(99m)Tc] filtered SC preparations > [(99m)Tc] regular SC > [(99m)Tc] liposomes > [(99m)Tc] HSA. [(99m)Tc] liposome imaging can be used to develop novel liposome compositions with improved lymph node diagnostic and drug delivery characteristics.     

Sipple's syndrome with liver tumors examined by iodine-131 MIBG and technetium-99m(V)-DMSA

This case report describes the localization and categorization of tumors using 99mTc(V)-dimercaptosuccinic acid and [131I]metaiodobenzylguanidine scans in a very uncommon case of medullary thyroid carcinoma associated with pheochromocytoma (Sipple's syndrome) and hepatocellular carcinoma. Technetium-99m(V)-dimercaptosuccinic acid showed accumulation only in medullary thyroid carcinoma, but [131I]metaiodobenzylguanidine scans were positive in both medullary thyroid carcinoma and pheochromocytoma. In advanced Sipple's syndrome, combined use of [99mTc(V)]dimercaptosuccinic acid and [131I]metaiodobenzylguanidine may be useful for the categorization of tumor mass lesions and planning appropriate therapy.     

99Tc(m)-tetrofosmin scintimammography for detecting breast cancer: a comparative study with 99Tc(m)-MIBI.

Scintimammography using 99Tc(m)-MIBI (99Tc(m)-sestamibi) has demonstrated promising results in the detection of breast cancer. Recently scintimammography using 99Tc(m)-tetrofosmin has been suggested as a better diagnostic tool and a more convenient agent to use in this condition. In this study we compared both agents in 35 consecutive women with abnormal mammographic or physical findings. Thirty-four of them underwent MIBI scan, followed by tetrofosmin scan 2 days later (performed on all 35 women). Within 2 weeks, a pathological diagnosis was obtained either by needle or open biopsy. In both scans the uptake ratio between the lesion and the background uptake was calculated. Twenty patients who underwent tetrofosmin scan and 19 patients with MIBI scan had malignant breast tumours, while 15 women had benign lesions. The sensitivity, specificity, positive and negative predictive values and total accuracy of the MIBI scan were 89.4%, 80%, 85%, 85.7% and 85.3%, respectively; almost identical values were obtained with tetrofosmin (90%, 80%, 85.6%, 85.7% and 85.7%, respectively). The uptake ratios in the MIBI and tetrofosmin scans were 1.68 +/- 0.52 and 1.7 +/- 0.47, respectively. No differences were found between the two scintimammographies in all the parameters examined. In conclusion, MIBI and tetrofosmin breast scans are accurate and equally efficient for the detection of breast malignancies.     

Cyclotron production of (99m)Tc: experimental measurement of the (100)Mo(p,x)(99)Mo, (99m)Tc and (99g)Tc excitation functions from 8 to 18 MeV

Introduction

The cyclotron-based ¹⁰⁰Mo(p,2n)^99mTc transformation has been proposed as a viable alternative to the reactor based ²³⁵U(n,f)⁹⁹Mo→^99mTc strategy for production of ^99mTc. Despite efforts to theoretically model the amount of ground-state ^99gTc present at end of bombardment for the (p,2n) reaction, experimental validation has yet to be performed. The co-production of ^99gTc may have important implications in both the subsequent radiopharmaceutical chemistry and patient dosimetry upon injection.

Methods

To determine the extent of ^99gTc co-production, we have experimentally measured the ¹⁰⁰Mo(p,x)⁹⁹Mo, ^99mTc, and ^99gTc excitation functions in the 8–18 MeV range using a combination of natural abundance and 97.42% enriched ¹⁰⁰Mo foils along with γ-ray spectrometry and ICP-MS. Although the excitation functions for production of ⁹⁹Mo and ^99mTc have been presented previously in the literature, to the best of our knowledge, this work presents the first experimental evaluation of the ¹⁰⁰Mo(p,2n)^99gTc excitation function.

Results

From the experimental cross-section measurements, the ^99mTc production yields and ^99mTc/^99m+gTc nuclei ratio were calculated for various thick target irradiation conditions. Results suggest that TBq quantities of ^99mTc can be achieved with a ^99mTc/^99m+gTc nuclei ratio that is on par with the current ⁹⁹Mo/^99mTc generator standard eluted at a 24-h frequency.

Conclusion

These findings suggest that the cyclotron production of ^99mTc may be a feasible alternative to the current reactor-based production strategy.     

99mTc(V)-DMSA SPECT for the assessment of disease activity in Graves' ophthalmopathy

OBJECTIVE: The aim of this study was to evaluate the use of 99mTc(V)-dimercaptosuccinic acid (99mTc(V)-DMSA) scintigraphy for the assessment of disease activity in patients with Graves' ophthalmopathy (GO) and compare their clinical parameters. METHODS: The study involved 20 patients who were clinically inactive and eight patients who were clinically active, a total 28 GO patients (18 female, 10 male; mean age: 39.2+/-13.4 years) and 12 control subjects (six female, six male; mean age: 57.12+/-12 years). Planar and SPECT orbital images were obtained 4 h after the intravenous injection of 555-740 MBq 99mTc(V)-DMSA, using low-energy, high-resolution, parallel-hole collimators with dual-head detectors. All SPECT data were reconstructed on conventional axial, sagittal and coronal projections using an iterative reconstruction. Semi-quantitative evaluation was performed comparing the orbital activity with nasal activity based on four grades. GO was classified according to the NOSPECS classification of the American Thyroid Association. Disease was considered clinically active if symptoms and signs deteriorated over 3 months. RESULTS: No significant correlation was detected between clinical activity and classification (P=0.192). However, clinical activity and 99mTc(V)-DMSA uptake were significantly correlated (P=0.0001). There was no correlation between the clinical classification and scintigraphic grading. Bilateral orbital index of the active group was significantly higher than that of the inactive group (P=0.0001). CONCLUSION: 99mTc(V)-DMSA imaging discriminates the active from inactive GO as well as showing an ongoing subclinical inflammation in the orbits of the patients with GO, regardless of the disease activity clinically. Our results revealed that 99mTc(V)-DMSA is a promising agent for the diagnosis of active Graves' ophthalmopathy.     

99Tcm(V)-DMSA显像诊断急慢性骨关节炎价值的研究

目的 :研究99Tcm(V) DMSA(二巯基丁二酸钠 )SPECT显像对急慢性骨关节炎的诊断价值。方法 :急性化脓性骨关节炎患者 17例和慢性骨关节病患者 19例行99Tcm(V) DMSA显像 ,并进行半定量分析。结果 :99Tcm(V) DMSA在急性化脓性骨关节炎病灶处有明显趋骨性浓集 ;而慢性骨关节疾病病灶处99Tcm(V) DMSA显像也有明显的趋骨浓集。半定量分析示99Tcm(V) DMSA显像急性化脓性骨关节炎的放射性靶与非靶组织比值 (L/N)为 3.4 95± 0 .74 2 ,慢性骨关节病的放射性靶与非靶组织比值 (L/N)为 3.14 4± 0 .4 0 0 ,二者之间没有明显差异 (P >0 .0 5 )。结论 :99Tcm(V) DMSA可用于骨组织急慢性炎症的诊断 ,但不能区分骨组织病变的良恶性质。     

~(99m)Tc标记annexin V类显像剂细胞凋亡显像在肿瘤研究中的应用及进展

细胞凋亡在肿瘤的发生发展过程中起着重要的作用,成功的肿瘤治疗将在肿瘤组织内诱导肿瘤细胞产生凋亡。99mTc标记annexin V类显像剂凋亡显像能够在体内早期、无创伤性地检测到治疗所引起的细胞凋亡,这将有助于早期评判肿瘤患者的治疗效果及预后。