Assessment of striatal dopamine D2/D3 receptor availability with PET and 18F-desmethoxyfallypride: comparison of imaging protocols suited for clinical routine.

Unlabelled: Assessment of striatal dopamine receptor availability with (18)F-desmethoxyfallypride PET is of high diagnostic utility in parkinsonism. The present study was undertaken to define the optimal clinical scan protocol with regard to quantification accuracy and scan time.

Methods: Fourteen patients with parkinsonian syndromes underwent (18)F-desmethoxyfallypride PET over 90 min.

Dual-biomarker imaging of regional cerebral amyloid load and neuronal activity in dementia with PET and 11C-labeled Pittsburgh compound B.

Unlabelled: PET studies with biomarkers of regional neuronal activity (cerebral glucose metabolism or blood flow [CBF]) and amyloid-β (Aβ) depositions provide complementary information for the early diagnosis of dementia and follow-up of patients with dementia. We investigated the validity of relative regional CBF estimates (R(1)) gained from pharmacokinetic analyses of (11)C-labeled Pittsburgh compound B ((11)C-PIB) PET studies as a marker of neuronal activity and neurodegeneration.

Methods: Twenty-two patients with cognitive impairment (16 patients with early Alzheimer disease) underwent (18)F-FDG and (11)C-PIB PET studies for the assessment of regional glucose metabolism and Aβ load.

3D-Cardiac-PET. A Recommendable Clinical Alternative to 2D-Cardiac-PET?

The objective of this study was to test the clinical practicability of a 3D-cardiac-positron emission tomography(PET) procedure. During preoperative viability diagnostics of the myocardium with fluorine-18-fluorodeoxyglucose(18F-FDG)PET, comparative recordings were made in 2D (ECAT Exact) and 3D Mode (Quest). Ten patients (2 women, 8 men, ages 34-72 years) with coronary artery disease and a known myocardial infarction in the history were examined.

Follow-up in neuroblastoma: comparison of metaiodobenzylguanidine and a chimeric anti-GD2 antibody for detection of tumor relapse and therapy response.

Early and correct diagnosis of local tumor recurrence, occurrence of metastases, and therapy response are essential in patients with neuroblastoma stage IV. The aim of the study was to evaluate the diagnostic value of metaiodobenzylguanidine (mIBG) and a chimeric GD2 antibody in the follow-up of patients with neuroblastoma. In a prospective study, mIBG (N = 31 scans) and immunoscintigraphy were compared with a chimeric antiganglioside antibody, ch14.

Investigations on skeletal growth zones via bone scans as base of determination of optimal time for surgery in mandibular asymmetry.

Unlabelled: AIM of the study was to find out wether there is a common stop of growth of mandibular bone, so that no individual determination of the optimal time for surgery in patients with asymmetric mandibular bone growth is needed. As there are no epiphyseal plates in the mandibular bone, stop of growth cannot be determined on X-ray films.

Methods: Bone scans of 731 patients [687 patients (324 male, 363 female) under 39 y for exact determination of end of growth and 44 (21 male, 23 female) patients over 40 y for evaluation of non-growth dependent differences in tracer uptake] were reviewed for the study.

Influence of patient position in myocardial SPECT on the diagnosis of CHD.

Aim: Of the study was to show that changing patient position from supine to prone results in improved specificity of myocardial SPECT (MS).

Methods: We examined the influence of patient position in MS on the diagnosis of coronary heart disease (CHD) in 151 patients. By using a Tc-99m-labeled compound (Tetrofosmin, Myoview, Nycomed, Amersham) examinations could be performed in supine and prone position within 35 minutes.

Differential diagnosis of metastases in bone scans: chemotherapy induced bone necrosis.

Aim: Influenced by the incorrect diagnosis of a bone metastasis caused by bone necrosis we evaluated reasons and frequency of bone necrosis in patients referred for bone scanning in follow-up of tumors.

Methods: Bone scans performed within two years on patients with primary bone tumors or tumors metastatic to bone were reviewed in respect to the final diagnosis bone necrosis.

Results: We found the cases of three young patients who presented the appearance of hot spots on bone scintigrams which were finally diagnosed as bone necrosis.

[Differential diagnosis of childhood osteomyelitis--classification according to scintigraphic, radiologic and magnetic resonance tomographic characteristics].

We present a retrospective study on children with the final diagnosis osteomyelitis, who have been examined in Tübingen from 1985 to 1991. The different types of infantile osteomyelitis were classified due to the causative organism and findings in 3-phase scintigraphy and X-ray films. For the chronic type of osteomyelitis the study was extended to the years from 1979 to 1991 and the results of an earlier report were included.

Catecholamine secreting glomus tumor detected by iodine-123-MIBG scintigraphy.

We report the case of a 41-yr-old woman who presented with arterial hypertension and tinnitus in the right ear synchronous with pulse. She had previously undergone surgery for suspected pheochromocytoma without positive therapeutic effect. CT and MRI revealed a homogenous tumor with contrast enhancement in the right hypotympanon and foramen jugulare, and [123I]metaiodobenzylguanidine (MIBG) scintigraphy demonstrated strong tracer uptake in the same area.

Experimental topographic study of high-resolution tympanocochlear scintigraphy using the human temporal bone model.

To determine the diagnostic value of tympanocochlear scintigraphy (TCS), which is still used for the visualization of alterations of labyrinthine bone metabolism due to active otosclerosis, resolution and detection limits were examined in a normal human temporal bone model. After incubation in technetium-99m-labeled diphosphonate solution, scintigraphic imaging showed the zygomatic process and the clivus as landmarks for fine structures of the petrous bone. For further differentiation, labyrinthine fine structures were marked with radioactive tracers of 0.

A phase I study of human/mouse chimeric antiganglioside GD2 antibody ch14.18 in patients with neuroblastoma.

9 patients with stage IV neuroblastoma were treated with 19 courses of human/mouse chimeric monoclonal antiganglioside GD2 antibody ch14.18 at dose levels of 30, 40 and 50 mg/m2/day for 5 days per course. The maximum tolerated dose (MTD) per injection was 50 mg/m2/day.

Incidental finding of a hepatic lesion: differential diagnostic problems for fibrolamellar hepatic carcinoma.

We report the case of a 39-yr-old female with a liver lesion that was incidentally detected by ultrasound. Examination of biopsy specimens revealed focal nodular hyperplasia. A metastatic tumor in the right os ilium developed in the following weeks and showed specific uptake of 99mTc-hepatic 2,6-dimethyliminodiacetic acid (HIDA), suggesting metastasis from a differentiated hepatocellular carcinoma.

[Follow-up evaluation of metastatic neuroblastoma using high dose [131I-meta]iodobenzylguanidine].

Between 1989 and 1990 nine children with neuroblastoma stage IV (according to Evans) have been treated with high-dose [131I-meta]Iodobenzylguanidine (HD-mIBG). The total HD-mIBG dose administered to each child was at mean 699.3 +/- 111 MBq/kg body weight.

Noninvasive procedures for diagnosis of renovascular hypertension in renal transplant recipients--a prospective analysis.

The purpose of this study was to clarify the selectivity and specificity of noninvasive procedures for diagnosis of clinically suspected posttransplant renovascular hypertension. We prospectively investigated 25 renal transplant recipients with arterial hypertension and clinically suspected stenosis of the graft artery (8 female and 17 male patients; ages 45 +/- 15 years). We performed a captopril test with 25 mg captopril (n = 25), renography with technetium-99m diethylene triamine penta-acetic acid (99mTc-DTPA) before and after angiotensin-converting enzyme (ACE) inhibition with determination of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) (n = 23) and color-coded duplex ultrasonography of the transplant kidney vessels (n = 24).

A phase I study of neuroblastoma with the anti-ganglioside GD2 antibody 14.G2a.

Nine patients with neuroblastoma stage IV were treated with the murine monoclonal antibody 14.G2a, directed against disialoganglioside GD2. The antibody was injected daily for 5-10 days and the total applied dosage ranged between 100 mg/m2 and 400 mg/m2.

Case report 756: Chronic multifocal osteomyelitis.

We report the case of a young boy referred to our Department of Nuclear Medicine under the suspicion of a malignant tumor. The leading clinical symptoms were pain in the joints and loss of weight and vitality. Radiographic findings were suggestive of osteogenic sarcoma, but bone scans showed multiple increased tracer depositions along the cortex of femur and tibia, and in the lower and upper jaw.

Detection of infection in postoperative orthopedic patients with technetium-99m-labeled monoclonal antibodies against granulocytes.

A prospective study of 106 orthopedic patients was performed for the detection of infection in the early postoperative stage using 99mTc-labeled murine Mabs directed against epitopes on granulocytes. Accuracy was 81% in the hips (n = 26), 81% in the thigh (n = 21), 84% in the knee (n = 19), and 100% in the tibia (n = 27). The technique did not work well in the spine where false-negative results were observed in the three patients studied.

Treatment of neuroblastoma with [131I]metaiodobenzylguanidine: long-term results in 25 patients.

From 1984 to 1990 we have treated altogether 25 children with [131I]metaiodobenzylguanidine (131I-MIBG) for a refractory, relapsed or metastasized neuroblastoma. Three children had stage III and 22 children had stage IV of the disease; at diagnosis their ages were between 4 months and 10 years. Children with stage III disease had at diagnosis a median age of 3.

[Comparative diagnosis of focal liver changes using computed tomographic and scintigraphic methods].

The value of scintigraphic methods for the diagnosis of focal lesions of the liver (IDA, colloids, blood pool) in comparison to dynamic sequential computer tomography (CT) has been examined in this study. We found CT to be diagnostic in typical cases. For example, focal nodular hyperplasia is characterized by a rapid, strong increase and subsequent decrease after application of contrast medium (71%), whereas hemangiomas show a delayed density increase mostly at the rim (20%).

Application of an anti-myosin antibody for scintigraphic differential-diagnosis of infantile tumors.

Immunoscans with the Fab-fragment of the monoclonal anti-myosin antibody R11D10 labeled with 111In showed significant uptake in rhabdomyosarcoma, rhabdoid tumor, and primitive neuroectodermal tumor. The diagnosis of an antimyosin positive or negative tumor with the aid of the immunoscan was superior to clinical findings in combination with ultrasound and CT, and to histological diagnosis in tumor biopsies. In addition chemotherapeutically induced renal impairment can be diagnosed by diminished renal uptake of antimyosin.

Application of the murine anti-Gd-2 antibody 14.Gd-2a for diagnosis and therapy of neuroblastoma.

We have tested the sialoganglioside monoclonal antibody Gd-2a for scintigraphic diagnostic and for immunotherapy in children with neuroblastoma stage IV. We could confirm tumor sites with Gd-2a scans in 1/2 children. Doses of 20-60 mg/m2 were administered daily for 5-10 days.

Radio-immunodetection of myosarcoma using 111indium antimyosin.

Radio-labelled antimyosin-monoclonal antibodies (AMA) have been introduced to demonstrate myocardial necrosis after cardiac infarction or in cardiac allograft transplants. As rhabdomyosarcoma (RMS) and leiomyosarcoma (LMS) are tumors of myogenic origin, thus often containing myosin, we decided to use the 111In-labelled Fab fragment of AMA (Centocor) in scintigraphic tumor detection. We examined 13 children with histologically-confirmed RMS and LMS, and five other children with other types of soft tissue sarcomas.

[Comparison of the clinical value of an iterative reconstruction procedure with that of a filtered back projection in SPECT of the liver].

We have tested an iterative reconstruction procedure against the usual filtered back-projection in 14 patients with SPECT-examinations of various liver diseases. The aim of the examinations was to assess the presence of liver tumors in most cases. Further indications were Budd-Chiari syndromes and a liver malconfiguration in one case.