Uptake Of 67Ga-citrate Research Articles

Thyroid uptake of 67Ga-citrate is associated with thyroid autoimmunity and hypothyroidism in patients with sarcoidosis

To evaluate the association of gallium-67 ((67)Ga)-citrate thyroid uptake with the presence of thyroid disorders in patients with sarcoidosis (S patients). Eighty-four S patients were evaluated by a complete thyroid work-up (neck ultrasound, circulating thyroid hormones and anti-thyroid antibodies, fine-needle aspiration). In S patients with (67)Ga thyroid uptake (respect those without): serum thyroid-stimulating hormone, the titre of anti-thyroid peroxidase (AbTPO) and/or anti-thyroglobulin antibodies (AbTg), and the prevalence of S patients with hypothyroidism or with positive AbTg or AbTPO was significantly higher; a thyroid hypoechoic pattern was more frequent. The prevalence of thyroid nodules was not significantly different between the two groups. Two cases of papillary thyroid cancer were observed in S patients without (67)Ga thyroid uptake, whilst no case in those with (67)Ga thyroid uptake. (67)Ga thyroid uptake is associated with the presence of aggressive autoimmune thyroiditis and hypothyroidism in S patients; thyroid function and ultrasonography should be performed in the presence of (67)Ga thyroid uptake.

Monitoring Treatment Responses in Patients with Pulmonary TB Using Serial Lung Gallium-67 Scintigraphy

Gallium-67 scintigraphy is more sensitive than chest radiography in a single concurrent detection of pulmonary tuberculosis (TB). As for inflammation, the intensity of pulmonary uptake of 67Ga citrate theoretically is a function of the inflammation level in the lung. To maximize clinical applicability of 67Ga scintigraphy in the evaluation of pulmonary TB, we prospectively assessed serial qualitative associations between intensity of the uptake of 67Ga citrate and the severity of lung inflammation, reflected by the burden of Mycobacterium tuberculosis in the sputum of patients undergoing anti-TB chemotherapy. Each enrolled patient had chest radiographic, microbiologic, 67Ga imaging, and semiquantitation of sputum acid-fast bacillus (AFB) assessments before and at the third and sixth months after receiving anti-TB chemotherapy. The burden of pulmonary M. tuberculosis (presumably, in proportion to the semiquantitation of AFB in sputum) and the intensity of 67Ga citrate uptake in the lung at each synchronized assessment were regarded as a paired variable. Odds ratios were obtained from odds (derived using generalized estimating equations) in favor of higher pulmonary 67Ga uptake in differing scores of semiquantitation of sputum AFB. Linear trend for pulmonary 67Ga citrate uptake corresponding to varied pulmonary M. tuberculosis burdens was assessed using contrast analysis of their odds ratios. Thirty patients (24 men and six women) with pulmonary TB were enrolled. Eighty-six paired semiquantitations of sputum AFB-67Ga-scintigraphic studies were collected. Twenty-six patients were cured of their pulmonary TB. The pulmonary 67Ga uptake increased in proportion to the higher score of semiquantitation of sputum AFB (p = 0.009, for trend). In patients with pulmonary TB, the higher the burden of M. tuberculosis in the lung, the higher the intensity of pulmonary 67Ga citrate uptake. Serial 67Ga-scintigraphy examinations are helpful in evaluations of the effectiveness of anti-TB therapy when assessments based on chest radiography are difficult.

Chronic Pyelonephritis Presenting as Multiple Tumor-Like Renal Lesions

We encountered a 49-year-old Japanese man in whom tumor-like renal lesions developed as a result of chronic Staphylococcus aureus pyelonephritis. The patient complained of general fatigue, weight loss, and anorexia for 6 months. Contrast-enhanced computed tomography (CT) of the abdomen revealed multiple low-density lesions in both kidneys and paraaortic lymphadenopathy. A strong uptake of Ga67 citrate in the lesions and elevation of serum soluble interleukin-2 receptor and thymidine kinase activity were strongly suggestive of primary renal lymphoma; however, histologic examination of renal biopsy specimens revealed severe tubulointerstitial change, consistent with chronic pyelonephritis. Following systemic antibiotic treatment, multiple tumor-like lesions regressed 4 months later. This case suggested that chronic pyelonephritis could present as bilateral renal tumors.

Dramatic change of Ga-67 citrate uptake before and after corticosteroid therapy in a case of cardiac histiocytosis (Erdheim-Chester disease)

Dramatic change of Ga-67 citrate uptake before and after corticosteroid therapy in a case of cardiac histiocytosis (Erdheim-Chester disease)

Unusual uptake on gallium-67 imaging in organizing pneumonia.

Gallium-67 imaging has been used not only as an aid in the evaluation of disease activity, but also to estimate the response to treatment with corticosteroids. The authors described a successfully treated organizing pneumonia with unusual intense Ga-67 citrate uptake. A 65-year-old man was hospitalized with a 6-month history of cough. A Ga-67 scan showed unusually intense uptake in the right lung. Transbronchial lung biopsy and bronchoalveolar lavage specimens revealed organizing pneumonia with no evidence of bacterial colonization. Soon after receiving intravenous methylprednisolone for 3 days, the consolidation rapidly shrunk, and Ga-67 uptake improved.

Differentiation of Low-Grade Gastric MALT Lymphoma and High-Grade Gastric MALT Lymphoma: The Clinical Value of Ga-67 Citrate Scintigraphy—A Pilot Study

Ga-67 citrate scintigraphy has been routinely and extensively used to evaluate non-Hodgkin's lymphoma (NHL) for more than 20 years. Gastric lymphoma of mucosa-associated lymphoid tissue (MALT) is by far the most common extranodal primary NHL. Gastric MALT lymphoma can be classified as low-grade (LG) or high-grade (HG). Low-grade gastric MALT lymphoma can be cured by eradication of Helicobacter pylori; but radiotherapy and/or chemotherapy and/or surgery are the major methods of treatment for the HG gastric MALT lymphoma. However, it is difficult to differentiate these two groups by clinical parameters and endoscopic findings. The purpose of this study was to determine whether Ga-67 citrate scintigraphy can distinguish the LG gastric MALT lymphoma from the HG gastric MALT lymphoma. Twenty-one patients (11 men and 10 women ranging in age from 38 to 83 years) with histologically confirmed gastric MALT lymphoma were enrolled. Twelve patients had LG and nine patients had HG. All 21 patients underwent Ga-67 citrate scintigraphy before treatment. The results of Ga-67 citrate scintigraphy were classified as positive or negative. In the LG group, nine patients had negative results and three patients had positive results. In the HG group of nine patients, all patients had positive results. Among the three patients who had positive results in the LG group, the uptake of gastric MALT lymphoma was lower than that of the liver. The Ga-67 citrate scintigraphy is of good clinical value for the differentiation of the LG gastric MALT lymphoma and the HG gastric MALT lymphoma. We think that the major value of Ga-67 citrate scintigraphy will be in following the patients with HG gastric MALT lymphoma after treatment to assess response of therapy and to detect possible recurrence and perhaps in determining transformation from the LG to HG gastric MALT lymphoma. However, further investigation is needed to understand the relationship between the uptake of Ga-67 citrate in gastric MALT lymphoma and transformation.

Simultaneous Tc-99m MDP and Ga-67 citrate uptake of benign lymphoid hyperplasia in the mastoid region.

Simultaneous Tc-99m MDP and Ga-67 citrate uptake of benign lymphoid hyperplasia in the mastoid region.

Histiocitoma fibroso maligno de partes blandas. Visualización en gammagrafía ósea

Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignant tumour in late adult life. MFH has been mentioned to have avid uptake of 67Ga citrate, and only 38% is uptake of 99mTc-MDP, although few cases of MFH have been reported. We present the case of a 73 years old male patient with MFH. In the blood pool phase of the bone scintigraphy, MFH was presented as an intense hyperactive lesion. In the late phase the tumor is one of the few MFH described to have avid uptake for 99mTc-MDP. In this work we also review some cases of MFH described and the different techniques used in the diagnosis and follow-up of these tumours.

Symmetrically increased uptake of Ga-67 citrate in the breasts: A patient with liver cirrhosis

A 63-YEAR-OLD man presented with liver cirrhosis with ascites and splenography. He was referred to our department for performance of a whole body scan of gallium (Ga-67) citrate. In addition to bilateral diffusely increased radioactivity in the lung fields, liver atrophy, and splengography, the gallium scan revealed 2 symmetrically round foci with intense radioactivity in the anterior aspects of the lower chest (Fig 1). His chest x-ray revealed no active lung lesion. The patient had marked breast hypertrophy, but no breast mass or inflammatory signs were noted on the physical examination. This incidental finding on the gallium scan was thought to be caused by gynecomastia, presumably because circulating estrogens are not inactivated in patients with liver cirrhosis. Common 1) Physiological conditions a) Postpartum 1-7 b) Pregnancy 8,9 c) Puberty I,l~ 2) Drug induced a) Estrogen TM ~,~ b) Oral contraceptives containing estrogens 2 c) Reserpine 2 d) Tofranil 2 e) Meprobamate 2 f) Prochlorperazine 2.13,14 g) Phenothiazines 8 h) Metoclopramide 13,14 i) Chlorpromazine 14,2s 3) Gynecomastia a) Orchiectomy 8,12,16,17 b) IdiopathiO s c) Liver cirrhosis Uncommon 1) Renal Failure 2 2) Obesity 2 3) Postabortion 4 4) Idiopathic galactorrhea 8,19 Rare 1) Breast augmentation with silicon 2~ 2) Choriocarcinoma 22 3) Non-African Burkitt's lymphoma 23 4) Neonate with breast feeding 24 5) Hypothalamic granuloma 25

Therapy and prevention of arthritis by recombinant adeno-associated virus vector with delivery of interleukin-1 receptor antagonist.

To evaluate the recombinant adeno-associated virus vector encoding interleukin-1 receptor antagonist (rAAV-IL-1Ra) complementary DNA for its potential in the treatment and prevention of lipopolysaccharide (LPS)-induced arthritis. The therapeutic effect of rAAV-IL-1Ra on arthritis was studied by injecting knees of Sprague-Dawley rats with LPS and rAAV-IL-1Ra and then evaluating the severity of arthritis by leukocyte counts in synovial fluid, histologic changes of synovium, and uptake of 67Ga citrate in joint tissue. To study the therapeutic effect on recurrent arthritis, we induced recurrent arthritis by a second injection of LPS 80 days after primary LPS and rAAV-IL-1Ra injections and then evaluated the severity of recurrent arthritis. To study the prevention of arthritis, rAAV-IL-1Ra was injected into normal joints. After 100 days, LPS was used to induce arthritis, and the severity of arthritis was evaluated. The production of the rAAV-IL-1Ra transgene was up-regulated by LPS-induced joint inflammation and proved to be efficacious in the therapeutic and preventative protocols. Not only primary but also recurrent arthritis could be suppressed by a single injection of rAAV-IL-1Ra. We found that the transgene expression of IL-1Ra could be reactivated by a second challenge with LPS delayed for 80 days after rAAV administration. The therapeutic level of IL-1Ra protein reached a mean +/- SD of 5.8+/-0.5 ng/ml in synovial fluid. In addition, the rAAV transgene persisted within normal joints for at least 100 days and could still be induced to express, after LPS insult, a high level of IL-1Ra (mean +/- SD 5.2+/-0.8 ng/ml) that prevented the occurrence of arthritis. This gene therapy, by combining highly efficient and stable rAAV gene delivery, disease-regulated gene expression, and the antiinflammatory effect of IL-1Ra, provides a valuable approach for long-term protection against, and prevention of, arthritis.

Diffuse lung uptake of Ga-67 citrate in treated lymphoma: another milestone on the road to understanding.

There are approximately 51,000 new cases of non-Hodgkin lymphoma and 7,800 new cases of Hodgkin disease reported yearly. Combined, these diseases account for 23,000 deaths. As medical oncology advances, the probability of curing cancer will increase because of improvements in diagnostic and therapeutic interventions. Anatomic diagnostic studies such as computed tomography (CT) and magnetic resonance (MR) imaging are generally used to identify and stage lymphoma; however, when the involved nodes are of normal size, CT and MR imaging are incapable of helping to distinguish between normal nodes and those involved with either Hodgkin or non-Hodgkin lymphoma. The problem of differentiating active lymphoma from scar or necrosis in residual masses after radiation therapy and/or chemotherapy, especially in the thorax, has been well documented in the medical literature. Whether gallium imaging is useful in this situation has been the subject of controversy over the years, and there have been many important detours and milestones on the road to our understanding of the role that gallium-67 scintigraphy should play. 22 refs.

Evaluation of hilar 67Ga-citrate uptake in bronchogenic carcinoma

We evaluated hilar uptake on 67Ga-citrate scintigraphy and correlated with hilar lymph node metastases in one-hundred seventeen cases (two-hundred thirty four hila) of bronchogenic carcinoma. Hilar uptake was classified into three grades independently on anterior and posterior chest views: no uptake (grade 0), uptake equal to that in the thoracic vertebrae (grade 1), uptake higher than that in the thoracic vertebrae (grade 2). If a summed grade of anterior and posterior view was larger than 3, hilar uptake was considered as positive. In forty-four cases (forty-nine hila) with hilar lymph node metastases, positive hilar uptake was found in ten cases (eleven hila), resulting in sensitivity of 22% based on cases and 23% based on hila. In seventy-three cases (one-hundred forty-six hila) without hilar lymph node metastases, positive hilar uptake was found in six cases (ten hila), resulting in specificity of 91% based on cases and 93% based on hila. In comparison to scintigraphic findings of unilaterally positive hilar uptake, findings of bilaterally positive hilar uptake showed significantly lower accuracy in determining presence of hilar lymph node metastases. No definite correlation between hilar uptake and histopathology or 67Ga-citrate uptake in a primary tumor was observed. The results indicate that usefulness of 67Ga-citrate scintigraphy is limited when evaluating hilar lymph node metastases in bronchogenic carcinoma.

65Zn uptake by liver of rats fed 3′-methyl-dimethylaminoazobenzene

The uptake of 65Zn, determined by γ-counting and also by autoradiography, significantly increased with the increasing level of metallothionein in liver 4 weeks after the start of feeding a diet containing 3′-methyl-dimethylaminoazobenzene (3′-Me-DAB), at which time the serum γ-glutamyl transpeptidase activity was not yet significantly elevated. At this time, furthermore, hepatic uptake of 67Ga-citrate did not increase and that of 99mTc-Sn-colloid decreased in 3′-Me-DAB-fed rats. These results suggest that a short-life gamma-emitting isotope such as 69mZn may be useful for the detection at the early stage of hepatic carcinogenesis.

Soft-tissue tumors: diagnosis with Tc-99m (V) dimercaptosuccinic acid scintigraphy.

To assess the potential of technetium-99m (V) dimercaptosuccinic acid (DMSA) scintigraphy for diagnosis of soft-tissue tumors. Tc-99m (V) DMSA scintigraphy was performed in 76 patients with histologic proof of soft-tissue tumors. In 57 of these patients, gallium-67 citrate scintigraphy was performed within 2 weeks after Tc-99m (V) DMSA scintigraphy. Uptake of Tc-99m (V) DMSA was clearly detected in almost all sarcomas, metastatic carcinomas, highly recurrent benign tumors (ie, extra-abdominal desmoids and tenosynovial giant cell tumors), superficial and deep hemangiomas, and granulomatous soft-tissue lesions but was not found in other benign solid tumors of soft tissue. Uptake of Ga-67 citrate was clearly detected in all inflammatory lesions and metastatic carcinomas, eight of 14 sarcomas (57%), and two of 10 highly recurrent benign tumors (20%) but was not found in hemangiomas or benign soft-tissue tumors. Low-grade malignant and highly recurrent benign lesions, which often recur after surgery, were detected more accurately with Tc-99m (V) DMSA scintigraphy than with Ga-67 citrate scintigraphy.

Effects of metastatic and non-metastatic mammary adenocarcinoma on tissue distribution of gallium-67 in the rat

The purpose of this work was to study the effect of metastatic and non-metastatic mammary adenocarcinoma on tissue distribution of gallium-67 (67 Ga) citrate in Fischer-344 female rats by the use of gamma counting techniques. The homogenate (0.1 mm) of a sample of metastatic and non-metastatic tumor was implanted by subcutaneous injection in the right footpad of each animal's hind extremity. The animals bearing metastatic tumor were studied 2-24 days and the non-metastatic group 2-30 days after the implantation of tumor homogenate. The control group consisted of four animals and tumor-bearing groups of seven to eight animals at each time point. All animals were injected with 1.11 MBq of 67Ga citrate by intravenous administration and sacrificed in halothane anesthesia 48 h later. The relative tissue uptake data are presented as arithmetical mean value with a standard error and graphically demonstrated as normalized data with respect to control. The results demonstrate that 67Ga citrate uptake was largely unaffected in most organs by the presence of either metastatic or non-metastatic tumor. Gallium-67 uptake, however, was significantly and consistently increased in the popliteal lymph nodes of the ipsilateral extremity of tumor implant in the metastatic group. No difference was observed in the non-metastatic tumor group. The findings of this experimental work indicate that the host reaction to the tumor does not modify the gallium uptake characteristics in the normal tissues of tumor-bearing animals.

Lung inflammation in coal miners assessed by uptake of 67Ga-citrate and clearance of inhaled 99mTc-labeled diethylenetriamine pentaacetate aerosol.

We compared the diffuse lung uptake of 67Ga-citrate, an index of inflammatory lung activity, with the lung clearance of inhaled 99mTc-labeled diethylenetriamine pentaacetate (DTPA) aerosol, an index of pulmonary epithelial permeability, in a group of 19 West Virginia coal miners whose pulmonary status was compatible with coal worker's pneumoconiosis. 99mTc-DTPA clearance alone and 67Ga-citrate uptake alone were measured in nine and five additional subjects, respectively. The objective of this study was to determine if increased 99mTc-DTPA lung clearance was caused by inflammation at the lung epithelial surfaces. Subjects inhaled approximately 150 microCi (approximately 5.6 MBq) of 99mTc-DTPA aerosol, and quantitative gamma camera images of the lungs were acquired at 1-min increments for 25 min. Regions of interest (ROI) were selected to include (1) both lungs; (2) each individual lung; and (3) the upper, middle, and lower thirds of each lung. 99mTc-DTPA clearance was determined from the slopes of the respective time-activity plots for the different ROI. Each subject was intravenously administered 50 miCroCk (1.9 MBq)/kg 67Ga-citrate 48 to 72 h before imaging the body between neck and pelvis. The extent of 67Ga-citrate lung uptake was expressed as the gallium index (GI). Mean radioaerosol clearance half-time (T1/2) for the six nonsmoking coal miners (60.6 +/- 16.0 min) was significantly shorter (p less than 0.001) than for the nonsmoking control group (123.8 +/- 28.7 min). T1/2 for the 12 smoking miners (18.4 +/- 10.2 min) was shorter than for the smoking control group (33.1 +/- 17.8 min), but the difference did not attain statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

Intense Muscle Uptake of Ga-67 Citrate and Tc-99m MDP in a Patient with Aplastic Anemia

An unusual distribution of Tc-99m MDP and Ga-67 citrate in several muscle groups is described in a 14-year-old boy with aplastic anemia and normal renal function at the time of imaging. Although the patient did not develop musculo-skeletal signs or symptoms, a subsequent autopsy revealed widespread muscle calcification.

Marked Uptake of Ga-67 Citrate in A Giant Leiomyoma Uteri

Marked Uptake of Ga-67 Citrate in A Giant Leiomyoma Uteri

Current Concepts in the Management of Sarcoidosis

Sarcoidosis can affect almost every organ. It has diverse clinical presentations and a variable natural history. Lungs and intrathoracic lymph nodes are the most commonly involved tissues. A major challenge to clinicians is the early identification of those patients with aggressive disease in whom therapy might arrest progression. Although lung uptake of 67Ga citrate, elevated serum angiotensin converting enzyme (ACE) levels and elevated T lymphocyte count in bronchoalveolar lavage fluid are all thought to reflect disease activity, they are by no means reliable markers. Because recent studies have shown that corticosteroid treatment does not avert pulmonary fibrosis and permanent impairment of pulmonary function, the use of these agents is restricted to the palliative treatment of disabling symptoms and physiological derangements. Corticosteroids are effective in reducing ocular inflammation, correcting hypercalcaemia, improving pulmonary function and alleviating symptoms related to hepatic, splenic, articular, myocardial, neural and cutaneous involvement. In the small proportion of patients who do not respond to moderate tolerable doses of steroids, alternative drug therapy such as immunosuppressives or immune modulators must be considered.

Effects of iron-binding proteins on in vitro uptake of 67Ga-citrate by tumor cells

A comparative study of carrier-free 67Ga-citrate uptake by Ehrlich ascites tumor cells in the presence of lactoferrin, transferrin and ferritin has demonstrated that lactoferrin considerably increases the uptake of 67Ga, and that this increase seems to be determined by its iron-load. The other iron-binding proteins assayed have a null or negative effect. Their behavior in the presence of sodium citrate supports the concept of lactoferrin-binding by the cells as responsible for the uptake. The different behavior of 67Ga-citrate iron-binding protein complexes appears to support this hypothesis.