Tumor imaging with carbon-11 labeled alpha-aminoisobutyric acid (AIB) in patients with malignant melanoma.

The potential usefulness of [C-11]-labeled alpha-aminoisobutyric acid (AIB) for tumor imaging has been demonstrated previously in our findings of increased tumor uptake with C-14-labeled AIB in human melanoma heterotransplants in nude mice, and subsequently, in a single case study using C-11 AIB to demonstrate the extent of metastases in patient with widespread malignant melanoma. We report here on the use of C-11 AIB in ten patients with metastatic or unresectable malignant melanoma. Five patients had intense tracer uptake at all known sites of tumor involvement.

Correlation between iodine-131 MIBG imaging and biological markers in advanced neuroblastoma.

I-131 metaiodobenzylguanidine (MIBG) imaging was performed in 38 patients with advanced neuroblastoma. Abnormal images were found in patients with elevations of urinary vanillylmandelic acid and dopamine and high serum neuron-specific enolase levels. Normal or minimal elevation of markers was seen in patients with negative images.

Perfusion of colorectal hepatic metastases. Relative distribution of flow from the hepatic artery and portal vein.

The importance of portal circulation in the delivery of drugs and nutrients to colorectal hepatic metastases is controversial. Using 13N (nitrogen 13) amino acids and ammonia with dynamic gamma camera imaging, we demonstrate, for the first time in human beings, a quantitative advantage of hepatic artery compared with portal vein infusion. Eleven patients were studied by hepatic artery injection, five patients were studied by portal vein injection, and two patients had injections through both routes.

Abnormal gallium scintigraphy in pulmonary alveolar proteinosis (PAP).

A patient with medulloblastoma of the cerebellum developed dyspnea and hypoxemia. Pulmonary function tests showed decreased lung volume and diffusing capacity, while the chest radiographs initially showed only mild interstitial infiltrates. Repeated gallium scans showed diffuse lung uptake and diagnosis of pulmonary alveolar proteinosis was made by open lung biopsy.

Imaging studies of patients with malignant fibrous histiocytoma using C-11-alpha-aminoisobutyric acid (AIB).

Alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid which is rapidly transported into viable cells by the A-type or alanine-preferring amino acid transport system, has been labeled with the short-lived, positron-emitting radionuclide carbon-11. Carbon-11 labeled AIB is currently being evaluated as a tumor imaging agent for in vivo amino acid transport studies in patients with cancer. In this study, C-11 AIB was used to image two patients with malignant fibrous histiocytoma (MFH), a pleomorphic sarcoma.

Technetium-99m albumin scintigraphy in the diagnosis of protein-losing enteropathy.

While several studies have documented protein losing enteropathy by measuring the excretion of intravenously administered 131I- or 51Cr-labeled albumin, the efficacy of 99mTc-labeled albumin in detecting protein loss in the bowel has not been described. We report here a case of severe protein-losing enteropathy demonstrated by abnormal excretion of 99mTc albumin into the bowel.

Technetium-99m RBC venography revealing bilateral iliac vein obstruction.

Tc-99m RBC venography demonstrated bilateral iliac vein obstruction with subsequent collateral flow through the internal iliac veins into the internal and perimuscular rectal plexuses.

Gallbladder visualization on a technetium-99m MDP bone scan.

A bone scan performed on a 54-year-old woman with metastatic breast carcinoma and concurrent cholelithiasis demonstrated intense gallbladder concentration of radionuclide.

Tumor imaging with carbon-11 labeled alpha-aminoisobutyric acid (AIB) in a patient with advanced malignant melanoma.

A 29 year-old-man presenting with advanced metastatic malignant melanoma was successfully imaged using carbon-11 (11C) labeled alpha-aminoisobutyric acid (AIB), a synthetic, non-metabolized amino acid transported into viable cells by the A-type, or alanine-preferring, amino acid transport system. Tumor located in the hilum of the lung was well visualized with 11C-AIB prior to chemotherapy. A gallium image with liver subtraction using 99mTc-sulfur colloid demonstrated regions of increased activity in liver which correlated with regions of increased activity on the 11C-AIB liver image.

Imaging of human tumors and organs with N-13-labeled L-methionine.

The work described herein is the first reported use of nitrogen-13-labeled L-methionine in human subjects. Three volunteers and 14 patients with a variety of solid tumors were scanned after intravenous administration of L-(N-13) methionine. In both volunteers and cancer patients, uptake of label was seen in the liver and pancreas, with smaller amounts of label detected in the heart, urinary bladder, and salivary glands.

Radioactive iodine treatment of metastatic thyroid carcinoma with clinical thyrotoxicosis.

We present a case of well-differentiated follicular carcinoma of the thyroid with hyperfunctioning metastases and clinical thyrotoxicosis. The recommended I-131 treatment dose for patients with widespread bone metastases from thyroid carcinoma is 200 mCi. However, in a patient with hyperfunctioning metastatic tumor and increased radioiodine uptake, the treatment dose should be modified.

Predicting tumor response in patients with colorectal hepatic metastases.

Until now, there has been no reliable means of predicting tumor response to chemotherapy in patients with metastatic colorectal cancer. Using arterial nuclide flow scans as a determinant of tumor response, the degree of tumor perfusion was evaluated in a blinded prospective study. Seventy-three patients with colorectal hepatic metastases received continuous hepatic arterial (N = 52) or systemic intravenous (N = 21) chemotherapy using an implantable pump.

Early detection of anthracycline-induced cardiotoxicity by stress radionuclide cineangiography in conjunction with Fourier amplitude and phase analysis.

Thirty-three cases of anthracycline related cardiotoxicity occurred in our institution in patients with a previously negative cardiovascular history, physical examination, and normal ECG. A total of 95 RNCA studies were performed in this group (73 studies included both rest and exercise RNCA). Twenty-one patients had two or more serial studies.

Airway humidification with high-frequency jet ventilation.

Humidification of inspired gases is indispensible to prevent serious injury to the tracheal mucosa of patients on mechanical ventilation. High-frequency jet ventilation (HFJV), recently introduced for the management of some forms of respiratory failure, presents unusual technical problems of humidification. The present investigation evaluated a technique to humidify jet gases by delivering small droplets of normal saline in front of the injector cannula, and utilizing the jet flow to nebulize the fluids administered.

Combined Fourier amplitude and phase imaging in patients with coronary artery disease.

Fourier amplitude and phase image analysis were evaluated in 66 patients. Thirty patients served as a control group and 36 had coronary artery disease (CAD). Each patient in our control group had a rest and exercise radionuclide cineangiogram (RNCA) study (60 total).

A clinical evaluation of the RNCA study using Fourier filtering as a preprocessing method.

Forty-one patients (25 male, 16 female) were studied by RNCA in our institution. There were 42 rest studies and 24 stress studies (66 studies total). Sixteen patients were normal, 15 had ASHD, seven had a cardiomyopathy, and three had left-sided valvular regurgitation.

Fourier amplitude and phase analysis in the clinical evaluation of patients with cardiomyopathy.

Fifty-four patients with a cardiomyopathy were studied by RNCA and Fourier amplitude and phase image analysis. The study group included patients with ischemic cardiomyopathy (27) and an equal number of patients with a primary cardiomyopathy: drug-induced (22), idiopathic (three), radiation-induced (one), and amyloidosis (one). Twenty-eight patients had rest studies alone and 26 had both rest and stress studies (80 total).

Semiquantitative gallium scintigraphy in patients with osteogenic sarcoma.

Sequential gallium scans were performed in 37 patients with newly diagnosed osteogenic sarcoma. High gallium uptake was found more often in males in the 10 to 19 age group and in femoral lesions. High uptake was also seen in patients who had predominantly osteoblastic or mixed changes on radiographs and in those who had a soft tissue mass.

In vivo studies of 111In-labelled canine lymphocytes.

[111In]oxine was used to label canine periperal blood lymphocytes from two normal animals and one animal with breast carcinoma. Using 150 microCi of [111In]oxine to label 50 X 10(6) cells yielded a labeling efficiency between 40 and 75% and a viability of about 95%. Gamma camera images obtained 24-44 h after injection showed uptake in the subcutaneous lymph nodes of the head, neck, axilla, pelvis and popliteal regions.

Intratumoral consumption of indium-111 labeled platelets in a patient with hemangiomatosis and intravascular coagulation (Kasabach-Merritt syndrome).

Previous studies regarding sites of platelet destruction in patients with the Kasabach-Merritt syndrome are conflicting. The authors recently studied an adult patient with multiple large hemangiomata, thrombocytopenia, and intravascular coagulation by external imaging following the injection of autologous Indium-111 labeled platelets. Sequential images showed prompt accumulation of platelet-associated radioactivity in areas within the right hemithorax which corresponded to certain tumors noted on the chest roentgenogram.

Quantitative scanning of soft-tissue sarcomas with nitrogen-13-labeled L-glutamate.

Nitrogen-13-L-glutamate, a labeled amino acid enzymatically synthesized from cyclotron-produced N-13 ammonia and alpha-ketoglutaric acid, was used as an imaging agent in 14 patients with soft-tissue sarcomas. Concentration of nitrogen-13 label within the sarcoma was seen in 11 of the 14 patients; in some cases, clinically inapparent metastatic tumor lesions could also be detected. In eight patients, the tumor response to chemotherapy was evaluated by serial studies with this agent.

PET tomographic imaging of the human heart, pancreas, and liver with nitrogen-13 derived from [13N]-L-glutamate.

The first commercial version of the Massachusetts General Hospital (MGH) positron camera was used to image the relative distributions of 13N (T1/2 = 9.96 min) in the human heart, pancreas, and liver after intravenous administration of [13N]-L-glutamate. The instrument was operated in two imaging modes.