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Sample records for 99m mibi para

  1. Combined Tc-99m sesta MIBI scin

    Enas Abdel Ghany Ibrahim

    2015-12-01

    Conclusions: Accurate localization of adenomas should be obtained prior to surgery for minimal invasive surgical procedure. In this study, combined ultrasonography and Tc-99m MIBI improved localization of parathyroid adenomas.

  2. MIBI-99mTc mammary scintigraphy

    121 patients suspected of breast cancer were studied with MIBI-99mTc to evaluate the suitability of the mammary scintigraphy in patients with doubtful cancer diagnosis.The results show 93 % sensitivity and 95 % specificity and indicate the usefulness of this procedure to increase the accuracy of the diagnosis

  3. Combined Tc-99m sesta MIBI scin

    Enas Abdel Ghany Ibrahim; Momena Essam Elsadawy

    2015-01-01

    Purpose: To evaluate the role of combined high resolution ultrasonography and technetium Tc-99m methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy in preoperative detection and localization of parathyroid adenoma, for better operative outcome. Patients and methods: 40 patients were included in this study, 25 of them were females and 15 were males, with age ranging between 31 and 75 (mean 46 ± 15). All patients presented with some of symptoms of hyperparathyroidism with venous blood ...

  4. Evaluation of myocardial perfusion using Tc-99m MIBI

    Tc-99m MIBI (methoxy isobutyl isonitrile) is newly introduced cationic myocardial perfusion agent. For its favorable dosimetry, upto 30 mCi of Tc-99m MIBI can be used in a patient. Therefore, unlike T1-201, first-pass ejection fraction, ventricular wall motion, and SPECT studies are readily evaluated using Tc-99m MIBI on patients who are undergoing myocardial perfusion study. Nineteen individuals entered into this study and 9 of 19 had T1-201 myocardial scintiscan. For the detection of myocardial ischemia, an IV dipyridamole with hand-grip or bicycle exercise was used. Tc-99m MIBI scintigraphic findings are compared to patients 'EKG' T1-201 scans and coronary angiograms. The result were summerized as follows; 1. In 9 cases, Tc-99m MIBI studies were comparable to T1-201 scintiscans. 2. In the remaining 10 cases, Tc-99m MIBI images were correlated well with clinical pictures, EKG, and angiographic findings. 3. Using Tc-99m MIBI, one can easily obtain fist-pass ejection fraction, ventricular wall motion and SPECT studies. It was concluded that Tc-99m MIBI seems to be an excellent agent for myocardial perfusion study. Tc-99m MIBI images are superior in quality than T1-201 images mainly due to high photon yield and ideal energy of Tc-99m MIBI

  5. Myocardial imaging with Tc-99m MIBI in human subjects

    The kinetics of myocardial imaging with Tc-99m methoxy methylpropyl isonitrile (MIBI) were studied in four healthy adult volunteers and ten patients with coronary artery disease and ischemia on exercise Tl-201 imaging. After administration of 4-10 mCi of Tc-99m MIBI, patients were reexcerised to the same level and imaged in the same manner at peak exercise levels and after rest. Low initial lung uptake, rapid biliary excretion, and good myocardial contrast without a change in heart rate or redistribution over 2 hours were seen on both exercise and rest injected studies. The data suggest the usefulness of Tc-99 MIBI in tomography, in the gated study of wall motion studies, in the assessment of acute infarction, and in the detection of coronary artery disease

  6. Phase I clinical study on 99mTc-MIBI

    A phase I clinical study on 99mTc-hexakis 2-methoxy isobutylisonitrile (99mTc-MIBI) was carried out in 6 normal volunteers. There was no significant change in vital signs and laboratory parameters attributing to the reagent other than complaint of slight and transient metallic taste immediately after the injection in 4 volunteers. The highest dosimetry was calculated as 1.1 mGy/37 MBq at lower large intestine, which was within the acceptable range. 99mTc-MIBI was rapidly cleared from the blood and accumulated in the heart immediately after the injection with 1.4% dose and 1.8% dose at 5 min at rest and at stress, respectively. The retention of radioactivity in the heart well continued for at least several hours. The heart-to-lung ratio was over 2.00 at 5 min and heart-to-liver ratio was over 1.00 at 60 min. Myocardial planar and SPECT images were obtained with high quality. In conclusion, 99mTc-MIBI is a useful myocardial perfusion imaging agent. (author)

  7. Comparative {sup 99m}Tc-MIBI, {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin uptake in human soft tissue sarcoma cell lines

    Rodrigues, M.; Chehne, F.; Sinzinger, H. [Dept. of Nuclear Medicine, University Hospital, Vienna (Austria); Kalinowska, W.; Zielinski, C. [Clinical Div. of Oncology, Department of Internal Medicine I, University Hospital, Vienna (Austria)

    2000-12-01

    The uptake characteristics of technetium-99m hexakis-2-methoxyisobutylisonitrile (MIBI), {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin in human soft tissue sarcoma cell lines were investigated and compared. After 10-120 min of incubation at 37 C, 32 C and 22 C with {sup 99m}Tc-MIBI, {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin, the kinetics of cellular uptake of these tracers in human soft tissue sarcoma cells SW 684 (fibrosarcoma), SW 872 (liposarcoma), SW 982 (synovial sarcoma) and SW 1353 (chondrosarcoma) was assessed. The uptake of {sup 99m}Tc-MIBI, {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin was temperature dependent. The kinetics of uptake of {sup 99m}Tc-MIBI and of {sup 99m}Tc-tetrofosmin was similar between fibrosarcoma and liposarcoma cells, as well as between synovial sarcoma and chondrosarcoma cells. {sup 99m}Tc-furifosmin showed similar uptake kinetics in all cell lines. The uptake of {sup 99m}Tc-furifosmin was, however, significantly higher in liposarcoma than in the other cells. The data indicate that the cellular uptake of {sup 99m}Tc-MIBI, {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin is dependent on cellular metabolic activity. (orig.)

  8. Comparative 99mTc-MIBI, 99mTc-tetrofosmin and 99mTc-furifosmin uptake in human soft tissue sarcoma cell lines

    The uptake characteristics of technetium-99m hexakis-2-methoxyisobutylisonitrile (MIBI), 99mTc-tetrofosmin and 99mTc-furifosmin in human soft tissue sarcoma cell lines were investigated and compared. After 10-120 min of incubation at 37 C, 32 C and 22 C with 99mTc-MIBI, 99mTc-tetrofosmin and 99mTc-furifosmin, the kinetics of cellular uptake of these tracers in human soft tissue sarcoma cells SW 684 (fibrosarcoma), SW 872 (liposarcoma), SW 982 (synovial sarcoma) and SW 1353 (chondrosarcoma) was assessed. The uptake of 99mTc-MIBI, 99mTc-tetrofosmin and 99mTc-furifosmin was temperature dependent. The kinetics of uptake of 99mTc-MIBI and of 99mTc-tetrofosmin was similar between fibrosarcoma and liposarcoma cells, as well as between synovial sarcoma and chondrosarcoma cells. 99mTc-furifosmin showed similar uptake kinetics in all cell lines. The uptake of 99mTc-furifosmin was, however, significantly higher in liposarcoma than in the other cells. The data indicate that the cellular uptake of 99mTc-MIBI, 99mTc-tetrofosmin and 99mTc-furifosmin is dependent on cellular metabolic activity. (orig.)

  9. Accumulation of Tc-99m-MIBI and Tc-99m-tetrofosmin in tumor cells. Uptake and washout studies

    Aim: To investigate in-vitro the uptake and washout of Tc-99m-MIBI and Tc-99m-tetrofosmin in human breast adenocarcinoma and soft tissue sarcoma cell lines. Methods: The uptake of Tc-99m-MIBI and Tc-99m-tetrofosmin (at 370C, 10, 30 and 60 minutes after incubation with 7.4x10E5 Bq each tracer) was investigated in breast adenocarcinoma MCF-7 and SK-BR-3 cells, synovial sarcoma SW 982 cells and chondrosarcoma SW 1353 cells (concentration of 1x10E6 cells/ml incubation medium). Tracer uptake in cells incubated with ouabain (Na/K-ATPase pump inhibitor; 100 μM and 1mM; 15 and 30 minutes), nigericin (increases mitochondrial potential and disrupts cell membrane potential; 5 and 50 μg/ml; 15 minutes) and carbonyl cyanide m-chlorophenylhydrazone (CCCP) (depolarizes mitochondrial membrane; 10 and 100 μM; 30 minutes) was compared to that in cells without incubation with chemical agents (control cells). The washout (at 370C, 10-60 minutes, 30 and 60 minutes after tracer incubation) of Tc-99m-MIBI and Tc-99m-tetrofosmin was studied in MCF-7 cells, SK-BR-3 cells , SW 1353 cells and fibrosarcoma SW 684 cells. Results: Cellular tracer uptake decreased with ouabain (decrease of Tc-99m-tetrofosmin > Tc-99m-MIBI in SK-BR-3 cells and SW 982 cells) and increased with nigericin (increase of Tc-99m-MIBI > Tc-99m-tetrofosmin in all cells) as compared to the uptake in control cells. With CCCP, decrease of Tc-99m-MIBI uptake in cells preincubated with nigericin was higher than that in cells under basal conditions, whereas a similar decrease of Tc-99m-tetrofosmin uptake in these two group of cells was found. Washout of Tc-99m-MIBI from all cells was lower than that of Tc-99m-tetrofosmin. No significant difference in cell-associated activity of both tracers was found between washout after 30 minutes and that after 60 minutes of incubation, in all cells. Washout of Tc-99m-MIBI from SK-BR-3 cells Tc-99m-tetrofosmin) and Na/K-ATPase pump (Tc-99m-tetrofosmin > Tc-99m-MIBI). Tc-99m-MIBI and Tc-99

  10. Quantification analysis in Tc-99m MIBI myocardial perfusion scintigraphy

    Aims: Technetium-99-MIBI myocardial perfusion scintigraphy is a routinely employed nuclear medicine procedure. This study was carried out to get additional information in terms of Lung-heart ratio (LHR), Right ventricular index (RVI) by computer assisted quantification analysis of this procedure. Material and Methods: Fifty diagnosed cases of coronary artery disease (CAD) underwent 99mTc-MIBI planar studies at stress and rest. A group of 15 subjects with low pre-test likelihood of CAD and normal exercise and rest 99mTc-MIBI images was used as control. LHR was calculated from the static images in the anterior view. A circular region of interest (ROI) of about 8 pixel in diameter was selected in left lung area at maximal count density as assessed visually. Similar ROI was drawn on left ventricular wall at maximal count density area, as assessed visually. Ratio of the counts in the lung ROI to the counts in the myocardial ROI was expressed as Lung Heart ratio or 'lung index. LHR = Average counts in Lung ROI/Average counts in Left Myocardial ROI. Right ventricular index (RVI) was determined from the static images in LAO 450 views. ROIs were drawn on the right ventricle (RV) with maximal counts and on the left ventricle (LV) with maximal counts as assessed visually. The ratio of the counts in the two ROIs gave the right ventricular index. RVI = Average counts in RV ROI/ Average counts in LV ROI. Results: A close correlation was noted in the findings of three independent observers. In patients or coronary artery disease group (CAD Group), stress was induced by treadmill exercise or dipyridamole infusion. The CAD Group showed higher LHR at stress and at rest than controls. Student's t-test comparison of patients versus controls. p99mTc-MIBI myocardial perfusion images provides reproducible and clinically useful information regarding left ventricular function in CAD patients

  11. The Reevaluation of MIBI as the Ligand of 99mTc-MIBI Radiopharmaceutical for Myocardial Imaging

    Z. Nurlaila; I. Daruwati

    2008-01-01

    Methoxy isobutyl isonitrile labelled with technetium-99m (99mTc) radionuclide can be used for the evaluation of acute myocardial infarction. The 99mTc-MIBI radiopharmaceutical is available in the lyophilized-kit, which is separately packed with its radionuclide. Recently, in CNTMR-BATAN Bandung, 99mTc-MIBI radiopharmaceutical was prepared using MIBI ligand synthesized in 1996 as lyophilized-kits having the radiochemical purity less than 90 % and not accumulated in the myocardium. It could be ...

  12. Different dynamic of Tc-99m-tetrofosmin and Tc-99m-MIBI in a parathyroid adenoma; Unterschiedliche Dynamik von Tc-99m-Tetrofosmin und Tc-99m-MIBI in einem Nebenschilddruesen-Adenom

    Nowak, B.; Sabri, O.; Reinartz, P.; Kleinhans, E.; Zimny, M. [Universitaetsklinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Hoff, C. [Universitaetsklinikum Aachen (Germany). Medizinische Klinik III

    1999-07-01

    Case report of a patient with hypercalcemia and suspected parathyroid adenoma. Because of a previous strumectomy a precise preoperative localization of the suspected parathyroid adenoma was demanded. Tc-99m-tetrofosmin scintigraphy in double phase technique failed to detect a parathyroid adenoma by failing to show a region of increased focal uptake with delayed washout in relation to the thyroid gland. Only comparison of the Tc-99m-tetrofosmin images with a Tc-99m-pertechnetate scan revealed a right caudal parathyroid adenoma. A double phase Tc-99m-MIBI study of the same patient was able to localize this parathyroid adenoma without the need of a corresponding Tc-99m-pertechnetate scintigraphy due to a differential washout with persistent focal uptake in the parathyroid adenoma and a progressively decreasing uptake in the thyroid tissue. This case indicates that Tc-99m-tetrofosmin is a suitable agent for parathyroid imaging only if used together with Tc-99m-pertechnetate but is seems to lack the differential washout characteristics of Tc-99m-MIBI according parathyroid gland and thyroid gland. (orig.) [German] Bei einer Patientin mit Hyperkalzaemie und Verdacht auf primaeren Hyperparathyreoidismus wurde wegen einer vorherigen Strumektomie eine genaue praeopertive Lokalisationsdiagnostik gefordert. Eine in Zwei-Phasen-Technik durchgefuehrte Szintigraphie mit Tc-99m-Tetrofosmin allein erbrachte keinen sicheren Nachweis eines Nebenschilddruesen-Adenoms, da an keiner Lokalisation eine fokale Mehranreicherung mit relativ zur Schilddruese verzoegertem Washout festzustellen war. Erst der Vergleich mit dem Tc-99m-Pertechnetat-Szintigramm ergab den Hinweis auf ein Nebenschilddruesen-Adenom rechts kaudal. Eine zusaetzlich durchgefuehrte Tc-99m-MIBI-Szintigraphie konnte dieses Adenom alleine aufgrund einer hier vorhandenen Persistenz der Nuklidspeicherung im Nebenschilddruesen-Adenom bei gleichzeitig deutlichem Washout aus der uebrigen Schilddruese nachweisen. Dies weist darauf

  13. Pituitary Incidentalomas Detected with Technetium-99m MIBI in Patients with Suspected Parathyroid Adenoma: Preliminary Results

    Tiktinsky, Ekaterina; Horne, Tifha; Friger, Michael; Agranovich, Svetlana; Lantsberg, Sophie

    2012-01-01

    Tc-99m MIBI (MIBI) is a cationic lipophilic agent, which has traditionally been used for myocardial perfusion scintigraphy, detection and monitoring of different benign and malignant tumors. The objective of this study was to evaluate the frequency of pituitary incidentalomas detected on MIBI scans performed on patients with suspected parathyroid adenomas and to provide semiquantitative analysis of tracer uptake in the pituitary region. Tomographic images of MIBI scans on 56 patients with sus...

  14. Localization of primary hyperparathyroidism using {sup 99m}Tc-MIBI scintigraphy

    Yane, Katsunari; Emoto, Mie; Okamoto, Hideyuki; Yuki, Kazue; Hosoi, Hiroshi [Nara Medical Univ., Kashihara (Japan); Miyahara, Hiroshi [Osaka Prefectural Hospital (Japan)

    2003-03-01

    To determine the clinical utility of 99mTc-MIBI scintigraphy (MIBI) in the localization of hyperfunctioning parathyroid lesions, detection of lesions in 14 patients with primary hyperparathyroidism was compared between MIBI, ultrasonography and computed tomography (CT). MIBI (85.7%) and ultrasonography (78.5%) demonstrated higher detection rates than CT (50%). Furthermore, combination of MIBI and ultrasonography (92.8%) increased the detection rate. One case of ectopic parathyroid adenoma was detected only on MIBI. The smallest parathyroid lesion detected using MIBI was a parathyroid adenoma weighing 300 mg. A combination of MIBI and ultrasonography is therefore useful for the localization of primary hyperparathyroidism, and MIBI is particularly useful for detecting ectopic lesions. (author)

  15. The usefulness of 99mTc-MIBI in the detection of active pulmonary tuberculosis

    The use of radiopharmaceuticals in evaluation of pulmonary tuberculosis may help to resolve difficult diagnostic problems such as discordance between sputum examinations and chest roentgenographic findings. We investigated the usefulness of 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy in the detection of active pulmonary tuberculosis. Forty-six patients with suspected active pulmonary tuberculosis were studied with sputum smear of AFB, sputum AFB culture, chest X-ray and MIBI scan. MIBI image was obtained 15 and 60 min after intravenous injection of 370MBq(10mCi) 99mTc-MIBI. In 16 patients of them Ga scans were performed in addition to MIBI scan. Repeated MIBI scans were done in 7 patients with active pulmonary tuberculosis after 4∼6 months of antituberculous chemotherapy. Thirty-two patients were confirmed as active tuberculosis by sputum culture. Sensitivity of MIBI scan to active tuberculosis was 87.5%(28/32) and MIBI findings were negative in all of 14 patients with inactive disease. Focal uptake of MIBI was dense in the area that was strongly suggested active tuberculous lesions by chest roentgenogram. There was no discordance between MIBI and Ga image in 16 patients. But the uptake areas of Ga images were broader than that of MIBI images. After 4∼6 months of antituberculous treatment all repeated MIBI scans revealed negative findings except 1 patient with persistent active pulmonary tuberculosis due to drug resistance. MIBI scan could be used in the detection of active pulmonary tuberculosis as a useful noninvasive diagnostic tool

  16. Different dynamic of Tc-99m-tetrofosmin and Tc-99m-MIBI in a parathyroid adenoma

    Case report of a patient with hypercalcemia and suspected parathyroid adenoma. Because of a previous strumectomy a precise preoperative localization of the suspected parathyroid adenoma was demanded. Tc-99m-tetrofosmin scintigraphy in double phase technique failed to detect a parathyroid adenoma by failing to show a region of increased focal uptake with delayed washout in relation to the thyroid gland. Only comparison of the Tc-99m-tetrofosmin images with a Tc-99m-pertechnetate scan revealed a right caudal parathyroid adenoma. A double phase Tc-99m-MIBI study of the same patient was able to localize this parathyroid adenoma without the need of a corresponding Tc-99m-pertechnetate scintigraphy due to a differential washout with persistent focal uptake in the parathyroid adenoma and a progressively decreasing uptake in the thyroid tissue. This case indicates that Tc-99m-tetrofosmin is a suitable agent for parathyroid imaging only if used together with Tc-99m-pertechnetate but is seems to lack the differential washout characteristics of Tc-99m-MIBI according parathyroid gland and thyroid gland. (orig.)

  17. The Reevaluation of MIBI as the Ligand of 99mTc-MIBI Radiopharmaceutical for Myocardial Imaging

    Z. Nurlaila

    2008-01-01

    Full Text Available Methoxy isobutyl isonitrile labelled with technetium-99m (99mTc radionuclide can be used for the evaluation of acute myocardial infarction. The 99mTc-MIBI radiopharmaceutical is available in the lyophilized-kit, which is separately packed with its radionuclide. Recently, in CNTMR-BATAN Bandung, 99mTc-MIBI radiopharmaceutical was prepared using MIBI ligand synthesized in 1996 as lyophilized-kits having the radiochemical purity less than 90 % and not accumulated in the myocardium. It could be caused by several factors, among others were technical preparation of lyophilized dry-kit and the quality of MIBI; therefore the reevaluation of the ligand for the quality improvement was needed. Firstly, MIBI ligand was recristallized. It was found that MIBI as [Cu(MIBI4]BF4 salt was a glassy solid with the melting point of 98 -99 oC. The infra red analysis showed the presence of spectra vibration at 1085, 1180 cm-1 and 2180, 2220 cm-1 for –OCH3 and N≡C groups, respectively. The preparation of 99mTc-MIBI was performed by adding 99mTc radionuclide into new MIBI liquid-kit, then boiled in water bath for minimum period of 10 minutes. The radiochemical purity of 99mTc-MIBI was analysed by thin layer chromatographic method using absolute ethanol as a mobile phase. The pre-clinical evaluation was observed in Wistar rat and clinical studies were performed in volunter using gamma camera. It is revealed that the radiochemical purity of more than 90 % i.e. 96.83 ± 1.43 % was still stable until 24 hours storage at room temperature. The stability studies of 99mTc-MIBI in human blood plasma showed that in 6 hours, the radiochemical purity was decreased to 90.89 ± 2.90 %. Clinical application of 99mTc-MIBI with tomography techniques using gamma camera showed the distinct accumulation of radioactivity in the heart.

  18. A correlative study between {sup 99m}Tc-ESTCPTA and {sup 99m}Tc-MIBI in rats

    Unak, Perihan E-mail: unak@bornova.ege.edu.tr; Enginar, Huseyin; Zuemruet Biber, F.; Yurt Lambrecht, Fatma; Aslani, M.A.A.; Ozkilic, Hayal

    2002-11-01

    Tissue distribution of the {sup 99m}Tc labeled derivative of the estrogen compound 3,17-{alpha}-estradiolyl propyl 1,4,8,11-tetraazacyclotetradecanyl-1-(4-methylbenzoic acid) ester (ESTCPTA), which has an 3,17-{alpha}-estradiolyl propinol coupled to 1-(4-methylbenzoic acid)1,4,8,11-tetraazacyclotetradecane (CPTA), was compared to {sup 99m}Tc-MIBI (methoxyisobutyl isonitrile) in female Albino Wistar rats. Tissues of interest included lung, liver, heart, kidneys, spleen, stomach, intestines, pancreas, muscle, blood, breast, ovary, fat, and uterus. {sup 99m}Tc-ESTCPTA uptake by the uterus and ovary, as ER-rich tissues, was highly selective. Maximum uptakes for {sup 99m}Tc-MIBI and {sup 99m}Tc-ESTCPTA are 90 min in breast, ovary and uterus. The pancreas also showed significant receptor saturated and unsaturated ratios for {sup 99m}Tc-ESTCPTA. Results are sufficiently encouraging to generate further evaluation of these and related compounds as possible estrogen receptor based tumor imaging and therapeutic agents in estrogen-rich tissues.

  19. Myocardial reversibility detection. Rest NTG 99mTc-MIBI versus 201Tl reinjection. Preliminary results

    This study test whether sublingual administration of nitroglycerin (NTG) could improve the capability of 99mTc-MIBI to detect reversibility in exercise-induced perfusion defects and to compare it with the 201Tl stress-redistribution-reinjection protocol. Twenty-one patients with previous myocardial infarction were submitted to exercise, rest and NTG rest 99mTc-MIBI imaging (3-day protocol). The patients also underwent exercise, redistribution and reinjection 201Tl myocardial scintigraphy. A total of 273 myocardial segments were analyzed: 76 (28%) had irreversible defects on stress-rest 99mTc-MIBI, 60 (79%) appeared as fixed defects and 16 (21%) were reversible on NTG rest 99mTc-MIBI. Of the 78 myocardial segments with irreversible defects on standard stress-redistribution thallium cardiac imaging, 63 (81%) did not change and 15 (19%) demonstrated enhanced uptake of thallium after reinjection. Data show that rest NTG 99mTc-MIBI study improves the detection of reversible myocardium versus standard exercise/rest 99mTc-MIBI and achieve similar results than 201TI reinjection protocol. (author)

  20. [Complementary scintigraphic examinations (99mTc-MDP, 99mTc-MIBI and Octreoscan) in breast neoplasm assessment].

    Stefănescu, C; Chossiere, L; Rusu, V; Meignan, M

    1996-01-01

    Scintigraphic imagery was used in breast carcinoma mostly for the bone metastases screening, using 99mTc-MDP. Others radiopharmaceuticals can be used to visualize either the primary tumour or the soft tissues metastases. It's mainly the case of 99mTc-MIBI, and also of some somatostatin analogues, like Octreoscan. This case report of a patient with a T3N1M+ breast adenocarcinoma having different secondary sites represent also a prove of the complementarity of these explorations, which give the possibility of diagnostic and therapeutic evaluation and, in the same time, the possibility of a better understood of the metastasizing mechanism. PMID:9455458

  1. Bone marrow uptake of 99mTc-MIBI in patients with multiple myeloma

    In a previous study, we showed the ability of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scan to identify active disease in patients with multiple myeloma (Eur J Nucl Med 1998; 25: 714-720). In particular, a semiquantitative score of the extension and intensity of bone marrow uptake was derived and correlated with both the clinical status of the disease and plasma cell bone marrow infiltration. In order to estimate quantitatively 99mTc-MIBI bone marrow uptake and to verify the intracellular localization of the tracer, bone marrow samples obtained from 24 multiple myeloma patients, three patients with monoclonal gammopathy of undetermined significance (MGUS) and two healthy donors were studied for in vitro uptake. After centrifugation over Ficoll-Hypaque gradient, cell suspensions were incubated with 99mTc-MIBI and the uptake was expressed as the percentage of radioactivity specifically retained within the cells. The cellular localization of the tracer was assessed by micro-autoradiography. Twenty-two out of 27 patients underwent 99mTc-MIBI scan within a week of bone marrow sampling. Whole-body images were obtained 10 min after intravenous injection of 555 MBq of the tracer; the extension and intensity of 99mTc-MIBI uptake were graded using the semiquantitative score. A statistically significant correlation was found between in vitro uptake of 99mTc-MIBI and both plasma cell infiltration (Pearson's coefficient of correlation r=0.69, P99mTc-MIBI inside the plasma cells infiltrating the bone marrow. Therefore, our findings show that the degree of tracer uptake both in vitro and in vivo is related to the percentage of infiltrating plasma cells which accumulate the tracer in their inner compartments. (orig.)

  2. Diagnostic value of Tc-99m MIBI SPECT in the differential diagnosis of lung lesions

    Aim: This study was conducted to assess the feasibility of using Tc-99m labelled 2-methoxy isobutyl isonitrile (MIBI), which shows uptake in malignant lung lesions, to evaluate benign and malignant lung lesions and to assess the value in the differential diagnosis. Methods: The patients randomly selected among the patients examined at the Kocaeli University Pulmonary Clinic. (19 men, 18 women) who had a pathological PA chest x-ray and did not received any treatment. After intravenous injection of 15-25 mCi Tc-99m MIBI, early (10 minutes) and delayed (2,5 hours) static spot images of posterior and anterior thorax and SPECT images were obtained. The assessment of MIBI uptake was done visually and quantitatively. Results: Of the 18 patients with primary bronchial carcinoma, increased abnormal uptake of MIBI corresponding to the lesion location was found in 14 patients with planar imaging and in 15 patients with SPECT imaging. Three patients did not have any unusual activity accumulation. Of the 19 patients with benign lesions, 4 had abnormally increased uptake of MIBI. In the detection of malignant lesions Tc-99m MIBI was found to have 83.3% specificity, 78.9% sensitivity, 78.9% positive predictive value, and 81.1% negative predictive value. Conclusion: Tc-99m MIBI tumor scintigraphy might be a valuable non-invasive method for the differential diagnosis of malignant and benign lung lesions, however further studies are required as it has relatively low sensitivity and specificity

  3. Preliminary clinical observation of 99mTc-MIBI breast tumor imaging

    An effective, noninvasive diagnostic method of breast cancer is investigated. 99mTc-MIBI breast tumor imaging was performed in 78 patients with palpable breast mass. All was pathologically proved after operation. Of 78 patients, 42 were breast carcinoma, among them 35 were detected using 99MTc-MIBI scintigraphy. The smallest detectable mass was a infiltrating ductal carcinoma measuring 1.5 cm x 1.5 cm x 1.2 cm. Of 36 patients with benign lesions, 30 with negative result, among the 6 positive one, 5 were big adenoma, 1 was plasma cell mastitis. The sensitivity and specificity of 99mTc-MIBI imaging in detecting breast cancer wa 83.3% either. 99mTc-MIBI scintigraphy can be used as an accessory method in detecting breast cancer. But it was useless for differentiation between breast cancer and big adenoma

  4. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    Cınar, Alev; Sadıc, Murat; Demırel, Koray; Korkmaz, Meliha

    2013-01-01

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of ...

  5. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of distribution of this radiotracer in order to recognize the abnormal uptake. Here in, we present a large diaphragmatic hernia, seemed as a mirror vision of myocardium that was determined incidentally during the MPI with 99mTc MIBI

  6. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    Cınar, Alev; Sadıc, Murat; Demırel, Koray; Korkmaz, Meliha

    2013-01-01

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of distribution of this radiotracer in order to recognize the abnormal uptake. Here in, we present a large diaphragmatic hernia, seemed as a mirror vision of myocardium that was determined incidentally during the MPI with 99mTc MIBI. PMID:24379540

  7. The value of {sup 99m}technetium-MIBI scintiscanning for diagnostic evaluation of breast cancer; Stellenwert der {sup 99m}Technetium-MIBI-Szintigraphie in der Mammadiagnostik

    Hagedorn, K.; Kraemer, S.; Lang, N. [Universitaets-Frauenklinik, Erlangen (Germany); Schulz-Wendtland, R.; Bautz, W. [Universitaet Erlangen-Nuernberg (Germany) Institut fuer Diagnostische Radiologie; Kat, S.; Wolf, F. [Universitaet Erlangen-Nuernberg (Germany). Nuklearmedizinische Klinik

    1998-03-01

    We performed {sup 99m}Tc-MIBI scintiscanning in 42 patients with indications for surgery of mammary lesions, ascertained by palpation, mammography, ultrasonography, or MRI. We had a total of 62 histologically examined tumors for our analysis, comprising 24 benign tumors (10 fibroadenomas, 1 papilloma, 1 cyst, 1 lymph node, 10 mastopathies), 4 in-situ carcinomas, and 34 malignant tumors (32 duct carcinomas, 1 intramammary lymph node matastasis, 1 low-grade malignant sarcoma). The benign mammary gland tumors were not shown by contrast agent accumulation in the {sup 99m}Tc-MIBI scintiscans. Out of 14 carcinomas of a size less than 15 mm across, only 5 were detected by scintiscanning, and none of the in-situ carcinomas was revealed in the scintiscans. However, all malignomas of a size of 15 mm or more were detected by scintiscanning. The results of the comparative analysis of the diagnostic methods relating to sensitivity and specificity are (n=58, without CIS):{sup 9}9mTc-MIBI scintiscans: 73.5%/100%; mammography: 94,1%/62.5%; palpation:82.4%/91.7%; ultrasonography:94.1%/58.3%. As compared to the other four methods, {sup 9}9mTc-MIBI scintiscanning ranks last in terms of sensitivity, and is the best method interms of specificity. The high specificity shown by our study could not be confirmed by other studies, and the sensitivity is particularly restricted when tumors are small in size, or at unfavourable locations. The conclusion therefore is that this scintiscanning method is not to be recommended as a screening method, nor is it a method of choice for complementary diagnostic evaluation of breast lesions, except perhaps for a few specific cases. (orig./CB) [Deutsch] Wir fuehrten die {sup 99m}Tc-MIBI-Szintigraphie bei 42 Patientinnen mit operationsbeduerftigem Mammabefund durch, die zuvor palpatorisch, mammographisch, sonographisch und zum Teil mittels Magnetresonanztomographie der Mamma untersucht worden waren. Insgesamt konnten wir 62 histologisch untersuchte

  8. Comparison of uptake of 99mTc-MIBI, 99mTc-tetrofosmin and 99mT-Q12 into human breast cancer cell lines

    Technetium-99m hexakis-2-methoxyisobutyl-isonitrile (MIBI), 99mTc-tetrofosmin and 99mTc-Q12 were all introduced for myocardial imaging but found additional applications as they are taken up by different tumours, enabling imaging of these lesions in patients. The aim of this study was to compare the uptake characteristics of these compounds in vitro in the human adenocarcinoma breast cell lines MCF-7 and ZR-75. It was shown that 99mTc-MIBI had the highest cellular uptake (15.9%±0.5% dose/mg protein after 60 min in MCF-7, and 14.2%±0.4% dose/mg protein in ZR-75), followed by 99mTc-tetrofosmin (6.8%±0.6% dose/mg protein in MCF-7, and 8.2%±0.2% dose/mg protein in ZR-75) and 99mTC-Q12 (3.2%±0.1% dose/mg protein in MCF-7, and 3.5%±0.3% dose/mg protein in ZR-75 cells). For all three compounds tenfold differences in specific activity did not influence total cell-associated radioactivity. Uptake of 99mTc-MIBI and 99mTc-tetrofosmin was obviously lower at 4 C than at 37 C, whereas 99mTc-Q12 uptake showed only slight temperature dependence. When uptake was compared in cells grown to different cell densities (1 mg/ml cellular protein versus 0.3 mg/ml), no differences in uptake were detected when uptake was corrected for the amount of cellular protein present in the dishes. Furthermore, for all compounds it was shown that cellular radioactivity decreased rapidly after washing. Apart from the differences in cellular uptake of the three compounds after 60 min, no differences in residual cellular radioactivity after washing were found between the different compounds when expressed as a percentage of their 60-min uptake, suggesting that the efflux process of the radiolabelled compounds was similar. The differences in cell-associated activity after 60 min were thus presumably caused by differences in uptake. (orig./MG)

  9. Preparation of kit MIBI for 99mTc Labeling Using in Nuclear Medical Diagnostic Imaging

    99mTc-MIBI is the cation complex of 99mTc of oxidation states +1 with ligand methoxy-isobutyl-isonitrile using diagnostic imaging of many illnesses especially use in myocardial perfusion studies. Coronary artery disease present is quite common in our country so that need to use kit MIBI for labelling with Tc-99m is great. Therefore we implement studies of preparation of kit MIBI and find the labelling procedure with Tc-99m of labelling yield or the highest radiochemical purity. In this annual report presents the results of researches made be like finding the optimal conditions for the labelling procedure, preparation procedure of kit MIBI and SnCl2.H2O content. This report also describes studies of the optimization of the preparation of 99mTc-MIBI. Stability studies of these complexes are also described. The comparative results between our kit and Cardiolite® kit are reported. Also the results of sterility test and bacterial endotoxin test are presented. (author)

  10. Diagnosis and monitoring of skin cancer no-melanoma using 99mTc-MIBI. Studies in an animal model

    The aim of the work was to evaluate the usefulness of 99mTc-MIBI as a tracer for the tumor diagnosis and progression of NMSC in a chemically induced model in mice. After administration of 99mTc-MIBI animals were sacrificed at different times. Samples of tumor and healthy skin were dissected in order to perform histological analysis and to evaluate 99mTc-MIBI uptake. Animals under 22 weeks of tumor evolution showed a statistically difference in 99mTc-MIBI uptake between healthy skin and NMSC. Our results showed that the better protocol for the study of the tumor diagnosis and progression of NMSC in mice is the administration of 1 mCi of 99mTc-MIBI and acquisition of images 30 minutes post injection. Results showed that, as tumor progresses, the uptake of 99mTc-MIBI is significantly lower than healthy skin

  11. Evaluation of multiple myeloma with technetium-99m-MIBI scintigraphy

    Aim: To evaluate the clinical utility of whole-body scintigraphy with 99mTc-MIBI in the detection of bone marrow involvement in patients (pts) with multiple myeloma (MM) and related monoclonal disease, in assessing a disease extent and activity, and to define the relationship of different patterns of 99mTc-MIBI uptake with clinical status and stage of disease. Material and Methods: Eighty-three consecutive pts (40 men and 43 women) with MM or monoclonal gammopathy of undetermined significance (MGUS) enrolled in this study were divided into three subgroups: 1. Forty-three MM pts with active disease (AD) in stage II or III according to standard criteria, 2. Thirteen pts in complete remission (CR), and 3. Twenty-seven MGUS pts or MM pts in stage IA. Whole-body scans were obtained 10 min after the i.v. injection of 740 MBq 99mTc-MIBI in anterior and posterior view. The scans were scored semi-quantitatively according to extension and intensity of tracer uptake. Results: Thirty-nine MM pts in the first subgroup with AD showed different patterns of 99mTc-MIBI uptake of high intensity while 4 exhibited physiological distribution of tracer. All thirteen pts in CR in the second subgroup showed a negative 99mTc-MIBI scan. In the third subgroup, twenty-three MGUS pts had no pathological uptake of the radiotracer while 3 MM pts in stage IA presented the diffuse and one both focal and diffuse pattern of 99mTc-MIBI uptake. The uptake score correlated significantly with clinical status and stage of disease and its activity as determined by infiltration of bone marrow by plasma cells (p<0.05), paraprotein (p<0.05), beta2-microglobulin (p<0.05), serum thymidinekinase (p<0.05) and telopeptide-ICTP (p<0.05). Overall sensitivity of the scintigraphic procedure was 91% and specificity 90%. Conclusion: Our results show that whole-body 99mTc-MIBI scintigraphy provides important information which is clinically useful in the detection of bone marrow involvement and in assessing the extent

  12. [Imaging of hyperparathyroidism-Ultrasonography and 99mTc-MIBI scintigraphy-].

    Kawabe, Joji; Higashiyama, Shigeaki; Yoshida, Atsushi; Kotani, Kohei; Shiomi, Susumu

    2016-06-01

    Treatments for primary hyperparathyroidism due to adenoma, hyperplasia and carcinoma and secondary hyperparathyroidism are mainly surgical resections of them. Accurate imaging diagnoses of the existences and the regions are very important for reductions of invasiveness. We describe ultrasonography and 99mTc-MIBI scintigraphy of hyperparathyroidism. We explain an advantage, a disadvantage and diagnosability of these modalities. We mention utilities of SPECT/CT, too. We show echogram and 99mTc-MIBI scintigraphy images about 3 cases of hyperparathyroidism. PMID:27230842

  13. Iterative reconstruction: an improvement of technetium-99m MIBI SPET for the detection of parathyroid adenomas?

    Moka, D.; Eschner, W.; Voth, E.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, University of Cologne (Germany); Larena-Avellaneda, A. [Dept. of Surgery, St. Katharinen-Hospital, Frechen (Germany)

    2000-05-01

    The purpose of this study was to assess the value of technetium-99m methoxyisobutylisonitrile (MIBI) single-photon emission tomography (SPET) and an iterative reconstruction algorithm for the preoperative localisation of parathyroid adenomas (PTAs). Seventy-two patients (26 male, 46 female, mean age 58{+-}16 years) with known primary hyperparathyroidism were examined preoperatively. First, a thyroid examination was performed to detect possible MIBI-accumulating thyroid lesions. Planar scans were then acquired 15 and 120 min and tomographic images 120 min after intravenous injection of 740 MBq {sup 99m}Tc-MIBI, using a triple-head gamma camera (Picker Prism 3000). Additionally, {sup 99m}Tc-MIBI/ {sup 99m}Tc-pertechnetate subtraction scintigraphy of the early planar images was performed. The SPET data were evaluated using an iterative reconstruction (multiplicative iterative SPET reconstruction: MISR) as well as a standard algorithm (FBP: filtered back-projection with application of a 3-D low-pass postfilter). The weight of the resected PTAs ranged from 110 mg to 5 g. Using planar MIBI scans, correct localisation of the side of the PTA was possible in 81% of cases (58% for PTAs weighing less than 500 mg). Sensitivity increased to 94% using SPET and FBP, while with MISR it rose further, to 97%. Patients with PTAs weighing less than 500 mg showed a sensitivity of 88% with MISR and 81% with FBP. Furthermore, there was a clear improvement in image quality using MISR. None of the normal parathyroid glands were visualised. This study indicates that, in comparison with planar scintigraphy, {sup 99m}Tc-MIBI SPET is a more sensitive and specific tool for topographical localisation of PTAs, especially those that are small. There is a further improvement in sensitivity and image quality when iterative reconstruction is used instead of FBP. (orig.)

  14. Bone marrow uptake of {sup 99m}Tc-MIBI in patients with multiple myeloma

    Fonti, R. [Medicina Nucleare, Facolta di Medicina, Univ. Federico II, Naples (Italy); Centro per la Medicina Nucleare C.N.R., Cattedra di Medicina Nucleare, Napoli (Italy); Del Vecchio, S.; Zannetti, A.; Di Gennaro, F.; Pace, L.; Salvatore, M. [Centro per la Medicina Nucleare C.N.R., Cattedra di Medicina Nucleare, Napoli (Italy); De Renzo, A.; Catalano, L.; Califano, C.; Rotoli, B. [Cattedra di Ematologia, Dipt. di Medicina Clinica e Sperimentale, Napoli (Italy)

    2001-02-01

    In a previous study, we showed the ability of technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) scan to identify active disease in patients with multiple myeloma (Eur J Nucl Med 1998; 25: 714-720). In particular, a semiquantitative score of the extension and intensity of bone marrow uptake was derived and correlated with both the clinical status of the disease and plasma cell bone marrow infiltration. In order to estimate quantitatively {sup 99m}Tc-MIBI bone marrow uptake and to verify the intracellular localization of the tracer, bone marrow samples obtained from 24 multiple myeloma patients, three patients with monoclonal gammopathy of undetermined significance (MGUS) and two healthy donors were studied for in vitro uptake. After centrifugation over Ficoll-Hypaque gradient, cell suspensions were incubated with {sup 99m}Tc-MIBI and the uptake was expressed as the percentage of radioactivity specifically retained within the cells. The cellular localization of the tracer was assessed by micro-autoradiography. Twenty-two out of 27 patients underwent {sup 99m}Tc-MIBI scan within a week of bone marrow sampling. Whole-body images were obtained 10 min after intravenous injection of 555 MBq of the tracer; the extension and intensity of {sup 99m}Tc-MIBI uptake were graded using the semiquantitative score. A statistically significant correlation was found between in vitro uptake of {sup 99m}Tc-MIBI and both plasma cell infiltration (Pearson's coefficient of correlation r=0.69, P<0.0001) and in vivo score (Spearman rank correlation coefficient r=0.60, P<0.01). No specific tracer uptake was found in bone marrow samples obtained from the two healthy donors. Micro-autoradiography showed localization of {sup 99m}Tc-MIBI inside the plasma cells infiltrating the bone marrow. Therefore, our findings show that the degree of tracer uptake both in vitro and in vivo is related to the percentage of infiltrating plasma cells which accumulate the tracer in their inner

  15. Myeloma, source of false positive of parathyroid scintigraphy with {sup 99m}Tc-MIBI; Le myelome, source de faux-positif de la scintigraphie parathyroidienne au 99mTc-MIBI

    Zaabar, L.; Ben Sellem, D.; El Ajmi, W.; Slim, I.; Letaief, B.; Mhiri, A.; Ben Slimene, M.F. [Institut Salah Azaiez, Service de medecine nucleaire, Tunis (Tunisia)

    2010-07-01

    Purpose: Considering a specificity of the MIBI dual-phase parathyroid scintigraphy with {sup 99m}Tc-MIBI presents false positives which number has declined since the systematic implementation of the SPECT. We report a case of a superior mediastinal false-positive. Conclusions: the myeloma represents a potential cause of false-positive of parathyroid scintigraphy with {sup 99m}Tc-MIBI. (N.C.)

  16. 99mTc-MIBI SPECT in estimation of adalat influence on myocardial perfusion in CAD patients

    Calcium antagonists (CA) adalat effect on myocardial perfusion in CAD patients are studied using 99mTc-MIBI SPECT. 99mTc-MIBI SPECT provides useful information for evaluation of CA effect on myocardial perfusion and revealing of steel syndrome as a result of CA treatment. The IPD is one of the most sensitive signs of improvement in myocardial perfusion after treatment

  17. Non-visualized Thyroid Gland by Tc-99m MIBI Scan with Normal Thyroid Scan

    We present the case of a 21-year-old man who was referred to us for parathyroid scintigraphy with high blood levels of intact parathormone and osteoporosis. Several methods and radiopharmaceuticals, e.g., Tc-99m MIBI and Tl-201 chloride/Tc-99m pertechnetate (Tl-201/TcPO-4) subtraction, are commonly used for this purpose. We present the case of a thyroid gland that demonstrates quite normal Tc-99m pertechnetate uptake, no accumulation of Tc-99m MIBI, and very low grade Tl-201 uptake. To the best of our knowledge, no similar case has been reported previously. A 21-year-old male with osteoporosis and growth-development retardation was referred for MIBI parathyroid scan because of high blood levels of intact parathormone and bone-specific alkaline-phosphatase, which were 219.4 (15-88 pg/ml) and 355 (21-58 U/L), respectively. In his Tc-99m pertechnetate (TcPO-4) pinhole scintigraphy, bilateral clearly visualized radioactivity accumulation in the thyroid gland was seen. In both early or late images of the Tc-99m MIBI parathyroid scan, the thyroid gland was not visualized. Therefore, a Tl-201/TcPO-4 subtraction scan method was used. However, the Tl-201 accumulation level in the thyroid gland was not sufficient for the subtraction method. In his thyroid ultrasonography, the thyroid gland echo was homogenous, and there was neither any solid nor cystic lesion. The physical examination of his neck was normal. Other laboratory findings were all normal as follows. TSH: 3.03 (0.35-5.6 IU/mL), free T3: 3.66 (2.5-3.9 pg/mL), free T4: 0.90 (0.59-1.3 ng/dL), Anti-TPO:0.3 (0.40 IU/mL), Anti-TG-Ab: -4 subtraction methods are commonly applied. The thyroid gland was not visualized on Tc-99m MIBI scintigraphy of suppressed thyroid tissue in a study by Turkolmez et al.. It should be taken into account that sometimes we may not be able to visualize a normal thyroid gland, and in these cases we might encounter suboptimal visualization in T1-201 subtraction method as well. Erdil et al. foun

  18. Lesion localization in patients with hyperparathyroidism using double-phase Tc-99m MIBI parathyroid scintigraphy

    Shin, Jung Woo; Ryu, Jin Sook; Kim, Jae Seung; Moon, Dae Hyuk; Hong, Seung Mo; Gong, Gyung Yub; Hong, Suk Joon; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    1999-02-01

    This study was performed to evaluate the diagnostic usefulness of double-phase Tc-99m MIBI parathyroid scintigraphy with single photon emission computed tomography (SPECT) in patients with hyperparathyroidism. We also evaluated the relationship between Tc-99m MIBI uptake and oxyphil cell contents in parathyroid glands. The subjects were 28 parathyroid glands of 10 patients who underwent Tc-99m MIBI parathyroid scintigraphy and parathyroidectomy for clinically suspected hyperparathyroidism. Early and delayed pinhole images were obtained at 15 minutes and 2 hours after injection of Tc-99m MIBI, and SPECT images were followed. The weight and oxyphil cell contents of parathyroid tissue were obtained from pathologic specimen, and the scintigraphic findings were compared with histopathology. In surgical histopathology, 6 parathyroid adenomas and 9 parathyroid hyperplasias were confirmed. The sensitivity, specificity, and positive predictive value of early and delayed images were 46.7% (7/15), 76.9% (10/13), 70% (7/10) and 66.7% (10/15), 92.3% (12/13), 90.9% (10/11), respectively. SPECT image detected an additional small hyperplasia. The sensitivity, specificity, and positive predictive value of combined interpretation of early and delayed images with SPECT were 73.3% (11/15), 100% (13/13), 100% (11/11). The sensitivity was 100% (6/6) for adenoma, whereas that was 55.5% (5/9) for hyperplasia. Both adenomas and hyperplasias showed significantly increased oxyphil cell contents compared with normal parathyroid glands (p<0.0001), but the oxyphil cell content and weight were not significantly different between adenomas and hyperplasias. Double-phase Tc-99m MIBI parathyroid scintigraphy with SPECT is useful for lesion localization in patients with hyperparathyroidism. Although both adenoma and hyperplasia have increased oxyphil cell content, the sensitivity is high in adenoma, but low in hyperplasia.

  19. Mammography and 99mTc-MIBI scintimammography in breast cancer diagnosis

    The aim of this work has been to evaluate whether a diagnostic protocol based on the joint use of mammography and 99mTc-MIBI scintimammography can help to distinguish the lesions and to reduce the number of biopsies required in patients with suspected breast cancer. A total of 58 women were evaluated by palpation, mammography, scintimammography. Twenty-four patients were scintimammographed with 99mTc-MIBI at 10 min after injection. Thirty-four patients were taken double phase scintimammography with 99mTc-MIBI 10 min and 60-90 min after injection. Based on mammography, the suspicion degrees of malignancy were rated, and 30 results of malignancy were confirmed by histopathology. Based on mammography, 18 lesions were considered to be most probably benign (of which 3 were histopathologically breast cancer), 19 as indeterminate (of which 9 were histopathologically breast cancer), and 21 as malignant (of which 18 were histopathologically breast cancer). The results of early and delayed phases 99mTc-MIBI scintimammography were the same. The sensitivity, specificity and accuracy of scintimammography were 74.29%, 86.96% and 79.31%, respectively. Scintimammography gave 16 correct diagnosis in 19 mammogram indeterminate (84.2%) and demonstrated 5 out of 8 cases axillary lymph nodes metastasis (62.5%). These studies show that 99mTc-MIBI scintimammography used as a complementary testing technique to mammography is useful in the examination of patients with suspected breast cancer. The adoption of a joint mammography-scintimammography diagnostic protocol could considerably reduce the number of biopsies performed in patients with lesions of indeterminate mammographic suspicion of malignancy

  20. Technetium-99m tetrofosmin for parathyroid scintigraphy: a direct comparison with {sup 99m}Tc-MIBI, {sup 201}Tl, MRI and US

    Wakamatsu, Hideyuki [Dept. of Radiology, Noguchi Thyroid Clinic and Hospital Foundation, Oita (Japan); Noguchi, Shiro; Yamashita, Hiroyuki [Dept. of Surgery, Noguchi Thyroid Clinic and Hospital Foundation, Oita (Japan); Yamashita, Hiroto [Dept. of Pathology, Noguchi Thyroid Clinic and Hospital Foundation, Oita (Japan); Tamura, Shozo; Jinnouchi, Seishi; Nagamachi, Shigeki; Futami, Shigemi [Dept. of Radiology, Miyazaki Medical College, Miyazaki (Japan)

    2001-12-01

    The aim of this study was to evaluate the efficacy and role of technetium-99m tetrofosmin for the detection of abnormal parathyroid glands to be referred for surgical treatment. Twenty-eight consecutive patients, including 25 primary and 3 secondary cases of hyperparathyroidism, were evaluated. {sup 99m}Tc-tetrofosmin/{sup 99m}Tc-pertechnetate subtraction scintigraphy (TF/Tc) was performed on all patients, and the results were directly compared with those of {sup 99m}Tc-methoxyisobutylisonitrile (MIBI)/{sup 99m}Tc-pertechnetate subtraction scintigraphy (MIBI/Tc), {sup 201}Tl/{sup 99m}Tc-pertechnetate subtraction scintigraphy (Tl/Tc), magnetic resonance imaging (MRI) and ultrasonography (US). In cases of single-gland disease, the sensitivities of TF/Tc, MIBI/Tc, Tl/Tc, MRI and US were 63.2%, 68.4%, 57.9%, 55.6% and 63.2%, respectively. In cases of multi-gland disease, the sensitivities of TF/Tc, MIBI/Tc, Tl/Tc, MRI and US were 41.7%, 41.7%, 37.5%, 58.3% and 54.2%, respectively. In cases of parathyroid adenoma, the sensitivities of TF/Tc, MIBI/Tc, Tl/Tc, MRI and US were 68.8%, 75.0%, 68.8%, 62.5% and 75.0%, respectively. In cases of parathyroid hyperplasia, the sensitivities of TF/Tc, MIBI/Tc, Tl/Tc, MRI and US were 40.7%, 40.7%, 33.3%, 53.8% and 48.1%, respectively. It is concluded that, for the detection of abnormal parathyroid glands, {sup 99m}Tc-tetrofosmin is as useful as {sup 99m}Tc-MIBI and is more useful than {sup 201}Tl. (orig.)

  1. Tc-99m-MIBI brain SPECT in differentiating tumor recurrences from necrosis

    Brain SPECT using 99m-TC MIBI can distinguish between local tumor recurrence and radio necrosis of the primary brain tumor, whereas CT scan and MRI do not have this ability. 1. Is it possible to search for tumoral cells in the brain by using TC-99m MIBI? 2. How sensitive and specific is the SPECT in distinguishing the presence of active tumor in the brain and differentiating it from post-therapy necrosis? 3. Is it feasible to substitute this diagnostic modality for stereotactic biopsy surgery? Patients who presented to the neurosurgery clinic with the clinical manifestations of brain tumor relapse between 22nd August 1999 and 1.; February 2000 and were candidates for stereotactic biopsy were chosen. A 99m-TC MIBI SPECT was performed before biopsy. The total number of patients was 13. Five patients had the diagnosis of brain tumor by surgery and biopsy and had undergone a course of radiotherapy and chemotherapy. These patients were normal clinically and MIBI SPECT was done for the purpose of follow-up. Clinical manifestations consisted of, Weakness, Vertigo visual disorders, loss of consciousness, headache, aphasia and hemiparesis. The primary tumors were composed of a variety of lei sons including: grade I, II astrocytoma (62.5%), glioblastoma (25%) and medulloblastoma (12.5%). eight patients who had MIBI SPECT firstly and then had biopsy, brain tumor relapse was reported by both biopsy and SPECT in seven patients. This proved a 100% sensitivity and a 100% specificity for MIBI SPECT in differentiating, between tumor relapse and necrosis, a result comparable to stereotactic biopsy. Also in 5 patients with clinical evidence of remission, MIBI SPECT was negative for tumor recurrence in all. Patients who present with the clinical manifestations of brain tumor relapse, usually have a history of surgery, radiotherapy or chemotherapy and any invasive procedures like stereotactic biopsy on these patients carries a high risk for anesthesia and surgery, besides being costly

  2. Comparison of Tc-99m pertechnetate images with dual-phase Tc 99m MIBI and SPECT images in primary hyperparathyroidism

    Sait Sager

    2014-01-01

    Full Text Available Background: The purpose of this study was to evaluate the value of Tc-99m pertechnetate planar, dual-phase MIBI and MIBI-SPECT images in the determination and localization of parathyroid lesions. Materials and Methods: In this study, 38 patients who underwent operation for primary hyperparathyroidism were included. Tc-99m pertechnetate planar-pinhole imaging of the neck and then MIBI planar and SPECT images in supine position was performed. Late SPECT images were acquired 120 minutes after the injection. Early and late MIBI images were quantitatively evaluated. Results: Of the 38 patients, 30 of them had adenoma, 2 patients had hyperplasia and 6 of them were normal on planar images. Thirty-four of 38 patients were positive on SPECT images. SPECT images of the patients with positive results were matched with pathology results. Conclusion: As a result, Tc-99m pertechnetate planar-pinhole, Tc-99m MIBI planar and SPECT images are useful for localization of parathyroid lesions especially in multinodular thyroid gland. However, US or CT images are necessary for more accurate localization and Tc-99m pertechnetate images are useful for interpreting and comparing with the early and late MIBI images.

  3. Synthesis of Cu[MIBI]4Cl to prepare 99m Tc [MIBI]6+ as a myocardial perfusion agent

    2-Methoxyisobutylisonitrile (MIBI) is a key starting material in the preparation of technetium-99m hexakis (2-methoxyisobutylisonitrile). This cationic complex has been reported to be clinically useful as myocardial perfusion agent. In this work, we designed an improved synthetic method to prepare 2-methoxyisobutylisonitrile in a two step synthesis with an overall yield of 52.9 % , on the basis of 2-methoxyisobutylamine is a primary amine which, when is heated with a mixture of chloroform and alcoholic potash, produces an isonitrile. Its spectroscopic properties as well as the preparation of its copper and technetium-99m complexes are also presented. (Author)

  4. Three-dimensional display of 99mTc-MIBI myocardial scintigraphy

    One of 99mTc-hexakis, 99mTc-methoxyisobutyl isonitrile (MIBI), has been demonstrated to have a myocardial uptake proportional to regional coronary blood flow. In this study, 99mTc-MIBI myocardial scintigraphy was performed for 16 patients with ischemic heart disease. After injection of 740 MBq of 99mTc-MIBI, 64 projection images were collected during a 360-degree rotation. Three-dimensional (3D) display of the left ventricle was reconstructed with depth-shading method from 99mTc-MIBI SPECT images, which were reconstructed by filtered back projection method. In 9 of the patients, left ventricular cineangiography were performed as diagnostic gold standard. Four physicians blinded to patients' clinical information interpreted 3D images and SPECT images on separate occasions. Diagnosis of hypoperfusion by 3D displays agreed with those of SPECT in 92.9% (104/112 segments), and disagreed in 7.1% (8 segments). Sensitivity and specificity of 3D images were 87.0% and 93.9%, which were not statistically different (p<0.05) from that of SPECT images (91.3%, 97.0%). Receiver operating characteristic (ROC) analysis revealed nearly identical curves for the two. Although 3D display had nearly identical diagnostic ability with SPECT, observers reported that 3D images were easier to diagnose than SPECT images. An advantage of the 3D display is that the display gives a more realistic impression of the left ventricle to an observer than tomography or planar imaging. Another advantage is that 3D display can reduce the amount of data storage compared with that of SPECT. In conclusion, 3D images may be useful for diagnosis of hypoperfusion of left ventricle. (author)

  5. 99mTc-MIBI scintigraphy and beta-2-microglobulin in patients with multiple myeloma

    Multiple myeloma is malignancy characterizing with autoimmune proliferation of malignant plasma cells. The aim of the study was to investigate the clinical usefulness of 99mTc-MIBI scintigraphy and serum beta-2-microglobulin for diagnosis, staging and therapy control in patients with multiple myeloma. 67 patients with multiple myeloma were investigated. 42 patients ware in active state and 25 patients were in remission. Planar images and/ or SPECT were performed on the rotating gamma camera (Siemens) 30 minutes and 3 hours after i.v. injection of 555-740 MBq 99mTc-MIBI. The uptake patterns were grouped as normal, diffusely increased and focal increased. Beta-2-microglobulin levels were measured by radioimmunoassay. The scintigraphy with 99mTc-MIBI was true positive in 40 patients with MM. From them, 21 patients were with diffuse uptake and 19 were with focal uptake with 29 lesions. 99mTc-MIBl marrow uptake correlated with the percentage of bone marrow plasma cells. All samples from patients in active state had a serum beta-2-microglobulin above the normal range. In two patients with false negative scan, the results were compared with the data of CT images. Positive clinical findings and increased value of tumour marker were found in these patients. One patient was with false positive scintigraphy. After therapy, the scintigraphy was true negative in 25 patients. In these patients in remission, the levels of the serum beta-2-microglobulin were near to the normal levels. In conclusion, our results demonstrated the effectiveness of both methods - 99mTc-MIBI scintigraphy and serum beta-2-microglobulin in different stage of the disease for the diagnosis, staging and therapy control by patients with multiple myeloma. (authors)

  6. First experience of brain tumour scintigraphy with 99mTc-MIBI before and after surgery

    Full text: Morphological imaging techniques like computed tomography and magnetic resonance imaging are routinely used to localize tumours. However, their use for prediction of histopathological diagnosis and tumour changes after treatment is difficult. Functional imaging using positron emission tomography and single photon emission computed tomography (SPECT) were introduced as non-invasive methods for the differentiation and evaluation of brain tumours, especially for their follow-up. The purpose of present study was to investigate the uptake of 99mTc-MIBI in case of malignant brain tumours before and after surgery. 25 patients (13 males and 12 females; age range 21-75 years; average age 48.76±17.25 years) with brain tumours were investigated. The histological diagnoses of the tumours were confirmed from surgical specimens. None of the patients had received any treatment before enrolment for the study. 99mTc-MIBI brain SPECT was performed 3.88±2.85 days before surgery and 9.88±2.24 days after surgery in all cases. SPECT scans were acquired in 64 projections over 360 deg. using a dual-head gamma camera (Siemens E.Cam) coupled with low energy collimator, 15 minutes after intravenous injection of 550 MBq 99mTc-MIBI. Data were recorded in a 64x64 matrix at a zoom factor of 1.78. SPECT images were reconstructed and analysed in the transversal, axial and coronal planes. The study results are presented in the table. Of the 25 tumors, only 19, majority glioblastoma (11) showed avid uptake in the pre- surgery scan. Tumors, II0 astrocytoma (1), oligoasrtrocytoma (1), III0 astrocytoma (3) were missed in the pre surgery scan. Comparison of pre- and postoperative images showed the reduction of 99mTc-MIBI uptake post-operatively except in one case of gliosarcoma where the uptake increased after surgery. In one case of III deg. astrocytoma the 99mTc-MIBI uptakes was observed only after the surgery. All post-operative images showed more intensive uptake in the scalp (zone of

  7. TB or cancer: Tc-99m MIBI or Tl-201 SPECT for focal pulmonary abnormalities

    Aim: Radiographically detected focal pulmonary abnormalities often suggest the presence of malignancy. Primary bronchogenic carcinoma and benign granulomas account for over 80% of these cases. Because of the high incidence of tuberculosis (TB) in South Africa, it is important to exclude TB as a cause of lung nodules. Both Tl-201 and Tc-99m MIBI, primarily used as myocardial perfusion imaging agents, are known to concentrate in tumors, which includes lung tumors. The main aim of the study was to determine whether it is possible to differentiate between a malignant lung nodule and a nodule due to tuberculosis by using Tl-201 and/or Tc-99m MIBI. Materials and methods: Patients presenting at the respiratory clinic with focal pulmonary abnormalities on chest X-ray (CXR) were included in the study. Tl-201 and Tc-99m MIBI studies were performed on the same day in all patients. Planar views and SPECT of the chest area were obtained. The follow-up of the patients generally included chest CT scan, bronchoscopy and one of the following: Thoracotomy, fine-needle aspiration cytology or repeated CXR documentation over two years. Histological, cytological or microbiological proof of the etiology of the solitary lung nodule was used as the 'gold standard' for determining the final diagnosis. In some cases a two-year follow-up period documenting no progression of lesion size was used to confirm the benign lesion. Results: Of the first 16 patients 13 were included in this report. These included 8 men and 5 women with a mean age of 53.4 years (range 29-72 years). In three patients the final diagnosis has not yet been established. Benign lesions were found in eight patients, five of these were proven TB. In seven of eight patients there was no or very vague uptake of activity in the lesions. One case of active TB showed high uptake with both tracers. Malignant lesions were present in five patients. Avid uptake of both Tl-201 and Tc-99m MIBI was found in these lesions. Uptake was also

  8. The Role of Scintimammography with 99mTc-MIBI in Evaluation of the Breast Lesions

    A. Khancherly

    2003-07-01

    Full Text Available The breast cancer is common in females.Early detection with safe , convenient , noninvasive and accessible diagnostic tools are important. X- ray mammography is still the first choice imaging for breast cancer, but has low specificity and limited value in dense breast and surgically scarred breasts. In recent years , MIBI scintimammography has been used for this purpose. The aim of this study was to determine diagnostic value of prone lateral 99mTc-MIBI scintigraphy in detection of primary breast cancer in patients with breast lesions. We evaluated 55 patients with breast lesions and/or suspicious mammographic findings with MIBI scintimammography. In all patients , the diagnosis was established by pathology. Pattern of MIBI uptake and ratio of lesion to normal tissue uptake was recorded. All lesions with focal uptake and T/N ratio of more than 1.31 were considered as positive. Absence of focal activity or diffuse uptake either unilaterally or bilaterally were considered negative for malignancy. Focal uptake with T/N ratio of 1.01- 1.30 was equivocal in MIBI scan. Mammographic and sonographic findings were classified as negative ( normal or benign , equivocal and Positive (suspecious for malignancy or strongly malignant. Of 55 patients , 10 had cancer in pathologic examination. The MIBI scan detected all of the 10 cancerous lesions. X-mammography was positive in 6 of 10 patients and was negative or equivocal in 3 of them. In this study the MIBI breast scintimammography showed sensitivity and specificity of 100% and 95.4%. With respect to the limitations of X-ray mammography particularly in the young females , dense breasts and surgically scarred breasts , and low specificity of it , MIBI scan can be used as complementary imaging to the mammography and sonography in the evaluation of the breast lesions.

  9. Miocárdio viável pela tomografia computadorizada com Tc-99m (MIBI) sensibilizada por nitroglicerina endovenosa Viable myocardium scintigraphy with intravenous nitroglycerine by computed tomography with Tc-99m (MIBI)

    José Ramos Filho; Marcos Welber Nascimento; Rafael Mariano Gislon da Silva; Thiago Negrini de Camargo; Roberto Simões de Almeida; Eloá Jacinto Lima

    2008-01-01

    FUNDAMENTO: A seleção de pacientes com doença coronariana crônica para recanalização baseia-se na detecção do miocárdio comprometido, potencialmente viável. OBJETIVO: Avaliar o miocárdio isquêmico, potencialmente viável pelo SPECT com MIBI sensibilizado por nitroglicerina em dose máxima tolerada. MÉTODOS: Investigamos de forma prospectiva, de abril de 2004 a novembro de 2005, pela tomografia computadorizada por emissão de fóton único SPECT com Tc-99m (MIBI), 40 pacientes (média etária 62 ± 8,...

  10. Regional lymph node staging in melanoma patients by means of 99mTc-MIBI scintigraphy

    Aim: Nearly 20% of melanoma patients with AJCC stages I-II who do not undergo sentinel/elective lymphadenectomy will develop regional lymph node metastases (RLM). Diagnosis of such lesions is frequently performed clinically during first two-year follow-up. Since 1996, our team has been studying the usefulness of 99mTc-MIBI scintigraphy in the evaluation of recurrent melanoma lesions. The aim of the present study was to prospectively evaluate the clinical value of 99mTc-MIBI scintigraphy in the diagnosis of sub-clinical RLM. Material and Methods: We included 66 patients within 6 months of melanoma diagnosis, with Breslow's thickness > 1.0 mm. When MIBI scans were performed, 49 of them did not have evidence of disease, and 17 presented clinically questionable regional lymph node lesions. Planar images of lymph node regions were acquired 10 min post-injection, using a dose of 740 MBq in a LFOV gamma camera equipped with a LEHR collimator. Scan findings were confirmed by pathology (n=41) or by clinical follow-up with an average time of 31 months (n=25). Results: Thirty out of 33 patients with RLM were correctly diagnosed: palpable lesions (n=14), non-palpable (n=16). In 3 cases that were initially MIBI negative, nodal metastases were found during follow-up. Diagnostic values were as followed: sensitivity 91% (76-98), specificity 85% (68-95), PPV 86% (70-95) and NPV 90% (74-98); (95% CI). Conclusion: 99mTc-MIBI scanning is a sensitive and specific technique for the diagnosis of sub-clinical nodal metastases. Therefore, it could be helpful in the follow-up of melanoma patients

  11. Diagnosis brain tumors with Tc-99m-MIBI and follow-up surrounding oedema after and post oedema therapy with Tc-99m-ECD

    Aim: To precisely diagnose the brain tumors and surrounding oedema is very difficult. The purpose of this study was to analyse the occurrence of visualisation the surrounding brain oedema after and post oedema therapy. Material and Methods: The study included 86 patients with brain tumor and surrounding oedema. All patients were simultaneously subjected SPECT scintigraphy with 550-740 MBq Tc-99m-MIBI as specific tumor marker and 550-740 MBq Tc-99m-ECD as brain oedema marker. Post oedema therapy were all patients SPECT scintigraphy with 550-740 MBq Tc-99m-ECD subjected as follow-up oedema regression. Results: In 86 patients with brain tumor and surrounding oedema the SPECT scintigraphy with Tc-99m-MIBI detected the tumor region while the SPECT with Tc-99m-ECD detected greater area on decreased accumulation implying the surrounding oedema. On the post oedema therapy SPECT scintigraphy with Tc-99m-ECD detected small or non area on decreased accumulation. Conclusion: SPECT scintigraphy of brain with Tc-99m-MIBI and Tc-99m-ECD is a methods for detection of brain tumors and surrounding oedema and enables follow-up effects of oedematous therapy

  12. Assessment of resistance to paclitaxel of murine tumors by 99mTc-MIBI/201Tl dual-radionuclide imaging

    This study investigated P-glycoprotein (Pgp) expression by murine tumors with and without resistance to paclitaxel and the role of 99mTc-2-methoxyisobutylisonitrile (MIBI)/201Tl imaging in predicting the effect of paclitaxel. Antitumor effect of paclitaxel and biodistribution of the radiopharmaceuticals were evaluated in mice bearing four tumor types. Pgp expression did not correlate with the antitumor efficacy of paclitaxel. Although the absolute uptake of 99mTc-MIBI did not correlate with Pgp expression, 99mTc-MIBI could predict paclitaxel sensitivity by its higher uptake

  13. Preoperative localization of parathyroid lesions in patients with primary hyperparathyroidism by {sup 99m}Tc-MIBI scintigraphy

    Suzuki, Noriyuki; Miura, Daisyu; Nakazawa, Hideki [Toranomon Hospital, Tokyo (Japan)

    2000-09-01

    The purpose of this study was to evaluate parathyroid scans obtained by early and late imaging following {sup 99m}Tc-MIBI injection. {sup 99m}Tc-MIBI scintigraphy was performed 15 min and 2 hr after intravenous injection of 300 MBq (or 370 MBq) of {sup 99m}Tc-MIBI. The subjects were 37 patients with primary hyperparathyroidism (adenoma, 34 cases; hyperplasia, 3 cases; and carcinoma 1 case) operated on between January 1994 and March 1996. Sensitivities for localization of adenoma, hyperplasia, and for the both lesions were 84%, 54%, and 76%, respectively. These results were poorer than the results of ultrasonography (US) (adenoma 91%, hyperplasia 54%, and both lesions 81%), and better than by {sup 201}TlCl/{sup 99m}Tc-O{sub 4}{sup -} subtraction scintigraphy (adenoma 69%, hyperplasia 23%, and both lesions 55%). Parathyroid gland weight and associated thyroid lesions decreased the sensitivity of localization detection using {sup 99m}Tc-MIBI. Combined use of {sup 99m}Tc-MIBI scintigraphy and US yielded higher sensitivity (89%), than obtained by either method alone. In the 53 cases operated on between April 1996 and March 2000 (adenoma, 47 cases; hyperplasia, 4 cases; carcinoma, 1 case; and diagnosis uncertain, 1 case), the sensitivities of {sup 99m}Tc-MIBI scintigraphy for the localization adenoma, hyperplasia, and for the both lesions were 83%, 20%, and 71%, respectively, versus 98%, 30%, and 85%, respectively, for US. It is possible that the light weight of parathyroid glands in the patients with hyperplasia decreased the sensitivity of late imaging. {sup 99m}Tc-MIBI scintigraphy is of high diagnostic value in terms of parathyroid function, and US in terms of morphology. The combination of {sup 99m}Tc-MIBI scintigraphy and US appeared to be the optimal diagnostic tool for localization of the lesion in hyperparathyroidism. (K.H.)

  14. The comparison of two gated SPET protocols: adenosine Tc-99m tetrafosmin and treadmill exercise Tc-99m MIBI

    The effect of adenosine and exercise on gated SPET left ventricular ejection fraction (LVEF), end diastolic volume (EDV) and end systolic volume (ESV) has not been fully investigated. The aim of the study was to compare functional measurements obtained in one-day adenosine rest and two-day stress-rest protocols in relation to ischaemia. Out of 226 consecutive patients examined with submaximal treadmill stress-rest 700 MBq Tc-99m MIBI, 26 were chosen to match those subjected to adenosine (140 μg/kg/min) enhanced by a low level exercise protocol (300 MBq and 700 MBq Tc-99m tetrofosmin for stress and rest respectively). All images were acquired on a double head system and were gated using 8 frames, 25 s per frame. ED and ES volumes increased after adenosine but decreased after treadmill resulting in the post-stress LVEF being significantly greater than after adenosine, 60 ± 11 v. 51 ± 13% (p < 0.01). This was caused by the smaller post-stress ESV in the treadmill group 40 ± 20 v. 51 ± 34, p < 0.05. In non-ischaemic scans the LVEF was greater (61± 8 v. 51 ± 14, p < 0.01) and EDV and ESV smaller after both stress and rest. The adenosine test may have an opposite influence on the EDV and ESV in comparison to the submaximal treadmill test and therefore the left ventricular function measurements after adenosine infusion should be interpreted carefully and may not represent those acquired after physical exercise. In the gated SPET scans showing ischaemia the post-stress EDV and ESV may be greater and the LVEF lower than at rest. (author)

  15. {sup 99m}Tc-MIBI scintigraphy of parathyroid adenomas and its relation to tumour size and oxyphil cell abundance

    Melloul, M.; Paz, A.; Cytron, S. [Dept. of Nuclear Medicine, Hasharon Hospital, Rabin Medical Center, Petah Tikva (Israel); Koren, R.; Gal, R. [Dept. of Pathology, Hasharon Hospital, Rabin Medical Center, Petah Tikva (Israel); Feinmesser, R. [Dept. of Oto-Rhino-Laryngology, Hasharon Hospital, Rabin Medical Center, Petah Tikva (Israel)

    2001-02-01

    The aim of this study was to assess the correlation between technetium-99m methoxyisobutylisonitrile (MIBI) uptake by parathyroid adenomas, oxyphil cell content and volume of the lesions. Thirty-one patients with parathyroid adenomas were evaluated prospectively. Preoperative double-phase {sup 99m}Tc-MIBI scintigraphy was performed in all patients and tracer uptake by parathyroid lesions was assessed semi-quantitatively employing region of interest ratios to normal adjacent neck areas. Surgical specimens underwent histological evaluation and oxyphil cell content was determined. The intensity of tracer uptake was compared with oxyphil cell content, volume of the lesions and serum levels of calcium and parathormone. {sup 99m}Tc-MIBI tracer uptake was correlated with oxyphil cell content, volume of parathyroid lesions and the functional status of the parathyroid adenomas. Tracer accumulation in oxyphil cells might partially explain the preferential {sup 99m}Tc-MIBI retention in parathyroid lesions. (orig.)

  16. 99mTc-MIBI scintigraphy of parathyroid adenomas and its relation to tumour size and oxyphil cell abundance

    The aim of this study was to assess the correlation between technetium-99m methoxyisobutylisonitrile (MIBI) uptake by parathyroid adenomas, oxyphil cell content and volume of the lesions. Thirty-one patients with parathyroid adenomas were evaluated prospectively. Preoperative double-phase 99mTc-MIBI scintigraphy was performed in all patients and tracer uptake by parathyroid lesions was assessed semi-quantitatively employing region of interest ratios to normal adjacent neck areas. Surgical specimens underwent histological evaluation and oxyphil cell content was determined. The intensity of tracer uptake was compared with oxyphil cell content, volume of the lesions and serum levels of calcium and parathormone. 99mTc-MIBI tracer uptake was correlated with oxyphil cell content, volume of parathyroid lesions and the functional status of the parathyroid adenomas. Tracer accumulation in oxyphil cells might partially explain the preferential 99mTc-MIBI retention in parathyroid lesions. (orig.)

  17. Comparison of the uptakes of Tc-99m MIBI and Tc-99m tetrofosmin in A549, an MRP-expressing cancer cell, in vitro and in vivo

    Uptakes of Tc-99m MIBI (MIBI) and Tc-99m tetrofosmin (tetrofosmin) in human non-small cell lung cancer A549, multidrug-resistance associated protein (MRP) expressing cell, were investigated in vitro and in vivo. Western blot analysis and immunohistochemistry were used for detetion of MRP in A549 cells with anti-MRPr1 antibody. Cellular uptakes of two tracers were evaluated at 100 μM of verapamil (Vrp), 50 μM of cyclosporin A (CsA) and 25 μM of butoxysulfoximide (BSO) after incubation with MIBI and tetrofosmin for 30 and 60 min at 37.deg.C, using single cell suspensions at 1x106 cells/ml. Radioactivities in supernatants and pellets were measured with gamma well counter. A549 cells were inoculated in each flanks of 24 nude mice. Group 1 (Gr1) and Gr3 mice were treated with only MIBI or tetrofosmin, and Gr2 and Gr4 mice were treated with 70mg/kg of CsA i.p. for 1 hour before injection of 370KBq of MIBI or tetrofosmin. Mice were sacrificed at 10, 60 and 240 min. Radioactivities of organs and tumors were expressed as percentage injected dose per gram of tissue (%ID/gm). Western blot analysis of the A549 cells detected expression of MRPr1 (190 kDa) and immunohistochemical staining of tumor tissue for MRPr1 revealed brownish staining in cell membrane but not P-gp. Upon incubating A549 cells for 60 min with MIBI and tetrofosmin, cellular uptake of MIBI was higher than that of tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetorfosmin. Percentage increase of MIBI was higher than that of tetrofosmin with Vrp by 623% and 427%, CsA by 753% and 629% and BSO by 219% and 140%, respectively. There was no significant difference in tumoral uptakes of MIBI and tetrofosmin between Gr1 and Gr3. Percentage increases in MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at

  18. Comparison of the uptakes of Tc-99m MIBI and Tc-99m tetrofosmin in A549, an MRP-expressing cancer cell, in vitro and in vivo

    Yoo, Jeong Ah; Jeong, Shin Young; Seo, Myung Rang; Bae, Jin Ho; Ahn, Byeong Cheol; Lee, Kyu Bo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of); Choi, Sang Woon; Lee, Byung Ho [Korea Institute of Chemical Technology, Daejon (Korea, Republic of)

    2003-12-01

    Uptakes of Tc-99m MIBI (MIBI) and Tc-99m tetrofosmin (tetrofosmin) in human non-small cell lung cancer A549, multidrug-resistance associated protein (MRP) expressing cell, were investigated in vitro and in vivo. Western blot analysis and immunohistochemistry were used for detetion of MRP in A549 cells with anti-MRPr1 antibody. Cellular uptakes of two tracers were evaluated at 100 {mu}M of verapamil (Vrp), 50 {mu}M of cyclosporin A (CsA) and 25 {mu}M of butoxysulfoximide (BSO) after incubation with MIBI and tetrofosmin for 30 and 60 min at 37.deg.C, using single cell suspensions at 1x10{sup 6} cells/ml. Radioactivities in supernatants and pellets were measured with gamma well counter. A549 cells were inoculated in each flanks of 24 nude mice. Group 1 (Gr1) and Gr3 mice were treated with only MIBI or tetrofosmin, and Gr2 and Gr4 mice were treated with 70mg/kg of CsA i.p. for 1 hour before injection of 370KBq of MIBI or tetrofosmin. Mice were sacrificed at 10, 60 and 240 min. Radioactivities of organs and tumors were expressed as percentage injected dose per gram of tissue (%ID/gm). Western blot analysis of the A549 cells detected expression of MRPr1 (190 kDa) and immunohistochemical staining of tumor tissue for MRPr1 revealed brownish staining in cell membrane but not P-gp. Upon incubating A549 cells for 60 min with MIBI and tetrofosmin, cellular uptake of MIBI was higher than that of tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetorfosmin. Percentage increase of MIBI was higher than that of tetrofosmin with Vrp by 623% and 427%, CsA by 753% and 629% and BSO by 219% and 140%, respectively. There was no significant difference in tumoral uptakes of MIBI and tetrofosmin between Gr1 and Gr3. Percentage increases in MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60

  19. 99mTc-MIBI SPET in non-small cell lung cancer in relationship with Pgp and prognosis

    Higher technetium-99m methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) has been reported to be associated with a positive response to chemotherapy. It has previously been found that in tumour cells, P-glycoprotein (Pgp) expression is of importance for tracer uptake. However, some studies have indicated that Pgp expression does not play an important role in 99mTc-MIBI uptake in NSCLC; indeed, a negative correlation between 99mTc-MIBI uptake and Pgp expression has been reported. Against the background of conflicting results, our aim was to evaluate the relationship between 99mTc-MIBI uptake, prognosis and Pgp expression in NSCLC. A total of 37 patients with NSCLC underwent 99mTc-MIBI single-photon emission tomography (SPET) before chemotherapy. In 19 patients both Pgp and p53 expression, and in two patients only p53 expression (due to the limited biopsy material), were measured with immunohistochemical staining. 99mTc-MIBI uptake was significantly higher in responders than in non-responders: 3.09±1.14 vs 2.24±0.88 (P99mTc-MIBI uptake tend to show a positive response to chemotherapy, and patients with ER and DR values above 3 have a significantly better prognosis. We also found that Pgp expression seems to play only a minor role in 99mTc-MIBI uptake. Our finding that patients with ER and DR values above 3 have a better prognosis needs to be confirmed in larger series of patients. (orig.)

  20. Dynamic coupling of 99mTc-MIBI efflux and apoptotic pathway activation in untreated breast cancer patients

    Our previous studies showed that the efflux rate of technetium-99m methoxyisobutylisonitrile (MIBI) is directly correlated to P-glycoprotein (Pgp) levels in breast carcinoma. The aim of this study was to test whether the Pgp-dependent efflux of 99mTc-MIBI is related to the apoptotic pathway activation in breast carcinoma. Thirty-three untreated non-consecutive patients were intravenously injected with 740 MBq 99mTc-MIBI and serial images were obtained up to 4 h. The rate of efflux was determined by mono-exponential fitting of decay-corrected time-activity curves. Tumour specimens were then obtained at surgery and processed for the determination of the apoptotic index by in situ end-labelling of DNA fragments (Tunel). The rate of tumour cell proliferation was also determined using Ki67 monoclonal antibody. All breast carcinomas showed focal uptake of 99mTc-MIBI and the time to half clearance varied between 85 and 574 min. The apoptotic index ranged between 0.3% and 4.2%, whereas the rate of proliferation varied between 13% and 40%. We found a positive and significant correlation between the apoptotic index and the rate of proliferation (r=0.79, P99mTc-MIBI was directly and significantly correlated with the apoptotic index (r=0.74, P99mTc-MIBI (r=0.57, P99mTc-MIBI sequestration, a model for the dynamic coupling of Pgp-dependent 99mTc-MIBI efflux and apoptotic pathway activation may be derived. (orig.)

  1. The Relation between Collateral Circulation and 99mTc-MIBI Heart SPECT

    The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and 99mTc-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I included 30 patients with grade 2, 3 Collateral flow. Group II included 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3; 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, 99mTc-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I . 3) The presence of good collateral channels was more frequently 99mTc-MIBI reversible perfusion defect (83.4% vs 15.3%, p99mTc-MlBI reversible perfusion defect.

  2. 99mTc-MIBI scintigraphy in metastatic renal cell carcinoma: clinical validation of the relationship between 99mTc-MIBI uptake and P-glycoprotein expression in tumour tissue

    Technetium-99m hexakis-2-methoxyisobutylisonitrile (MIBI) and thallium-201 imaging was performed in a patient with metastatic renal cell carcinoma (RCC), which is a well-known tumour type demonstrating P1-glycoprotein (PGP) overexpression. Two scintigraphic patterns - Tl(+)/MIBI(-) in primary tumour and Tl(+)/MIB(+) in metastatic tumour - were observed, suggesting high- and low-level PGP expression, respectively. Immunochemical study for PGP revealed strong staining of the primary tumour cells. This case clinically validates the previously suggested relationship between 99mTc-MIBI uptake and PGP expression. (orig.)

  3. The role of 99mTc-MIBI SPECT-CT in reoperation therapy of persistent hyperparathyroidism patients

    Yin Lijie

    2015-01-01

    Full Text Available To compare the role of 99mTc-MIBI SPECT-CT image and US in reoperation of persistent secondary hyperparathyroidism patients. A total of 8 persistent secondary hyperparathyroidism patients underwent parathyroidectomy. The sensitivity and accuracy of US and 99mTc-MIBI images before operation were determined. 9 of 14 surgical resection tissues from 8 persistent secondary hyperparathyroidism patients were confirmed to parathyroid hyperplasia. The results showed that the sensitivities were 77.8% and 100%, respectively, for US and 99mTc-MIBI SPECT-CT images. And the accuracies of US and 99mTc-MIBI dual time planar image and SPECT-CT were 50%, 78.6%, respectively. There was significantly difference between two procedures (P=0.021. The superior and inferior localization of glands were both detected by the ultrasound and scintigraphy. Two ectopic parathyroidism nodules were found by 99mTc- MIBI SPECT-CT imaging, while US provided no consistent findings. There was no significantly difference between two procedures (P=0.3. Although two cases of them were not confirmed by pathology, the iPTH of them (800 and 1429 respectively were much higher than other four cases (<400 pg/ml. PTX is a safe and effective treatment for the patients with persistent SHPT. 99mTc-MIBI planar and SPECT-CT imaging may provide more helps for clinician’s localization the hyperparathyroidism glands accurately.

  4. Regional detection of cervical LN metastasis in head and neck cancer with Tc-99m MIBI SPECT

    In head and neck cancer, it is very important to detecting cervical LN metastasis for decision of staging. The aim of this study was to evaluate diagnositc value of Tc-99m MIBI SPECT for the detection of cervical LN metastasis in head and neck cancer. Tc-99m MIBI SPECT was preformed at 10 minutes after injection of 740 MBq of Tc-99m MIBI on 24 patients (21 males, 3 females, mean age=60.8yr) who were performed surgery of head and neck tumors with cervical LN dissection. All LN lesions were subdivided according to anatomical position (level I, IIa, IIb, III, IVa, IVb, V). We interpreted LN metastasis by the anatomical level. Among 238 cervical LN levels, metastatic lesions were 17 and negative lesions were 221. Tc-99m MIBI SPECT revealed 16 TP, 1 FN, 24 FP, and 197 TN. The sensitivity and specificity for head and neck cancer were 94.1% and 89.1%, respectively. In the accuracy of Tc-99m MIBI for the detection of each level LN metastasis, level IIb was 4 FP, level III was 5 FP, level IVa was 1 FP, level IVb was 2 FP, and level V was 12 FP and 1 FN. If level V was excluded, sensitivity and specificity were 100% and 93.7%, respectively. Our study revealed that Tc-99m MIBI SPECT was a very useful for the screening method of detection of cervical LN metastasis in head and neck cancer

  5. Miocárdio viável pela tomografia computadorizada com Tc-99m (MIBI sensibilizada por nitroglicerina endovenosa Viable myocardium scintigraphy with intravenous nitroglycerine by computed tomography with Tc-99m (MIBI

    José Ramos Filho

    2008-09-01

    Full Text Available FUNDAMENTO: A seleção de pacientes com doença coronariana crônica para recanalização baseia-se na detecção do miocárdio comprometido, potencialmente viável. OBJETIVO: Avaliar o miocárdio isquêmico, potencialmente viável pelo SPECT com MIBI sensibilizado por nitroglicerina em dose máxima tolerada. MÉTODOS: Investigamos de forma prospectiva, de abril de 2004 a novembro de 2005, pela tomografia computadorizada por emissão de fóton único SPECT com Tc-99m (MIBI, 40 pacientes (média etária 62 ± 8,9 anos, 30 homens com obstrtução coronariana demonstrada angiograficamente, e a cintilografia miocárdica foi realizada em repouso e com nitroglicerina endovenosa (EV, iniciando com a dose (1 µg/kg/min e incremento a cada minuto, até a queda da pressão arterial sistólica em 20 mmHg. A redução da perfusão dos segmentos foi classificada em moderada e severa, e comparada depois da nitroglicerina. Analisamos as variáveis angiográficas, hemodinâmicas e de perfusão miocárdica. RESULTADOS: Analisamos 680 segmentos miocárdicos em repouso: 538 com distribuição homogênea e 142 com hipoperfusão (54 com redução moderada e 88 severa. Depois da nitroglicerina, ocorreu aumento da perfusão em 19 (47,5% de 40 pacientes. Tornaram-se viáveis 55 de 142 segmentos: 33 (61,1% com redução moderada e 22 (25% com redução severa, ambos apresentaram aumento significativo da distribuição do radiofármaco (p BACKGROUND: The selection of patients with chronic coronary disease for recanalization is based on the detection of the affected myocardium that is potentially viable. OBJECTIVE: To evaluate the potentially viable ischemic myocardium through single photon emission computed tomography (SPECT with MIBI after a maximum tolerated dose of I.V. nitroglycerin. METHODS: We prospectively investigated by SPECT with Tc-99m (MIBI, from April 2004 to November 2005, 40 patients (mean age: 62 ± 8.9 yrs, 30 men with coronary obstruction demonstrated

  6. A comparative study of 99mTc-HL91 and 99mTc-MIBI imaging in experimental tumor and inflammatory models

    Aim: 99mTc-HL91 is a newly developed hypoxic imaging agent for ischemic myocardium and tumor imaging. 99mTc-MIBI is one of imaging agent for mammary tumor imaging. The aim of this experiment is to evaluate the diagnostic value of 99mTc-HL91 in detection of solid tumor in experimental tumor and inflammatory models, via comparative study with 99mTc-MIBI. Material and Methods: HL91 kits was provided by China Nine Star Co. Three kinds of bearing solid neoplasm mice groups (bearing Ehrlich carcinoma mice, bearing H22 carcinoma mice and bearing human ovarian COC1 neoplasm nude mice) and two inflammatory model groups (chemical and bacterial inflammation) underwent static whole body planar images at 1 and 4 hours post injection of 99mTc-HL91. Two kinds of bearing neoplasm mice groups (bearing Ehrlich carcinoma mice, bearing H22 carcinoma mice) and two inflammatory model groups (chemical and bacterial inflammation) underwent static planar images post injection of 99mTc-MIBI, at early phase (10∼20 minutes) and delayed phase (2 hrs). All of mice were sacrificed at 4 hrs. The tumors, or inflammatory lesions, blood and contralateral muscles were removed, weighed and the radioactivity was measured. Regions of interesting (ROIs) were drawn around tumor, inflammatory lesions and contralateral muscles in planar images, and the radioactivity ratios of target (tumor or inflammatory lesions)-to-blood (T/B), target-to-non target (contralateral muscles) i. e. T/NT was calculated. Results: Neoplasm can be clearly visible in planar images at 1hr and 4 hrs post injection of 99mTc-HL91 in all tumor models. At same time inflammatory lesions cannot be seen clearly. Neoplasm can be seen in delayed phase in 99mTc-MIBI groups, but not easy to distinguish them from inflammation. Conclusion: Compared with 99mTc-MIBI imaging, 99mTc-HL91 has much more diagnostic value in detection of solid neoplasm, and can distinguish neoplasm from inflammation

  7. Diagnostic accuracy of Tc-99m MIBI scintimammography in breast cancer

    For the characterization of breast mass, the results of Tc-99m MIBI scintimmamography were much varied between studies. This may result from various factors including tumor size, experience of observer and expression of MDR gene, So, we evaluated the influence of tumor size, knowledge of clinical information, experience of observer and expression of Pgp53 gene on the accuracy of MIBI scintimmamography for the characterization of breast mass. MIBI scintimmamography was prospectively performed in 44 patients with breast masses before surgical resection. The anterior and both lateral prone chest images were acquired at 5 min and 3 hour after injection of 740 MBq of Tc-99m MIBI. Two independent observers reviewed the images for characterization of breast mass without any clinical information. Then the images were reviewed with knowledge of clinical information including tumor size and location. If lesions proved to be malignant, presence of Pgp53 was evaluated by immunohistochemical staining. The comparisons of intraobserver/interobserver diagnostic accuracy and variance were performed by chi-square test and kappa test, respectively. The 54.4% of all lesions (24/44) were malignant. The sensitive, specificity and accuracy of scintimmamography were 73.3%, 82.8%, 79.5% and 73.3%, 84.5%, 80.7% with/without clinical information in observer A, and 76.7%, 86.2%, 83% and 70%, 89.7%, 83% with/without clinical information in observer B, respectively. There were no significant differences in sensitivity, specificity and accuracy between two observers or in same observer with/without clinical information. The agreement for the characterization of breast mass between the two observers was significantly excellent (κ=0.876/ κ=0.897 with/without clinical information, respectively). Intraobserver variance according to the knowledge of clinical information was also small ( κ=0.795 in observer A; κ=0.900 in observer B). Pgp53 was positive in 8 lesions. The sensitivities of

  8. Role of scintigammagraphy with 99mTc-Gluthatione and 99mTc-MIBI in the evaluation and staging of lymphoma

    Full text: The aim of this study was to assess the utility of scintigammagraphy using 99mTc-MIBI and 99mTc-Gluthatione for the evaluation and staging of patients with lymphomas. We studied thirty patients (age range 16-66 years) of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). A control group (CG) of 8 patients with negative histological results was also studied. The patients were divided in three groups; HD group: thirteen patients (7 males and 6 females); NHL: seventeen patients (10 males and 7 females); CG: eight patients (2 males and 6 females). Scintigammagraphy studies were performed 20 min and 2 h after intravenous administration of 925-1110 MBq of 99mTc-MIBI or 99mTc-Gluthatione (GSH) using a gamma camera (Sophy DS-7, Sopha Medical System, France) equipped with low energy all purpose parallel hole collimator. Anterior and posterior images of thorax, abdomen and pelvis in 128x128 pixels matrix each for 1 million counts per view were acquired. A 20% window centered on the 140 keV was used for all acquisitions. All images were processed and analysed on a workstation (Power Vision, SMV, Canada) and interpreted by three qualified and experienced nuclear medicine specialist. The final diagnosis was reached by consensus. The images with a focal abnormal intense uptake were considered positive. Images showing diffuse bilateral and symmetrical uptake, bilateral lung uptake and intestinal uptake were considered negative. The overall sensitivity, specificity and accuracy of results for both radiopharmaceuticals were calculated using the histological findings, x-ray, ultrasound and CT scanning as confirmation criterion as gold standard. The nodular sclerosis was the most frequent type in HD group. In this group twelve patients were positive with 99mTc-MIBI scintigammagraphy while one was negative (nodular sclerosis, grade II). Scintigammagraphy with 99mTc-GSH was positive in all patients in HD group. However, scintigammagraphy with both radiopharmaceuticals

  9. Evaluation of some ratio effects in 99mTc-MIBI imaging of breast tumors

    2001-01-01

    The effectiveness of using some ratios in 99mTc-MIBI imaging fbr the diagnosis of breast tumors was evaluated. After 100 patients with the breast tumor underwent 99mTc-MIBI imaging, the ratios of tunor to contralateral uptake (T/N). tumor to heart uptake (T/H), and tumor to sternum uptake (T/S) were obtained and then analysed about their reproducibility and values in differentiating benign breast lesion the from malignant tumor. To detect breast cancers, the sensitivity, specificit y and accuracy of T/N were 92%, 90% and 91%, respectively. However, those of T/S were 70% (p <0.01), 74% (p <0.05), 72% (p <0.01), and those of T/H were 74%(p <0.05). 76% (p >0.05). 75% (p <0.01). The average coefticients of variation(CV) of T/N, T/S and T/H were 9.439±9.712. 4.856+4.420 (p >0.05), and 3.736±3.489 (p <0.05). It was found that T/N had the best sensitivity, specificity and accuracy todetect the breast cancer, but its reproducibility is poor. On the other hand, T/H has better reproducibility.

  10. Is Tc99m-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in Osteosarcoma?

    Vahidreza Dabbagh Kakhki

    2013-10-01

    Full Text Available Objectives: Multidrug resistance (MDR, which may be due to the over expression of P-glycoprotein (Pgp and/or MRP, is a major problem in neoadjuvant chemotherapy of osteosarcoma. The aim of this study was to investigate the role of Tc-99m MIBI scan for predicting the response to pre-operative chemotherapy. Materials and Methods: Twenty-five patients (12 males and 13 females, aged between 8 and 52y with osteosarcoma were studied. Before the chemotherapy, planar 99mTc-MIBI anterior and posterior images were obtained 10-min [tumor-to-background ratio: (T1/B110min] and 3-hr after tracer injection. After completion of chemotherapy, again 99mTc-MIBI scan was performed at 10-min after tracer injection. In addition to calculation of decay corrected tumor to background (T/B ratios ,  using the 10-min and 3-hr images of the pre-chemotherapy scintigraphy , percent wash-out rate (WR% of 99mTc-MIBI was calculated. Using the 10-min images of the pre- and post-chemotherapy scans, the percent reduction in uptake at the tumor site after treatment (Red% was also calculated. Then after surgical resection, tumor response was assessed by percentage of necrosis. Results: All patients showed significant 99mTc-MIBI uptake in early images. Only 9 patients showed good response to chemotherapy (necrosis≥90% while 16 patients were considered as non-responder (necrosis

  11. THE CLINICAL SIGNIFICANCE OF 99mTc-MIBI BREAST IMAGING IN THE DIAGNOSIS OF EARLY BREAST CANCER

    任长才; 金少津; 邹强; 朱汇庆; 王红鹰; 梁春立

    2001-01-01

    Objective: To find an effective, sensitive, specific and noninvasive diagnostic method of breast cancer. Methods: 109 masses of 102 patients with breast lesions smaller than 2 cm in diameter were divided into three groups to undergo 99mTc-MIBI imaging and compared with the results of pathology examination. 20 cases without breast lesions were selected as control. Abnormal condensation of 99mTc-MIBI in the breast reaching 10% higher than that in the counterpart of the healthy breast was regarded as positive. Results: Of 32 breast cancers, positive imaging appeared in 25. Negative imaging were found in 31 of 38 benign breast lesions. Of 39 occult breast lesions, positive imaging appeared in 6 and 3 of them were breast cancer, 2 of 3 patients with slightly increased 99mTc-MIBI imaging threshold were breast cancer also. No positive imaging was found in the control group. The diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value of 99mTc-MIBI was 88.4%, 89.2%, 88.0%, 75.0% and 95.3%, respectively. Conclusion: 99mTc-MIBI imaging had higher sensitivity and accuracy in the diagnosis of breast cancer and differentiation between benign and malignant breast lesions. It could provide useful information for the diagnosis of clinically suspected breast cancer.

  12. Preparation of 186 Re-MIBI Complex for Myocardial Perfusion Imaging as Potential Replacement of Analogues 99mTc-MIBI

    The aim of the present study is to label 2-methoxy isobutyl-isonitrile (MIBI) compound with pure 186 Re and study the optimum conditions to prepare the 186 Re-MIBI complex as a stable contrast agent for myocardial perfusion imaging. From the obtained data the complexation of MIBI with 186 Re was carried out of using 1 mg MIBI, 1 mg SnCl2, 3 mg gentesic acid and 1 ml 186 Re(37 MBq) at ph 2 in a boiling water bath for 30 min. The biodistribution studies in mice indicate that, the complex was cleared from the body by kidneys to urinary bladder and finally was eliminated from the body by urine. 186 Re-MIBI demonstrated satisfactory heart uptake and retention like 99mTc-MIBI (8.94% dose/organ at 5 minutes), blood clearance was fast, while liver activity decreased by time and negligible activity in the lunges. The obtained data showed that 186 Re-MIBI as a potential replacement of 99mTc-MIBI for myocardial perfusion imaging

  13. Relationship between the 99mTc-MIBI and expression of P-glycoprotein in lung cancer

    Objective: To correlate the imaging of 99mTc-MIBI with the expression of P-glycoprotein (PGP) in lung cancer. Methods: All patients, undergoing early (30 min) and delayed (3h) 99mTc-MIBI imaging before initiation of chemo-or radiotherapy, were diagnosed pathologically. Immunohistochemical studies were performed using a monoclonal antibody, P-170, developed against the internal epitope of PGP. Normal tissue and tumor washout rate and tumor-to-background ratio were correlated with the level of PGP expression. Results: There was an inverse correlation between tumor-to-background ratio and the density of PGP (P 0.1). Conclusion: The reduced ability for the tumors to accumulate MIBI correlates well with the increased levels of PGP expression, tumor washout rate of MIBI does not correlate with the density of PGP in tumor tissues

  14. Alternative chromatographic system for the quality control of lipophilic technetium-99m radiopharmaceuticals such as [99mTc(MIBI6]+

    D.P. Faria

    2015-01-01

    Full Text Available Knowledge of the radiochemical purity of radiopharmaceuticals is mandatory and can be evaluated by several methods and techniques. Planar chromatography is the technique normally employed in nuclear medicine since it is simple, rapid and usually of low cost. There is no standard system for the chromatographic technique, but price, separation efficiency and short time for execution must be considered. We have studied an alternative system using common chromatographic stationary phase and alcohol or alcohol:chloroform mixtures as the mobile phase, using the lipophilic radiopharmaceutical [99mTc(MIBI6]+ as a model. Whatman 1 modified phase paper and absolute ethanol, Whatman 1 paper and methanol:chloroform (25:75, Whatman 3MM paper and ethanol:chloroform (25:75, and the more expensive ITLC-SG and 1-propanol:chloroform (10:90 were suitable systems for the direct determination of radiochemical purity of [99mTc(MIBI6]+ since impurities such as 99mTc-reduced-hydrolyzed (RH, 99mTcO4 - and [99mTc(cysteine2]- complex were completely separated from the radiopharmaceutical, which moved toward the front of chromatographic systems while impurities were retained at the origin. The time required for analysis was 4 to 15 min, which is appropriate for nuclear medicine routines.

  15. Alternative chromatographic system for the quality control of lipophilic technetium-99m radiopharmaceuticals such as [99mTc(MIBI)6]+

    Knowledge of the radiochemical purity of radiopharmaceuticals is mandatory and can be evaluated by several methods and techniques. Planar chromatography is the technique normally employed in nuclear medicine since it is simple, rapid and usually of low cost. There is no standard system for the chromatographic technique, but price, separation efficiency and short time for execution must be considered. We have studied an alternative system using common chromatographic stationary phase and alcohol or alcohol:chloroform mixtures as the mobile phase, using the lipophilic radiopharmaceutical [99mTc(MIBI)6]+ as a model. Whatman 1 modified phase paper and absolute ethanol, Whatman 1 paper and methanol: chloroform (25:75), Whatman 3MM paper and ethanol:chloroform (25:75), and the more expensive ITLC-SG and 1-propanol: chloroform (10:90) were suitable systems for the direct determination of radiochemical purity of [99mTc(MIBI)6]+ since impurities such as 99mTc-reduced-hydrolyzed (RH), 99mTcO4- and [99mTc(cysteine)2]- complex were completely separated from the radiopharmaceutical, which moved toward the front of chromatographic systems while impurities were retained at the origin. The time required for analysis was 4 to 15 min, which is appropriate for nuclear medicine routines. (author)

  16. Alternative chromatographic system for the quality control of lipophilic technetium-99m radiopharmaceuticals such as [{sup 99m}Tc(MIBI){sub 6}]{sup +}

    Faria, D.P.; Buchpiguel, C.A.; Marques, F.L.N., E-mail: danielefaria1@gmail.com [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Faculdade de Medicina. Departamento de Radiologia. Servico de Medicina Nuclear

    2015-10-15

    Knowledge of the radiochemical purity of radiopharmaceuticals is mandatory and can be evaluated by several methods and techniques. Planar chromatography is the technique normally employed in nuclear medicine since it is simple, rapid and usually of low cost. There is no standard system for the chromatographic technique, but price, separation efficiency and short time for execution must be considered. We have studied an alternative system using common chromatographic stationary phase and alcohol or alcohol:chloroform mixtures as the mobile phase, using the lipophilic radiopharmaceutical [{sup 99m}Tc(MIBI){sub 6}]{sup +} as a model. Whatman 1 modified phase paper and absolute ethanol, Whatman 1 paper and methanol: chloroform (25:75), Whatman 3MM paper and ethanol:chloroform (25:75), and the more expensive ITLC-SG and 1-propanol: chloroform (10:90) were suitable systems for the direct determination of radiochemical purity of [{sup 99m}Tc(MIBI){sub 6}]{sup +} since impurities such as {sup 99m}Tc-reduced-hydrolyzed (RH), {sup 99m}TcO4{sup -} and [{sup 99m}Tc(cysteine){sub 2}]{sup -} complex were completely separated from the radiopharmaceutical, which moved toward the front of chromatographic systems while impurities were retained at the origin. The time required for analysis was 4 to 15 min, which is appropriate for nuclear medicine routines. (author)

  17. Preoperative localization of parathyroid lesions. Value of {sup 99m}Tc-MIBI tomography and factors influencing detection

    Ansquer, C.; Carlier, T.; Kraeber-Bodere, F. [Hotel Dieu Univ. Hospital, Nantes (France). Nuclear Medicine Dept.; Mirallie, E. [Hotel Dieu Univ. Hospital, Nantes (France). Surgery Dept.; Abbey-Huguenin, H. [Rene Gauducheau Centre, Saint Herblain (France). Biostatistics Dept.; St Jacques Univ. Hospital, Nantes (France). PIMESP; Aubron, F. [Ultrasonography Centre, Nantes (France)

    2008-07-01

    The aim of our study was to assess retrospectively the value of {sup 99m}Tc-MIBI SPECT in the localization of parathyroid lesions in primary hyperparathyroidism and to determine the impact of PTH level, age, sex, characteristics of the lesions and thyroid nodules on the sensitivity of imaging. Patients, methods: Fifty nine patients who were cured after the resection of 60 lesions (50 adenomas, 9 hyperplasias and 1 carcinoma, 9 of them in ectopy) were selected. {sup 99m}TcO{sub 4}{sup -}, early and late {sup 99m}Tc-MIBI planar images (n=59), {sup 99m}Tc-MIBI SPECT (n=58) and ultrasound (n=50) performed preoperatively were analyzed. The imaging results were compared to surgical and histological findings and correlated to different factors suspected of influencing the imaging's sensitivity. Results: Sensitivity of double phase {sup 99m}Tc-MIBI/{sup 99m}TcO{sub 4}{sup -} scintigraphy was higher than that of early or late scintigraphy alone. SPECT increased the sensitivity of scintigraphy from 85% to 92% and was useful to confirm doubtful foci and to localize ectopic lesions. Ultrasound (US) had the lowest sensitivity (56%) and the highest rate of false-positive results (n=10), but identified 2 adenomas which were not detected by scintigraphy. Combining all imaging modalities, sensitivity reached 96%. Better sensitivities were observed when age <69 years, preoperative PTH level {>=}155 pg/ml, weight of the gland {>=}0.80 g and in the absence of thyroid nodules. US was more influenced by these factors than scintigraphy. Conclusion: Combination of US, double-phase {sup 99m}Tc-MIBI/{sup 99m}TcO{sub 4}{sup -} planar scintigraphy and SPECT is the most accurate method for the detection of parathyroid lesions and should be performed before minimally invasive surgery, especially when PTH level is low, in older patients and in cases of multinodular goiter. (orig.)

  18. Role of 99mTc-MIBI in evaluation of palpable breast lesions

    Full text: Breast carcinoma is the most frequently diagnosed malignancy in women with 41% of all new cases diagnosed in developing countries. Over 323,000 women in the developing countries were detected in 1990, leading to 140,000 deaths. The annual incidence of breast carcinoma among women in Pakistan accounts for 32% of all detected carcinomas and 18% of all cancer related deaths. Three years data (2000-2002) collected from Bahawalpur Institute of Nuclear Medicine and Oncology (BINO) indicated that 16.5% of the total patients were registered with carcinoma breast. To reduce the mortality associated with this disease, screening of asymptomatic women has been advocated to diagnose problems at an early stage, particularly by X-ray mammography on annual basis after the age of 50. The available imaging modalities like mammography and ultrasound lack the desired specificity to differentiate the malignant masses from benign ones; hence there is a need to search for more specific imaging tool and to save the patients from unnecessary biopsies. Technetium-99m labeled methoxy-isobutyl-isonitrile (99mTc-MIBI) is a well-known cardiac perfusion-imaging agent. After convincing reports from various parts of the world that it specifically accumulates in malignant breast masses, we carried out a study to evaluate the diagnostic performance of 99mTc-MIBI scintimammography in palpable breast lesions. Patients with palpable breast lesions were studied after obtaining informed written consent. The study was carried out as a prospective trial. A total of 42 patients with 45 palpable breast masses were included in this study. The median age was 44 years (range 19-84 years). Tc-99m-MIBI was injected in a dose of 740 MBq in dorsal pedal vein and if unsuccessful then in medial cubital vein on the opposite side of the breast, to be imaged for the lump. Planar 10 minutes images in prone lateral and in supine position with arms raised behind the head were acquired 10 minutes and 60-90 minute

  19. Non-visualized Thyroid Gland by Tc-{sup 99m} MIBI Scan with Normal Thyroid Scan

    Koca, Gokhan; Atilgan, Hasan Ikbal; Baskin, Aylin; Demirel, Koray; Korkmaz, Meliha [Ankara Training and Research Hospital, Ankara (Turkmenistan)

    2013-09-15

    We present the case of a 21-year-old man who was referred to us for parathyroid scintigraphy with high blood levels of intact parathormone and osteoporosis. Several methods and radiopharmaceuticals, e.g., Tc-99m MIBI and Tl-201 chloride/Tc-99m pertechnetate (Tl-201/TcPO{sup -4}) subtraction, are commonly used for this purpose. We present the case of a thyroid gland that demonstrates quite normal Tc-99m pertechnetate uptake, no accumulation of Tc-99m MIBI, and very low grade Tl-201 uptake. To the best of our knowledge, no similar case has been reported previously. A 21-year-old male with osteoporosis and growth-development retardation was referred for MIBI parathyroid scan because of high blood levels of intact parathormone and bone-specific alkaline-phosphatase, which were 219.4 (15-88 pg/ml) and 355 (21-58 U/L), respectively. In his Tc-99m pertechnetate (TcPO{sup -4}) pinhole scintigraphy, bilateral clearly visualized radioactivity accumulation in the thyroid gland was seen. In both early or late images of the Tc-99m MIBI parathyroid scan, the thyroid gland was not visualized. Therefore, a Tl-201/TcPO{sub -4} subtraction scan method was used. However, the Tl-201 accumulation level in the thyroid gland was not sufficient for the subtraction method. In his thyroid ultrasonography, the thyroid gland echo was homogenous, and there was neither any solid nor cystic lesion. The physical examination of his neck was normal. Other laboratory findings were all normal as follows. TSH: 3.03 (0.35-5.6 IU/mL), free T3: 3.66 (2.5-3.9 pg/mL), free T4: 0.90 (0.59-1.3 ng/dL), Anti-TPO:0.3 (0.40 IU/mL), Anti-TG-Ab: <2.2 (0-+u/L), TSH receptor Ab: 1.0 (0.14 U/L), osteocalcine: 9.13 (1.5-15 ng/dL), growth hormone: 1.3 (0.014-5.21), calcitonin:17 (0.150 ng/mL), sedimentation:6 (0.15 mm/h). There were no significant symptoms of acute or chronic thyroiditis. The cause for discordant uptake in the thyroid gland with T1-201 and Tc-99m MIBI scan could not be provided through clinical or

  20. Effect of multidrug resistance gene-1(mdr1) overexpression on in-vitro uptake of 99mTc-sestaMIBI in murine L1210 leukemia cells

    To determine whether 99mTc-MIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively 99mTc-MIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular 99mTc-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr 1 gene) overexpression. We measured percentage uptake of 99mTc-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of 99mTc-MIBI were also evaluated with or without overexpression of mdr1 gene in cultured murine leukemia L1210 cells. The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of 99mTc-MIBI was higher in mdr1 negative L1210 cells than those of mdr1 positive cells, and higher when incubated in 37 .deg. C than 4 .deg. C. In the presence of verapamil, cyclosporin or dipyridamole, 99mTc-MIBI uptake was increased upto 604% in mdr1 positive cells. Cellular uptake of 99mTc-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest the 99mTc-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents in vitro

  1. Correlation between P-glycoprotein (P-gp) expression in parathyroid and Tc-99m MIBI parathyroid image findings

    Sun, S.-S.; Shiau, Y.-C.; Lin, C.-C.; Kao, Albert E-mail: albertkaotw@yahoo.com.tw; Lee, C.-C

    2001-11-01

    The major factor to influence localization of parathyroid adenomas is tumor size. P-glycoprotein (P-gp) expression in parathyroid adenomas has been considered to be an another possible factor to influence localization of parathyroid adenomas because false-negative studies have been reported with large tumors and true-positives reported with very small tumors in previous studies. The aim of this study was to characterize Tc-99m MIBI uptake and retention by parathyroid adenomas and to correlate this with cell surface expression of P-gp. Sixteen patients with parathyroid adenoma (larger than 1.5 gm) underwent dual-phase (10min and 2hr) Tc-99m MIBI parathyroid image immediately before parathyroid exploration. Tissues were obtained from normal and abnormal parathyroid glands and from the thyroid gland. Immunohistochemistry (IHC) was obtained with monoclonal antibodies to identify P-gp expression in all tissues. All of the 16 parathyroid adenomas and 32 normal control specimens (16 normal parathyroid and 16 normal thyroid specimens) were submitted for P-gp detection by IHC. The dual-phase Tc-99m MIBI parathyroid image accurately localized 14 parathyroid adenomas, but not the remaining 2 adenomas. The 14 parathyroid adenomas with significant Tc-99m MIBI uptake in delayed 2hr images revealed negative P-gp expression, but the 2 adenomas without significant Tc-99m MIBI uptake, as well as normal parathyroid and normal thyroid specimens, revealed positive P-gp expression when evaluated by IHC. Not only the size of parathyroid adenomas, but also significant P-gp expression limited the sensitivity of dual-phase Tc-99m MIBI parathyroid image to localize parathyroid adenomas before operation.

  2. 99mTc-MIBI SPECT in primary hyperparathyroidism. Influence of concomitant vitamin D deficiency for visualization of parathyroid adenomas

    Aim of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of 99mTc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT). Patients, methods: between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a 99mTc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase 99mTc-MIBI protocol with SPECT were compared with histopathology. Results: in 54 pts with normal vitamin D values late SPECT images identified more lesions (n 51, sensitivity 91%) than early planar (n = 45, sensitivity 82%) or late planar images (n = 50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n = 13, sensitivity 72%) than early planar (n = 10, sensitivity 56%) or late planar images (n = 10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a 99mTc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p = 0.1625; late planar: p = 0.0039; 99mTc-MIBI SPECT: p 0.1180. Conclusion: the likelihood of a pathological 99mTc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency. (orig.)

  3. Labelling, biodistribution and compartmental analysis of N-acetylcysteine labelled with Tc-99m. Comparative investigation with with {sup 99m} Tc-MIBI in an in vivo tumoral model; Estudo de marcacao, biodistribuicao e analise compartimental da N-acetil cisteina marcada com Tc-99m. Investigacao comparativa com MIBI-{sup 99m}Tc em modelo tumoral in vivo

    Faintuch, Bluma Linkowski

    1997-07-01

    Labelling and biodistribution studies were done with two different ligands, respectively Methoxy isobutyl isonitrile (MIBI) and N-acetylcysteine (NAC), employing Tc-99m as a tracer. The main objective was to assess the pharmacokinetic properties of the second substance, aiming at its possible application in cancer diagnosis. To this purpose an in vivo investigation was done using healthy and tumor-bearing rats with experimental cancer. Images of tumor-bearing rats registered in a scintillation camera indicated that with {sup 99m} Tc-MIBI none of the two selected times was adequate for visualization of the cancer mass. In contrast, {sup 99m} Tc-NAC permitted clear identification of the humor, four hours after injection. The results have demonstrated that {sup 99m} Tc-NAC is a radiopharmaceutical with affinity for cancer tissue and promising for further investigation concerning imaging diagnosis of tumors. (author)

  4. Localization of parathyroid adenoma by echography and scintigraphy with 99mTc-MIBI: the influence of lesion's weight

    In the examination for pre-surgery localization of a primary hyperparathyroidism (HPT I), the size of parathyroid lesion constitutes the main factor limiting the diagnostic efficiency of different imaging techniques. We have tried to test this hypothesis by echography and scintigraphy with MIBI for the detection of unique adenomas. The study covered 16 patients explored pre-surgically by echography and scintigraphy with 99mTc-MIBI for a HPT I as referred to a unique cervical adenoma (reference = surgery + anatomical-pathological examination). The scintigraphy with MIBI is achieved and interpreted by the 'double phase' technique proposed by Taillefer with pin-hole acquisition of 15 and 120 minutes after injection of around 370 MBq of 99mTc-MIBI. The average weight of adenoma is 3180 mg (218 to 22000). The echography localizes correctly the adenoma in 8 cases, in a wrong position, in 2 cases and does not find images evoking abnormal parathyroid in 6 patients. The MIBI visualizes properly the adenoma in 15 cases and in an incorrect position, in 1 patient. A table is given presenting the echography and MIBI-scintigraphy sensitivities as a function of adenoma weights. In conclusion, in our study the MIBI appear to be more sensitive than the echography in localizing the parathyroid adenoma. The diagnostic value of the two examinations appears to be independent of its weight; however, the results should be confirmed on larger batches

  5. Contribution of MIBI 99mTc mammary scintigraphy in mammary cancer detection

    Recent publications indicate the interest in 99mTc - SESTA-MIBI in diagnosing mammary cancers. The goal of this paper was to study the feasibility of this method and define its place relative to the classical tripod: mammography, echography, cyto-puncture. The mammary scintigraphy is achieved, in condition ventral-decubitus at 10 minutes after the injection of 20 mCi of SESTA-MIBI, in 100 patients for which a surgery decision was made. Ten minute incidences from the left, right and front sides were achieved. A visual score ranging from G1 to G4 was established: G1 - no anomalous fixation; G2 - slight fixation of irregular shape; G3 - moderate well-defined fixation; G4 - intense circular fixation. The final diagnosis is given by histology. Results with the score ranging from G1 to G4 for five diagnosis types are given. By considering G3 and G4 as positive to biopsy the sensitivity found was 91.2%; the specificity, 62.8%; the positive predicting value, 76.4% and the VPN, 84.4%. Five falsely negative cancers correspond to micro-calcification sub-centimeter lesions. In conclusion, the contribution of the mammary scintigraphy consists in identification of positive MIBI lesions having a uncertain and/or ensuring ensuring and multi-focal lesions for the cases in which the tripod indicate a single lesion. Making evident these multi-focal lesions allows establishing a surgical operation scheme which will guide an enlarged extirpation

  6. Effect of P-glycoprotein and multidrug resistance associated protein gene expression on Tc-99m MIBI imaging in hepatocellular carcinoma

    P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) expressions as well as Tc-99m methoxisobutylisonitrile (MIBI) images were assessed in 25 patients hepatocellular carcinoma (HCC). Tc-99m MIBI imaging was performed 10 minutes after intravenous injection of 20 mCi Tc-99m MIBI. Using immunohistochemical staining, 60% of the HCC lesions showed positive for Pgp and 64% showed positive for MRP. In 3 patients with MIBI uptake, immunohistochemical study of tumor tissue showed no Pgp stained cells. Nevertheless, they were all positive for MRP. The result of Tc-99m MIBI imaging is more related to the expression of Pgp than MRP gene. It is possible that other membrane transporters as well as Pgp and MRP are involved in the efflux of Tc-99m MIBI

  7. Interobserver Reproducibility of Segmental Scoring of 99mTc-MIBI Myocardial SPECT

    The accuracy of dipyridamole stress/rest 99mTc-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blinded to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females, mean age 58 ±7 yr) with suspected coronary artery disease who underwent both dipyridamole stress/rest 99mTc-MIBI myocardial SPECT and coronary angiography, The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five point scale (segmental score: O=normal, 1 =equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear- sons correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity. Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

  8. Non-Q-wave myocardial infarction: impaired myocardial energy metabolism in regions with reduced 99mTc-MIBI accumulation

    Reduced regional technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) accumulation in patients with chronic non-Q-wave infarction (NQWI) but without significant coronary artery stenosis indicates non-transmural damage of the myocardial wall. The aim of this study was to characterise cardiac energy metabolism after NQWI using phosphorus-31 magnetic resonance spectroscopy (31P-MRS) and to compare the biochemical remodelling with changes in regional 99mTc-MIBI uptake and with morphological and functional parameters assessed by magnetic resonance imaging (MRI). Fifteen patients with a history of NQWI, exclusion of significant coronary artery stenosis (31P-MRS to study the effects of NQWI on myocardial energy metabolism. Spectroscopic measurements were performed in the infarct-related myocardial region. Corresponding gradient-echo MR images and myocardial 99mTc-MIBI single-photon emission tomography images were acquired for exact localisation of the infarct region. All examinations were performed at rest under anti-ischaemic medication. Data were compared with those of patients in whom coronary artery disease had been excluded by angiography (group B, n=10). All patients of group A displayed anterior wall hypokinesia in the infarcted area on both ventriculography and MRI, with a reduced myocardial accumulation of 99mTc-MIBI (66.3%±11.8% vs 95.6%±2.2% in group B). The mean wall thickness during the complete cardiac cycle (9.5±1.8 mm vs 13.1±1.1 mm in group B, P99mTc-MIBI displays a reduced PCr/ATP ratio. Our results indicate that morphological remodelling after NQWI is accompanied by fundamental changes in cardiac energy metabolism. (orig.)

  9. Absorbed radiation to the nuclear medicine nurses from patients administered 201Tl and 99mTc- MIBI

    People who have administrated radiopharmaceuticals could be a source of radiation to their relatives, medical nurses, and people who have contact them. In this study, the dose rates at various distances of 5, 10,50 and 100 cm from 70 patients, who were administered diagnostic amounts of 201Tl -Chloride and 99mTc -MIBI, was measured using an ionization chamber. For determination of external radiation dose to the nurses the radiations in three deferent interval times have measured. The maximum values of external dose rates of 201Tl and 99mTc-MIBI were 11.2μSv/h ±2.3 and 43.1μSv/h ±11.9 respectively at 5 cm from the patients. Significant exposure from patients after injection of 99mTc -MIBI was limited on the day of administration. Departure doses rate of 201Tl fell gradually so by 3 days after administration was significant. Maximum and average absorbed dose of nuclear medicine staff for one 201Tl scan was 4.6 and 2.7μSv/h, and for 99mTc-MIBI was 18.1 and 9.8μSv/h in a working day. (author)

  10. Absorbed radiation to the nuclear medicine nurses from patients administered 201Tl and 99mTc- MIBI

    People who have administrated radiopharmaceuticals could be a source of radiation to their relatives, medical nurses, and people who have contact them. In this study, the dose rates at various distances of 5, 10,50 and 100cm from 70 patients, who were administered diagnostic amounts of 201Tl-Chloride and 99mTc-MIBI, was measured using an ionization chamber. For determination of external radiation dose to the nurses the radiations in three deferent interval times have measured. The maximum values of external dose rates of 201Tl and 99mTc- MIBI were 11.2μSv/h ±2.3 and 43.1μSv/h ±11.9 respectively at 5cm from the patients. Significant exposure from patients after injection of 99mTc-MIBI was limited on the day of administration. Departure doses rate of 201Tl fell gradually so by 3 days after administration was significant. Maximum and average absorbed dose of nuclear medicine staff for one 201Tl scan was 4.6 and 2.7μSv/h, and for 99mTc-MIBI was 18.1 and 9.8μSv/h in a working day. (author)

  11. Parathyroid glands: combination of (99m) Tc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules

    Colagrande, S; C. Biagini; BISI, G; L.Vaggelli; D. Borrelli; P. Cicchi; TONELLI, F; Amorosi, A; M.Serio; De Feo, M.L; Brandi, M.L.

    2000-01-01

    PURPOSE: To determine the appropriate choice of imaging techniques for localization of nodular lesions of parathyroid glands. MATERIALS AND METHODS: First, computed tomographic (CT), magnetic resonance (MR), ultrasonographic (US), and technetium 99m methoxyisobutyl-isonitrile (MIBI) scintigraphic images in 49 patients with primary hyperparathyroidism were retrospectively evaluated. A single-blind, prospective study that included 16 patients with primary hyperparathyroidism was then condu...

  12. {sup 99m}Tc-MIBI pinhole SPECT in primary hyperparathyroidism: comparison with conventional SPECT, planar scintigraphy and ultrasonography

    Carlier, Thomas; Bodet-Milin, Caroline; Kraeber-Bodere, Francoise; Ansquer, Catherine [Hotel Dieu University Hospital, Nuclear Medicine Department, Nantes (France); INSERM CRCNA, Nantes (France); Oudoux, Aurore [Hotel Dieu University Hospital, Nuclear Medicine Department, Nantes (France); Mirallie, Eric [Hotel Dieu University Hospital, Surgery Department, Nantes (France); Seret, Alain [University of Liege, Institute of Physics, Experimental Medical Imaging, Liege (Belgium); Daumy, Isabelle [Ultrasonography Center, Nantes (France); Leux, Christophe [Saint Jacques University Hospital, PIMESP, Nantes (France)

    2008-03-15

    A pinhole collimator is routinely used to increase the resolution of scintigraphy. This prospective study was conducted to determine the interest of {sup 99m}Tc-MIBI pinhole single-photon emission computed tomography (SPECT) for the preoperative localisation of parathyroid lesions in primary hyperparathyroidism. All patients underwent a neck ultrasonography (US), {sup 99m}TcO{sub 4}{sup -} and {sup 99m}Tc-MIBI planar images and two consecutive SPECT with a parallel (C-SPECT) and a pinhole collimator (P-SPECT). P-SPECT was performed with a tilted detector equipped with a pinhole collimator and reconstructed with a dedicated OSEM algorithm. A diagnostic confidence score (CS) was assigned to each procedure considering intensity and extra-thyroidal location of suspected lesions: 0 = negative, 1 = doubtful, 2 = moderately positive, 3 = positive. The results of these preoperative localisation studies were compared with surgical, pathological and 6-month biological findings. Fifty-one patients cured after surgery were included. Surgery revealed 55 lesions (median weight 0.5 g, 11 in ectopy). Sensitivities of US, planar imaging, C-SPECT and P-SPECT were, respectively, 51, 76, 82 and 87%. Nine glands were only detected by tomography and five glands only by P-SPECT. {sup 99m}Tc-MIBI/{sup 99m}TcO{sub 4}{sup -} planar scans and P-SPECT were complementary and, when combined together, showed the highest sensitivity (93%). Compared with planar imaging and C-SPECT, P-SPECT increased CS for 42 and 53% of lesions, respectively, and contributed to markedly reduce the number of uncertain results. A combination of planar {sup 99m}Tc-MIBI/{sup 99m}TcO{sub 4}{sup -} scintigraphy and P-SPECT appears to be a highly accurate preoperative imaging procedure in primary hyperparathyroidism. (orig.)

  13. Combined Use of Tc-99m MIBI Scan and MRI for Evaluation of Active Lesions in Multiple Myeloma

    Full text: Multiple Myeloma is a malignancy of plasma cells, in which neoplastic bone involvement is one of the leading symptoms. Many researchers have been trying to develop new imaging modalities and new methods for detecting the bone involvement, mainly because apart from the fact that bone marrow infiltration is one of the diagnostic criteria, typical radiographic findings can be found only in 60 70% of pts with first diagnosis of MM, and 10% of pts can present only osteoporosis-like changes. Purpose To evaluate the efficacy of 99mTc-MIBI whole-body scan in diagnosis of Multiple Myeloma, in correlation with other imaging modalities, and mainly with MRI. Material and Method: We performed a retrospective review of 29 cases of Multiple Myeloma Patients, all of them in active stage of the disease. All of them underwent 99mTc-MIBI whole body scan, MRI examination of the spine and a bone scan. Diagnosis and staging of the disease was made by using standard criteria. MRI was performed mainly for imaging spinal cord compression and for morphological characterization of lesions. We obtained saggital and transverse images which included T1-weighted spin-echo, T2-weighted turbo spin-echo and STIR sequences. We performed whole body MIBI scan in anterior and posterior views, 10 - 20 min after IV injection of 500-550 MBq of 99mTc-MIBI, using a dual head gamma-camera Philips- Axis. Results: We obtained pathologic changes in 25/29 pts that underwent whole-body MIBI scan(86.75%), and in 27/29(89.65%) for the MRI. Bone scan shown pathologic uptake of radiotracer in 18/29 pts(62.06%). In 4 pts that demonstrated pathologic increased uptake of MIBI we found photopenic lesions on the bone scan which were missed at the first interpretation of the bone scan; these lesions were reported only after comparative evaluation of bone scan and MIBI scan.We found three different patterns of pathologic MIBI uptake: focal increased uptake of MIBI in different sites (9 pts), diffuse increased

  14. Multiple myeloma: predictive value of Tc-99m MIBI scintigraphy and MRI in its diagnosis and therapy

    We assessed the validity of 99mTc-MIBI scintigraphy and MRI in the diagnosis and prediction of the effect of therapy in patients with multiple myeloma (MM) and monoclonal gammopathy of unknown significance (MGUS), in whom both examinations were performed within 14 days. Forty-seven consecutive patients with MM and 5 with MGUS were enrolled in the study. Out of 47 MM patients, 6 were in Durie-Salmon stage I and 41 had active disease in stage II or III. Fifteen patients were examined before and within 2 months of intensive chemotherapy. Anterior and posterior whole-body scans were obtained 10 min after IV administration of 740 MBq (20 mCi) 99mTc-MIBI. MRI of Th and LS spine, T1 w.i. and STIR in the sagittal plane were performed. Bone marrow pathological changes in 41 MM patients with active disease were detected in 39 (95%) scintigraphic examinations and in 38 (94%) of MRI. Among 41 MM patients with active disease, 21 showed diffuse patterns of 99mTc-MIBI uptake, 8 showed focal patterns and 10 showed both focal and diffuse patterns, while 34 patients exhibited focal lesions in MRI and 4 both focal and diffuse findings. Moreover, 5 of 38 patients had epidural mass and 18 had vertebrae compression. Out of 15 patients after therapy, 13 reached complete remission and 2 had stable disease. Normal 99mTc-MIBI scintigraphy was found in 11 (85%) patients with complete remission, 2 presented both focal and diffuse patterns of 99mTc-MIBI uptake. Two patients with stable disease also had focal and diffuse radiotracer uptake. MRI findings were normal only in 3 (23%) patients in complete remission. Eight patients exhibited focal lesions and 2 showed partial conversion in MRI. 99mTc-MIBI scintigraphy and MRI are methods of equal sensitivity in detecting active MM and complement each other. The advantage of 99mTc-MIBI scintigraphy is the possibility of whole body examination, which allows superiority in detection of MM in appendicular skeleton and extramedular lesions, and faster

  15. Contribution of the Technetium-99m-sestamibi (MIBI) scintigraphy in primary hyperparathyroidism to determination of parathyroidectomy

    Nishida, Takuro; Hayakawa, Katsumi; Nishimura, Kazumasa; Kawakami, Satoshi; Sakamoto, Makoto; Koh, Toshikiyo; Hida, Shuichi [Kyoto City Hospital (Japan)

    1999-02-01

    We reviewed retrospectively the 12 patients who underwent parathyroidectomy because of hyperparathyroidism and judged to what degree the Technetium-99m-sestamibi (MIBI) scintigraphy contributed to determination of parathyroidectomy. From the view point that weather parathyroidectomy could be decided without the MIBI scintigraphy, we classified the cases into three groups; great, fair, and poor contribution. We judged 4 cases as great contribution, 5 cases as fair contribution and 3 cases as poor contribution. We concluded that if the MIBI scintigraphy is positive in patients with primary hyperparathyroidism, parathyroidectomy is strongly recommended, because of its high sensitivity and accuracy for detection of parathyroid adenomas and because there were no false-positive cases with the MIBI scintigraphy. (author)

  16. 99mTc-(V)DMSA scintimammography in the assessment of breast lesions: comparative study with 99mTc-MIBI

    The purpose of this study was to evaluate and compare the diagnostic accuracy of pentavalent technetium-99m dimercaptosuccinic acid [99mTc-(V)DMSA] and 99mTc-methoxyisobutylisonitrile (MIBI) in the detection of primary breast cancer and metastatic lymph node involvement, and in the clarification of cases with indeterminate mammograms. Forty-one women (mean age±SD 55±7 years) referred for a suspicious breast lesion on physical examination and/or an abnormal mammogram underwent MIBI and (V)DMSA scintimammography (SMM) at separate sessions (48-h interval). Lateral prone and anterior supine images were obtained at 10 and 60 min after administration of 740-925 MBq of each tracer, in the arm contralateral to the breast lesion. The ipsilateral axillary region was also included in the field of view. The results of SMM and mammography were compared with histological findings. Breast cancer was histologically confirmed in 26 patients (mean diameter±SD 2.87±1.5 cm). Benign lesions were found in 15 patients (mean diameter±SD 2.04±2.7 cm). Mammography was definitely positive in 23/26 patients with breast cancer and indeterminate in 3/26 (sensitivity 88.4%). In benign lesions, mammography was true negative in 5/15 cases and indeterminate in 10/15 (specificity 33.3%). Both MIBI and (V)DMSA SMM detected 23/26 breast cancers (sensitivity 88.4%) and were true negative in 14/15 (specificity 93.3%). T/B ratios for breast cancer in MIBI and (V)DMSA scans were similar, and significantly higher than for benign lesions. MIBI correctly diagnosed 12/13 and (V)DMSA 11/13 cases in which the findings of mammography were indeterminate. In addition, (V)DMSA detected seven of eight cases of in situ ductal carcinoma (DCIS) associated with infiltrating carcinomas, while MIBI detected only two of these eight cases. (V)DSMA was also diffusely concentrated in benign lesions complicated by epithelial hyperplasia. Metastatic lymph node involvement was successfully imaged in 15/19 patients with

  17. 99mTc-MIBI Washout Rate to Evaluate the Effects of Steroid Therapy in Cardiac Sarcoidosis

    Masayoshi Sarai

    2013-10-01

    Full Text Available Objective: We sought to determine the usefulness of the 99mTc-MIBI (MIBI washout rate for the evaluation of steroid therapy in cardiac sarcoidosis (CS. Methods: Eleven CS patients underwent MIBI myocardial SPECT both before and 6 months after initiating steroid therapy. The washout rate (WOR of MIBI was calculated using early and delayed polar map images. The washout score (WOS of MIBI was derived from the difference between the early and delayed total defect scores (TDS. Results: Serum ACE and BNP exhibited significant improvement after the therapy (p = 0.004, p = 0.045. In the LV function, EDV and E/A ratio exhibited significant improvement after the therapy (p = 0.041, p = 0.007, while there were no significant differences between before and after therapy in EF or ESV. Early and delayed TDS showed no significant differences between before and after the therapy. In contrast, WOR differed significantly (p < .0001, while WOS did not differ significantly between before and after the therapy.Conclusion: The washout rate of MIBI is suitable for assessment of cardiac function in CS with steroid therapy, being especially better than the washout score of MIBI for assessment of disease activity of mild myocardial damage in CS with steroid therapy.

  18. 99mTc-MIBI Washout Rate to Evaluate the Effects of Steroid Therapy in Cardiac Sarcoidosis

    Shin-ichiro Morimoto

    2013-10-01

    Full Text Available Introduction: We sought to determine the usefulness of the 99mTc-MIBI (MIBI washout rate for the evaluation of steroid therapy in cardiac sarcoidosis (CS. Methods: Eleven CS patients underwent MIBI myocardial SPECT both before and 6 months after initiating steroid therapy. The washout rate (WOR of MIBI was calculated using early and delayed polar map images. The washout score (WOS of MIBI was derived from the difference between the early and delayed total defect scores (TDS. Results: Serum ACE and BNP exhibited significant improvement after the therapy (p = 0.004, p = 0.045. In the LV function, EDV and E/A ratio exhibited significant improvement after the therapy (p = 0.041, p = 0.007, while there were no significant differences between before and after therapy in EF or ESV. Early and delayed TDS showed no significant differences between before and after the therapy. In contrast, WOR differed significantly (p < .0001, while WOS did not differ significantly between before and after the therapy.Conclusion: The washout rate of MIBI is suitable for assessment of cardiac function in CS with steroid therapy, being especially better than the washout score of MIBI for assessment of disease activity of mild myocardial damage in CS with steroid therapy.

  19. A comparative study on thallium-201 and technetium-99m-MIBI, urinary excretion and external radiation dose

    Thallium Chloride and technetium-metoxy isobutyl isonitril (MIBI) are the most frequently used in Iran. The aim of this work was to study the kinetic and dosimetric characteristics of the above-mentioned radiopharmaceuticals produced at the cyclotron department of Nuclear Research Center for Agriculture and Medicine (NRCAM), In order to compare our results with others. The dose rates at various distances of 5, 10, 50 and 100cm from 70 patients, who were administered diagnostic amounts of 201Tl-Chloride and 99mTc-MIBI, was measured using an ionization chamber. The measurements were taken at three different time intervals, 0.5 hour, 3 hours and 5 hours after injection. In order to assess the excretion of activity, the urine from 16 patients was collected for the period of 24 hours after administration. Eight patients had received 201Tl-chloride and the rest 99mTc-MIBI. The period of urine collection was therefore limited 2 to 4 hours. The maximum values of external dose rates of 201Tl and 99mTc-MIBI were 11.2 μSv/h ±2.3 and 43.1μSv/h ±11.9 respectively at 5cm from the patients. Significant exposure from patients after injection of 99mTc-MIBI was limited on the day of administration. Departure dose rate of 201 Tl fell gradually so by 3 days after administration was significant. All excreted urine was also collected from 16 patients for the 24 days after administration. The urinary excretion rate of 201Tl was slow; about 2% of the activity within 24h after injection. The urinary excretion of 99mTc-MIBI was rapid, and large amount of activity was excreted in a few hours after injection; 22% within 20h after injection. According to this study for 99mTc-MIBI Cardiac investigations significant exposure from the patients are limited to the few hours after administration. In case of administration 201Tl the dose rates from the patients continues to decrease until three days after injection. Consideration of protection for carers is need during these days. These data

  20. Effect of verapamil on cellular uptake of Tc-99m MIBI and tetrofosmin on several cancer cells

    Kim, Dae Hyun; Yoo, Jung Ah; Bae, Jin Ho; Jeong, Shin Young; Suh, Myung Rang; Ahn, Byeong Cheol; Lee, Kyu Bo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2004-02-01

    Cellular uptake of {sup 99}mTc-sestamibi (MIBI) and {sup 99}mTc-tetrofosmin (TF) is low in cancer cells expressing multidrug resistance(MDR) by p-glycoprotein(Pgp) or multidrug related protein(MRP). Verapamil is known to increase cellular uptake of MIBI in MDR cancer cells, but is recently reported to have different effects on tracer uptake in certain cancer cells. This study was prepared to evaluate effects of verapamil on cellular uptake of MIBI and TF in several cancer cells. Cellular uptakes of Tc-99m MIBI and TF were measured in erythroleukemia K562 cell, breast cancer MCF7 cell, and human ovarian cancer SK-OV-3 cells, and data were compared with those of doxorubicin-resistant K562(Ad) cells. RT-PCR and Western blot analysis were used for the detection of mdr1 mRNA and Pgp expression, and to observe changes in isotypes of PKC enzyme. Effects of verapamil on MIBI and TF uptake were evaluated at different concentrations upto 200 {mu}M at 1*10{sup 6} cells/{sup m}l at 37.deg.C. Radioactivity in supernatant and pellet was measured with gamma counter to calculate cellular uptake ratio. Toxicity of verapamil was measured with MTT assay. Cellular uptakes of MIBI and TF were increased by time in four cancer cells studied. Co-incubation with verapamil resulted in an increase in uptake of MIBI and TF in K562(Adr) cell at a concentration of 100 {mu}M and the maximal increase at 50 {mu}M was 10-times to baseline. In contrast, uptakes of MIBI and TF in K562, MCF7m SK-OV3 cells were decreased with verapamil treatment at a concentration over 1 {mu}M. With a concentration of 200 {mu}M verapamil, respectively. Cellular uptakes of MIBI and TF in MCF7 and SK-OV-3 cells were not changed with 10{mu}M, but were also decreased with verapamil higher than 10{mu}M, resulting 40% and 5% of baseline at 50 {mu}M. MTT assay of four cells revealed that K562, MCF7, SK-OV3 were not damaged with verapamil at 200 {mu}M. Although verapamil increases uptake of MIBI and TF in MDR cancer cells

  1. The role of 99m-Tc-MIBI in diagnosis of breast cancer

    Mammography is the diagnosing method with the greatest usefulness in screening and diagnosis of breast cancer, but it has a low positive predictive value (p pv: 10-40%) . for enhancing the p pv of mammography a complementary diagnostic procedure id needed. Scintimammography (SMM) is a new, non- invasive method of imaging breast tumors which in various studies the overall sensitivity of 83-95. 5% and specificity of 52%-95%, in diagnosis of breast cancer is reported. The purpose of our study was to evaluate the usefulness of 99m Tc-MIBI SMM in our environment in detecting breast cancer and in reducing the rate of biopsy. 65 patients aged 23-70 years from Sep 2000 through Jan 2002 included in our study. Each patient had a physical examination by a breast surgeon in Motahari Clinic and each had mammography using a standard two view technique. Study entry criteria consisted of either a lesion found in mammography and or a mass palpated on physical examination that required biopsy or FNA cytology. All these patients had standard 99m Tc-MIBI SMM in Nuclear Medicine Department of Nemazee Hospital and reported by a nuclear medicine physician who were blinded to the clinical status, physical examination, x-ray mammogram and histopathologic results. Then the sensitivity and specificity of SMM were evaluated by SPSS and FPI INFO program considering the results of biopsy or those who refused biopsy or within deep seated lesion, the results of follow-up mammograms after 6 month, as gold standard. The sensitivity and specificity of SMM were 84/6% and 71/8% respectively the PPV was 66/6% and NPV was 87/5%. Which were the same as previously reported. SMM did not increase the specificity and PPV of mammography which were 71% and 64% respectively. The most important role for SMM is in category 3 (probably begin) and category 4(suggestive for malignancy) groups of mammograms. The NPV is 58% and 90/9% in these groups respectively so it could reduce the rate of biopsy. In lesions less

  2. Myocardial scintigraphy using 99m-Tc-methoxyisobutylisonitrile (Tc-MIBI): A full substitution of 201-Tl?

    The results of selective coronary angiography, myocardial 201-Tl scintigraphy (stress and redistribution) and after 99m-Tc-methoxyisobutylisonitrile stress and rest injections (Tc-MIBI, Cardiolite, DuPont de Nemours, USA) were compared in 19 patients with manifest ischemic heart disease in identical three projections and after same ergometric load. 16 patients had significant stenoses of 1-3 main coronary arteries inclusive of left coronary artery main stem, insignificant stenoses (<50%) were present in the remaining 3 patients. Scintigraphic localizations of accumulation defects in both Tc-MIBI and 201-Tl stress scintigraphy were in agreement in 70.6% of evaluated left ventricular wall segments. A positive 201-Tl redistribution and rest-stress Tc-MIBI scintigraphic difference agreed in 52.6% of images of all three projections with verified accumulation defects. The sensitivity of ischemic area detection in reference to coronary angiography was nearly identical in 201-Tl (75%) and Tc-MIBI scintigraphy (81.2%). Better physical properties of 99m-Tc from the point of view of a gamma camera detection, a possibility to get markedly higher counting rate and sufficient accumulation of the radiopharmaceutical in the perfused myocardium enable to reach scintigraphic pictures with a high contrast after labelled Tc-MIBI injection, even in case of sequential impulse summation during heart cycle (gating). (author) 1 tab., 1 fig., 14 refs

  3. Comparison of wall thickening and perfusion analysis in cardiomyopathy by gated Tc-99m MIBI

    The objective of this study was to clarify the relationship between left ventriculr (LV) function, wall thickening (WT) and perfusion in cardiomyopathy. Twenty-six cases (15 males, 11 females: mean age, 58 y), consisting of 10 healthy control subjects, 10 patients with hypertrophic cardiomyopathy (HCM) and 6 patients with idiopathic dilated cardiomyopathy (DCM) was studied with gated Tc-99m MIBI SPECT. LV WT, LV perfusion and function (LV wall motion, LVEDV, LVESV and LVEF) by using gated SPECT quantification and CEqual software were analysed. In HCM and DCM group, mean WT was significantly decreased. (HCM: 15.2±6.7%, DCM: 4.9%, control: 34.1±4.9% (p<0.01). Adenosine stress test didn't show any reversible or fixed perfusion defects in all HCM patients, controls and five DCM patients except one patient (but, no coronary artery stenosis in coronary angiography). LVEF for HCM, DCM and control was 48.4±13.2%, 28.7±8.8%, 62.7±9.5%, respectively (p<0.05)). LVEDV and LVESV didn't show a significant differences between HCM and control group, not DCM group. In HCM, WT was decreased as like DCM even though LV myocardial perfusion and function was reserved

  4. Significance of 99mTc-MIBI myocardial SPECT imaging in diagnosis of syndrome X

    To assess the value of myocardial imaging in the diagnosis of syndrome X, the study was performed with 99mTc-MIBI myocardial SPECT imaging in 64 patients. The patients were divided into three groups: group 1 had 21 patients diagnosed as syndrome X, group 2 had 17 patients with chest pain and normal coronary arteries without ST segment depression during exercise, group 3 had 26 patients with the angina pectoris and coronary stenoses≥50%. The myocardial SPECT imaging of the three groups was compared qualitatively and semi-quantitatively. Myocardial imaging identified 11 cases of myocardial ischemia from 21 patients with syndrome X. The ischemic score of myocardial imaging was 1.1 +- 0.3 for syndrome X and 1.8 +- 0.7 for patients with coronary heart disease (CHD) angina pectoris (t = 3.1746, P<0.01). Myocardial imaging may partly show myocardial ischemia in patients with syndrome X. The extent of ischemia in patients with syndrome X was significantly less than that in patients with CHD angina pectoris

  5. Tc-99m MIBI scintimammographic study with a new, simple imaging device

    Objective: The present study was performed in order to test the clinical value of a special breast imaging device made by ourselves in scintimammography. Method: The device is special wooden board with two cutouts at two borders. By two pairs of vertical troughs and two horizontal belts, it can be firmly fixed on the examine table. 60 patients with unilateral palpable breast masses were performed Tc-99m MIBI breast imaging with the help of the special device. The early and delay images were acquired at 10 min and 1 hr after intravenous injection, in positions of an anterior supine, a left lateral prone and a right lateral prone. A ratio of radioactivity value of mass to appositive corresponding tissue T/NT was half-quantitatively (T/NT≥1.21 is positive). Result: The diagnostic sensitivity and specificity was 92.9% and 90.6% respectively, and the accuracy was 91.7%; positive predictive value 89.7%; negative predictive value 93.5% and Youden index 83.5%. The lateral views (which were obtained with help of the device) were superior to routine anterior view in detecting lesions. Conclusion: The special device is simple and practical. It may be clinically applied to improve the SMM technique and diagnosis for breast mass

  6. Myocardial perfusion scintigraphy with technetium99m-MIBI in the diagnosis of coronary artery disease in women

    Aim: To assess the value of myocardial perfusion scintigraphy for coronary artery disease (CAD) in women, we compared the results of a technetium99m-methoxy-isobutyl-isonitrile (99mTc-MIBI) scintigraphy with those of a coronary angiography in a group of women referred for evaluation of chest pain. Material and Methods: Twenty women, 15 of them postmenopausal, were included. A 99mTc-MIBI myocardial scintigraphy with one-day protocol (rest-stress) was performed. When needed, a combined stress (ergometric plus dipyridamole) was used. Both qualitative and quantitative regional uptake analysis was done. In patients with normal coronary arteries and positive myocardial scintigraphies, measurements were made of serum cholesterol and triglycerides (CHOD-PAD enzymatic colorimetric test), and lipoprotein(a) -Lp(a)- (BioSCREEN Lp(a) method). Results: Change in regional uptake (stress/rest) was as follows: during stress 99mTc-MIBI, 116 segments had normal uptake (from 93±9% to 94±7%), 52 had moderately reduced uptake (from 67±9% to 75±17%), and 12 had severely reduced uptake (from 33±9% to 64±28%). Qualitative and quantitative analysis coincided in 18 cases. The two non-coincident cases were patients in whom qualitative analysis and coronary angiography were normal, but on quantitative analysis it appeared a reversible defect in one case and a 'reverse redistribution' pattern in the other. Breast attenuation defects were detected in four cases. Myocardial scintigraphy and coronary angiography coincided in 70% cases (figure). The remainder 30% was constituted by patients with positive scintigraphy and normal coronary arteries; among these cases, the 71% were postmenopausal and had systolic hypertension, chest pain at rest, positive ergometric test and hypercholesterolemia (table). Conclusion: We concluded that 99mTc-MIBI myocardial scintigraphy can help in the CAD diagnosis in postmenopausal women

  7. The value of Tc-99m MIBI scintigraphy in active disease and remission phase of multiple myeloma

    Background: 99m Tc methoxy isobutyl isonitrile (99m Tc -MIBI)has been proposed as a tumor seeking agent in malignant disease. The goal of this study is to evaluate the frequency distribution of the different patterns, intensity and extension of abnormal uptake identified in MIBI scan in relation with various clinical status of the patients diagnosed as a multiple myeloma. Methods: forty-three patients entered the study, including six patients with no prior treatment , 22 patients who received autologous bone morrow graft, and 15 patients with history of chemotherapy and radiotherapy. Plasma protein electrophoresis for monoclonal antibody, bone morrow biopsy and urine analysis for Bence-Jones protein has been carried out and standard criteria were used for diagnosis of active disease and remission phase for each patients. The extension of each lesion(E-score) on scintigraphy were categorized into E0-E3 by three nuclear physicians who were blinded to the patient's clinical condition. I-score was also obtained with comparing the intensity of the lesions with intensity of myocardial uptake and classified as I0-I3. Results: the sensitivity, specificity, positive predictive value and negative predictive value of 99m Tc -MIBI scan for determining active lesions and released cases were 69%, 100%, 100% and 60%, respectively. Nineteen patients were initially thought to be in remission phase, but scintigraphy was abnormal in 5 cases who were diagnosed as active myeloma later in the course of the study. There was a significant correlation between clinical status and pattern, intensity and extension of the abnormal uptake of 99m Tc -MIBI. Also a significant correlation between intensity and extension of the abnormal tracer uptake with serum monoclonal component and urine Bence-Jones protein was noted, however no correlation between blood hemo globulin and degree of extension in scintigraphy was seen. Conclusion: Our study suggests the pattern, extension and intensity of 99m Tc

  8. Clinical Investigation of 99mTc-MIBI Imaging in Head and Neck Tumors%头颈部肿瘤99mTc-MIBI阳性显像的临床研究

    刘志军; 张永学; 张萍; 张继青

    2006-01-01

    Objective: To investigate the diagnostic potential value of 99mTc-MIBI imaging in head and neck tumors. Methods: Ninety-one patients with malignant and benign head and neck lesions were subjected to99mTc-MIBI tomography, and 20 healthy volunteers served as control group. Results: The overall sensitivity, specificity, accuracy and positive predictive accuracy of early/delay 99mTc-MIBI imaging in diagnosis of head and neck malignant tumors were 78.7%/72.3%, 72.1%/88.4%, 75.6%/80.0% and 75.5%/87.2%respectively. The results of 99mTc-MIBI Imaging in diagnosis of nasopharyngeal cancer and sinonasal non-Hodgkin's lymphoma were more satisfactory than those in maxillary sinus cancer. In distinguishing recurrent/residual nasopharyngeal carcinoma and sinonasal non-Hodgkin's lymphoma, 99mTc-MIBI scintigraphy was superior to CT/MRI. Conclusion: 99mTc-MIBI imaging is a promising useful tool in identifying head and neck tumor, and it has a special value to evaluate the local invasion and metastasis involved.

  9. The significance of a dipyridamole induced 99mTc-MIBI perfusion abnormality on single photon emission tomography: A quantiative validation with labelled water and positron emission tomography

    To relate 99mTc-MIBI uptake to regional myocardial blood flow (rMBF), 99mTc-MIBI SPET and H215O PET scans were obtained at rest and after dipyridamole infusion in six patients with single vessel coronary artery disease. 99mTc-MIBI-H215O data sets were created for each segment perfused by the stenotic vessel and for a normal reference area, assigning regions on the SPET tomograms to comparable regions on the PET by similar transaxial image reconstructions. All patients demonstrated post-dipyridamole 99mTc-MIBI perfusion defects in the territories supplied by the stenotic arteries; Resting rMBF in these regions was slightly lower than that in the normal areas. A 43% ± 14% reduction in 99mTc-MIBI activity in the area at risk was coupled with on average a 60% ± 9% reduction in post-dipyridamole rMBF compared with control regions. Thus, SPET assessment of 99mTc-MIBI uptake tends to underestimate the perfusion contrast between areas with normal and areas with low coronary vasodilatory reserve when compared to PET. However, these findings may still not affect the clinical usefulness of 99mTc-MIBI and more extensive studies are required to confirm these results in the clinical environment (orig./MG)

  10. Effect of multidrug resistance gene-1(mdr1) overexpression on in-vitro uptake of {sup 99m}Tc-sestaMIBI in murine L1210 leukemia cells

    Chun, Kyung Ah; Lee, Jae Tae; Lee, Sang Woo; Kang, Do Young; Sohn, Snag Kyun; Lee, Jong Kee; Jun, Soo Han; Lee, Kyu Bo [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of); Chung, June Key [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-02-01

    To determine whether {sup 99m}Tc-MIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively {sup 99m}Tc-MIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular {sup 99m}Tc-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr 1 gene) overexpression. We measured percentage uptake of {sup 99m}Tc-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of {sup 99m}Tc-MIBI were also evaluated with or without overexpression of mdr1 gene in cultured murine leukemia L1210 cells. The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of {sup 99m}Tc-MIBI was higher in mdr1 negative L1210 cells than those of mdr1 positive cells, and higher when incubated in 37 .deg. C than 4 .deg. C. In the presence of verapamil, cyclosporin or dipyridamole, {sup 99m}Tc-MIBI uptake was increased upto 604% in mdr1 positive cells. Cellular uptake of {sup 99m}Tc-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest the {sup 99m}Tc-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents in vitro.

  11. Reproducibility of gated myocardial perfusion SPECT for the assessment of myocardial function: comparison with thallium-201 and technetium-99m-MIBI

    We compared the reproducibility of 291Tl and 99mTc-sestamibi (MIBI) gated SPECT (g-SPECT) for the assessement of myocardial function. G-SPECT acquisition for the assessment of myocardial function was repeated in the same position in 34 patients who received 201Tl and in 31 who received 99mTc-MIBI . The quantification of enddiastolic volume (EDV), endsystolic volume (ESV) and ejection fraction (EF) on 201Tl and 99mTc-MIBI g-SPECT were processed independently using Cedars quantitative g-SPECT software. The reporducibility of the assessment of myocardial function on 201Tl g-SPECT was compared to that of 99mTc-MIBI g-SPECT. Correlation between the two measurements for volumes and EF was excellent by the repeated g-SPECT studies of 291Tl(r=0.928 to 0.986; p99mTc-MIBI (r=0.979 to 0.997; p99mTc-MIBI g-SPECT(EDV: 14.1 ml, ESV; 9.4 ml and EF: 5.5%) than by repeated 201Tl g-SPECT (EDV: 24.1 ml, ESV: 18.6 ml and EF: 10.3%). The root mean square (RMS) values of the coefficient of variation (CV) for volumes and EFs were smaller by repeated 99mTc-MIBI g-SPECT (EDV: 2.1 ml. ESV 2.7 ml and EF:2.3%) than by repeated 2'01TI g-SPECT (EDV: 3.2 ml, ESV: 3.5 ml and EF: 5.2%). 99mTc-MIBI provides more reproducible volumes and EF and 201Tl on repeated acquisition s-SPECT. 99mTc-MIBI g-SPECT is the preferable method for the clinical monitoring of myocardial function

  12. Diagnostic ability of Tc-99m MIBI SPECT in coronary artery diseases in not affected by the degree of exercise

    The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression of exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmil exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease

  13. Prognostic value of normal exercise 99mTc-MIBI myocardial perfusion SPECT: comparison with exercise electrocardiography and coronary angiography

    Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise 99mTc-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. We evaluated 301 patients (mean age 52±10 years, 166 males and 135 females) with normal exercise 99mTc-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subjects were evaluated for cardiac events and followed for 8-55 months (mean 19±10 months) after imaging. During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patinets with positive (n=3D27) and negative (n=3D235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Patients with normal exercise 99mTc-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.=20

  14. Reproducibility of gated myocardial perfusion SPECT for the assessment of myocardial function: comparison with thallium-201 and technetium-99m-MIBI

    We compared the reproducibility of 201TI and 99mTc-sestamibi (MIBI) gated SPECT measurement of myocardial function using the Germano algorithm. Gated SPECT acquisition was repeated in the same prosition in 30 patients who received 201TI and in 26 who received 99m Tc-MIBI. The quantification of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) on 201TI and 99mTc-MIBI gated SPECT was processed independently using Cedars quantitative gated SPECT software. The reproducibility of the assessment of myocardial function on 201TI gated SPECT was compared with that of 99mTc-MIBI gated SPECT. Correlation between the two measurements for volumes and EF was excellent by the repeated gated SPECT studies of 201TI (r=0.928 to 0.986; p99mTc-MIBI (r=0.979 to 0.997; p99mTc-MIBI gated SPECT (EDV: 14.1 ml, ESV: 9.4 ml and EF: 5.5 %) than by repeated 201TI gated SPECT (EDV: 24.1 ml, ESV: 18.6 ml and EF: , 10.3%). The root mean square (RMS) values of the coefficient of variation (CV) for volumes and EFs were smaller by repeated 99mTc-MIBI gated SPECT (EDV: 2.1 ml, ESV: 2.7 ml and EF: 2.3%) than by more reproducible volumes and EF than 201TI on repeated acquisition gated SPECT. 99mTc-MIBI gated SPECT is the preferable method for the clinical monitoring of myocardial function

  15. Cardiac resynchronization therapy evaluated by myocardial scintigraphy with 99mTc-MIBI: changes in left ventricular uptake, dyssynchrony, and function

    99mTc-MIBI gated myocardial scintigraphy (GMS) evaluates myocyte integrity and perfusion, left ventricular (LV) dyssynchrony and function. Cardiac resynchronization therapy (CRT) may improve the clinical symptoms of heart failure (HF), but its benefits for LV function are less pronounced. We assessed whether changes in myocardial 99mTc-MIBI uptake after CRT are related to improvement in clinical symptoms, LV synchrony and performance, and whether GMS adds information for patient selection for CRT. A group of 30 patients with severe HF were prospectively studied before and 3 months after CRT. Variables analysed were HF functional class, QRS duration, LV ejection fraction (LVEF) by echocardiography, myocardial 99mTc-MIBI uptake, LV end-diastolic volume (EDV) and end-systolic volume (ESV), phase analysis LV dyssynchrony indices, and regional motion by GMS. After CRT, patients were divided into two groups according to improvement in LVEF: group 1 (12 patients) with increase in LVEF of 5 or more points, and group 2 (18 patients) without a significant increase. After CRT, both groups showed a significant improvement in HF functional class, reduced QRS width and increased septal wall 99mTc-MIBI uptake. Only group 1 showed favourable changes in EDV, ESV, LV dyssynchrony indices, and regional motion. Before CRT, EDV, and ESV were lower in group 1 than in group 2. Anterior and inferior wall 99mTc-MIBI uptakes were higher in group 1 than in group 2 (p99mTc-MIBI uptake. (orig.)

  16. Differences between accumulation of 99mTc-MIBI and 201Tl-Thallous Chloride in tumour cells: Role of P-glycoprotein

    Both 99mTc-MIBI and 201Tl have been used for tumour imaging. It has recently been reported that 99mTc-MIBI is a substrate for P-glycoprotein (Pgp), a membrane pump which mediates multidrug resistance. It has been evaluated the role of Pgp in the cellular accumulation of 201TI by using sensitive and resistant strains of Chinese hamster ovary (CHO) fibroblasts (AuxB1 and CHRC5, respectively) grown in suspension culture. 201Tl accumulation was the same in sensitive and resistant cells, whereas 99mTc-MIBI accumulation was much lower in resistant cells than in sensitive ones. Down-modulation of Pgp with 100 μM verapamil did not alter cellular accumulation of 201Tl while it significantly increased 99mTc-MIBI accumulation in both types of cell. Similarly, 10 μM verapamil did not affect the rate of washout of 201Tl from preloaded cells, while 99mTc-MIBI washout was greatly reduced in the presence of verapamil. These results suggest that 201Tl will accumulate in both sensitive and resistant tumour cells, whereas 99mTc-MIBI will be extruded from resistant cells and therefore may be less useful for tumour detection when the tumour cells express high Pgp levels

  17. Value of 99mTc-MIBI brain SPECT in differentiating recurrence and radiotherapy effects in tumors brain patients

    Full text: Accurate neuroimaging can assist in the diagnosis, management, prognosis, and follow-up of central nervous system (CNS) malignancies. Differentiation between tumor progression and radiation necrosis is one of the most difficult tasks in oncologic neuroradiology. The main role of functional imaging in oncological practice is to determine whether a lesion observed in an anatomical study such as CT scan or MRI consists of tumor cells or is formed by fibrotic tissue only. 99mTc-MIBI brain SPECT is considered a useful tool in the management of brain tumors. The demonstration of increased tracer extraction and subsequent accumulation in the lesion indicates viability of the suspected tumor mass. Aim: Gliomas, arising from glial cells, account for approximately the 45-55% of all brain tumors. 99mTc-MIBI tumor uptake is related to histological grading, cellular proliferation index and prognosis. Our aim was to evaluate 99mTc-MIBI brain SPECT and MRI studies efficacy in the differential diagnosis between recurrence of malignant gliomas and glioblastomas and the local modification after radiotherapy. Material and methods: Eight patients with suspected recurrence after surgical removal of a supratentorial glioma (2 low grade and 6 high grade), 6-12 months before study and treated with radiotherapy were investigated. For brain SPECT - 740MBq of 99mTc-MIBI were i.v. injected to each patient 15 minutes before image acquisition by a dual-head gamma camera, using a fan-beam collimator. Transverse, coronal and sagittal views were reconstructed. Gd-DTPA enhanced TI and T2 weighted MRI studies were carried out in every patient within 3 days before 99mTc-MIBI SPECT. The brain SPECT images were analyzed by calculating lesion-to-normal ratios (I/n). Areas of abnormal tracer uptake were defined as focally increased uptake or as asymmetric uptake, compared with the contralateral side. Uptake ratios were calculated using reference regions in the contralateral hemisphere, because

  18. Tc-99m MIBI imaging for secondary skeletal involvement in breast and prostate cancers and multiple myeloma

    Objective:The Objective of the study was to evaluate the role of Tc-99m MIBI whole body imaging in assessing secondary osseous involvement in patients with malignancy of breast, prostate or multiple myeloma. In this study a total of 41 patients were included. Out of these 18 had breast carcinoma, 12 had prostate carcinoma and 11 were diagnosed cases of multiple myeloma. All patients had their whole body MIBI imaging done which was compared with MDP bone scan by employing some other diagnostic modality (plain radiographs, CT scan, MRI scan or histopathological evidence) to confirm the lesions detected by either of the scans. The results of all the studies were evaluated qualitatively by assessing the number of lesions visually by three experienced nuclear physicians. Quantitative analysis of the lesions was also done, by calculating the lesion to normal uptake ratio, to augment the findings of visual assessment and for statistical analysis. Results: Results obtained in this study by MIBI and MDP imaging varied significantly among different groups and subgroups of patients depending on the primary malignancy and stage of therapy. However results obtained by imaging of patients within a group and subgroup were consistent with each other. MIBI scan showed a sensitivity of 99% in cases of multiple myeloma, where MDP scan was only 16% sensitive. In case of pre-therapy patients of breast and prostate carcinoma, the sensitivity of MIBI scan came out to be 80% and 74% respectively. In patients who were on chemo/radiotherapy MIBI scan was 54% sensitive in patients with breast carcinoma and 38% sensitive in patients with prostate carcinoma. MDP scan showed a sensitivity of 100% in all the groups. The positive predictive value of MIBI scan came out to be 100% but that of MDP was 42-76% in different groups. It is therefore concluded that the most significant role of MIBI imaging is in detection of bone metastases secondary to breast and prostate carcinoma in pre

  19. Scintigraphy with Tc99m-MIBI to annual prediction the evolution of women referred for evaluation of precordial pain

    In order to evaluate the capacity of myocardial perfusion scintigraphy with Tc99m-MIBI to predict the evolution of women referred for evaluation of precordial pain, the rates of cardiovascular events at one year were studied in a group of patients with normal scintigraphy (group 1: 17 patients) and in another with reversible perfusion defects (group 2: 17 patients). The one-day protocol was applied for scintigraphy with Tc99m-MIBI (rest/stress) with combined stress (ergometrin bicycle plus 0.28 mg/Ig of dipyridamole) in those cases where it was necessary. A quantitative and qualitative analysis of the regional uptake was made. Patients from group 1 were younger than those from group 2 (average age: 49 vs 55, respectively, p = 0.04) and they had less hypercholesterolemia (112 % vs 59 %, respectively, p = 0.01). The rates of appearance of cardiovascular events at one year were calculated for patients from group 2 by using the Kaplan-Meier's method. The rates of appearance of clinical events (myocardial infarction and unstable angina) and of revascularization procedures (percutaneous transluminal coronary angioplasty and aortocoronary bypass surgery) were 0.24 in both cases. Only a patient from group 1 presented varying angina at 5 months. No deaths were reported in any of the groups. 94 % of the patients with normal perfusion scintigraphy were free of events after a one-year follow-up, whereas only 53 % of those with reversible perfusion defects showed a similar behavior. It was concluded that myocardial perfusion scintigraphy with Tc99m-MIBI is a useful tool to predict the evolution of women referred for evaluation of precordial pain at one year

  20. 99mTc-MIBI scintigraphy as a functional method for multi drug resistance (MDR) evaluation in breast cancer patients

    Full text: The purpose of this study was to evaluate the role of 99mTc-MIBI scintigraphy for assessing MDR in breast cancer (BC) patients and correlate the results with P-gp overexpression. 22 women of 35-68 years age having breast cancer were studied. Two or 3 cycles of chemotherapy (NCT) were given to all patients using standard regimen (FEC in 15 and CMF in 7). Planar and SPECT scintigraphy using 740-925 MBq Tc-99m MIBI was performed before and after NCT. Focal uptake of Tc-99m MIBI in BC lesions was used as scintigraphic criteria of abnormality. Tumor/Background uptake index (T/B) was also calculated. Immunohistochemistry was carried out after surgery for P-gp detection in all cases. The degree of expression was evaluated according to the semiquantitative score analysis from 0 to 4. Planar imaging was true positive in 21 patients, false positive in 1 patient and false negative in 1 patient. SPECT imaging was true positive in 22 patients, false positive in 1 patient. SPECT showed additional tumor masses in 3 patients with multi focal BC. Sensitivity was 95% (21/22) and 100% (22/22) respectively for planar and SPECT detection of BC. P-gp expression was positive in 40.8% of patients and negative in 59.2%. Intensive 99mTc-MIBI uptake was seen on the planar images in 21 patients independent of P-gp expression. No significant relationship was seen between T/B Index and P-gp detection. Objectively 2 patients showed complete remissions, 50% tumoral reduction in 1 patient and minimal response (20-35% reduction) in 12 pts. No change in the lesion was noticed in 7 patients. T/B Index was reduced after NCT > 20% in 9 patients. In conclusion, use of SPECT is an important diagnostic approach for identification of deeply located breast cancer lesions and satellite tumor spots in multifocal BC. T/B Index does not correlate with P-gp overexpression. (author)

  1. Breast Scintigraphy using Tc-99m MIBI in Patients with Malignant Breast Mass: The correlation between scintigraphy and histopathology

    Purpose: In this study, we evaluated the relationship between measurements (10 minutes, 2 hours uptake ratio and washout ratio) acquired in Tc-99m MIBI breast scintigraphy and postoperative histopathologic finding. Materials and Methods: We studied 23 patients of breast malignant tumor (mean age = 50 ∫5.8 years old); 16 cases of invasive ductal carcinoma, 3 cases of metaplastic carcinoma, 2 cases of infiltrative ductal carcinoma and 2 cases of atypical ductal carcinoma. In all patients, Tc-99m MIBI breast Scintigraphy was obtained with measuring uptake and washout ratio. The regions of interests (ROI) were drawn within the central portion of the lesion and the diameters of ROI were about 70% of the diameter of the lesion. The uptake ratio was calculated by counts within the lesion in affecting side dividing by the counts of comparable region of opposite side in 10 minutes and 2 hours after injection. Washout ratio was calculated by subtracting counts at 2 hours from these at 10 minutes and dividing by the number of counts at 10 minutes. Histopathologic findings were graded by size of the mass, Ki-67 index, number of mitosis in 10 high power fields, number of metastatic lymphadenopathy and grade of structural atypism. To compare the measurement of Tc-99m MIBI breast scintigraphy and histopathologic finding, we used Pearson's correlation analysis and P<0.05 was regarded as significant. Results: There was statistically significant positive correlation between 10 minutes uptake ratio and 2 hours uptake ratio (r=0.91, P<0.01). There is positive relationship between 10 minutes, 2 hours uptake ratio and size of the lesion (r=0.48, r=0.31), between washout ratio and Ki-67 index (r=0.28), between washout ratio and size(r=0.29), but without statistical significance. There is negative relationship between 10 minutes, 2 hours uptake ratio and KI-67 index (r=-0.36, r=-0.29), between 10 minutes, 2 hours uptake ratio and number of mitosis (r=-0.30, r=-0.22), 10 minutes, 2 hours

  2. Rapid preparation and quality control of 99mTc-ECD, MAG3 and MIBI using microwave heating and sep-pak cartridges

    We evaluated a rapid preparation procedures for the labeling and quality control of 99mTc-ECD, MAG3 and MIBI using microwave heating and Sep-Pak cartridges. 99mTc labeling of ECD, MAG3, and MIBI kit preparation was performed according to the package inserts with microwave heating modification. Heating time was 10-15 sec, and heating was performed with 3 mm plastic bottle with screw cap to prevent radiation contamination. Labeling efficiency was obtained with C18 or Alumina N Sep-Pak cartridges. The radiochemical purity of 93 ∼ 96% for 99mTc-ECD and 95 ∼ 99% for 99mTc-MIBI was obtained using Alumina N Sep-Pak cartridge. The optimum irradiation time of microwave method for 3 ml 99mTc-labeled radiopharmaceutical solution was 10 sec for 99mTc-ECD and 99mTc-MIBI, and 15 sec for 99mTc-MAG3. The results of quality control data with Sep-Pak cartridges were well correlated wth TLC method. The total preparation time of these radiopharmaceuticals was 5 ∼ 6 min including quality control procedure. This study demonstrates that radiopharmaceuticals preparation by microwave heating and quality control by Sep-Pak cartridges can be efficiently utilized as an alternative to the recommended method by manufacture's manual

  3. Normal limits of left ventricular volumes and ejection fraction measured by gated myocardial perfusion SPECT: comparison of Tc-99m MIBI and Tl-201

    We evaluated radioisotope and sex-specific differences of normal limits for left ventricle volumes (LWs) and ejection fraction (EF) using myocardial perfusion gated SPECT (g-SPECT). Rest Tl-201/post-stress Tc-99m MIBI g-SPECT measurements with acquisitions of 8-frame were evaluated for 70 patients (mean age 55 ± 14, 56% female) who either had 50%) (n=58). LVEF, LWs were automatically determined by quantitative gated SPECT using QGS program. Similar results were obtained for mean LVEF between Tc-99m MIBI (62% ± 7%) and Tl-201 (63% ± 8%) g-SPECT measurements. In contrast, Tl-201 g-SPECT had significantly lower LWs values (EDV; 74 ± 23 mL, ESV; 28 ± 14 mL) than Tc-99m MIBI g-SPECT (EDV; 82 ± 25 mL, ESV; 32 ± 15 mL) (p<0.05). Women had significantly lower EDV (Tc-99m MIBI; 71 ± 18 mL, Tl-201; 65 ± 17 mL), and ESV values (Tc-99m MIBI; 27 ± 10 mL, Tl-201; 23 ± 8 mL) compared with EDV (Tc-99m MIBI; 96 ± 27 mL, Tl-201; 85 ± 24 mL), and ESV values (Tc-99m MIBI; 40 ± 17 mL, Tl-201; 36 ± 16 mL) of men (p<0.05). Women had significantly higher LV EF values (65% ± 7%) than men (60% ± 8%) by Tl-201 gated SPECT (p<0.05). These data suggest significant differeuces in normal limits for LWs and EF, according to genders and radiopharmaceutical. Therefore, the evaluation of cardiac function in patients should consider radioisotope and sex-matched normal values

  4. Labelling, biodistribution and compartmental analysis of N-acetylcysteine labelled with Tc-99m. Comparative investigation with with 99m Tc-MIBI in an in vivo tumoral model

    Labelling and biodistribution studies were done with two different ligands, respectively Methoxy isobutyl isonitrile (MIBI) and N-acetylcysteine (NAC), employing Tc-99m as a tracer. The main objective was to assess the pharmacokinetic properties of the second substance, aiming at its possible application in cancer diagnosis. To this purpose an in vivo investigation was done using healthy and tumor-bearing rats with experimental cancer. Images of tumor-bearing rats registered in a scintillation camera indicated that with 99m Tc-MIBI none of the two selected times was adequate for visualization of the cancer mass. In contrast, 99m Tc-NAC permitted clear identification of the humor, four hours after injection. The results have demonstrated that 99m Tc-NAC is a radiopharmaceutical with affinity for cancer tissue and promising for further investigation concerning imaging diagnosis of tumors. (author)

  5. Myocardial perfusion: Comparison between 99mTc-MIBI scintigraphy and microbubbles- Pesda and Levovist-echocardiography

    Myocardial perfusion scintigraphy has been used for the last 25 years. Recently echocardiography is trying to realize the same kind of test with microbubbles injected intravenously. Aim: Comparison of the results of myocardial perfusion scintigraphy with 99mTc-MIBI and microbubbles - Pesda and Levovist-echocardiography. The nuclear medicine is considered the gold standard. Material and method: We studied 27 patients, 15 male, aging 58+/- 12.5 years with angina unstable or myocardial infarction (19 pts ) and normal (8 pts ). All patients received 740 MBq of 99mTc-MIBI during the echo examination. The SPECT scintigraphies were performed in an ADAC Vertex Plus scintillation camera. The echo were performed in a HDI 3000/5000 ATL, P3-2 transducer, intermittent harmonic image, VHS and 2 independent observers. During the echo examination the patients received Pesda- 2-7 ml/min- and Levovist- 400mg/ml 2-4 min. Results: NM versus Pesda and NM versus Levovist are presented. Concordance 87% (K=0.42). Concordance 89% (K0.57). Conclusion: Despite of the feasibility, echocardiography can detect myocardial perfusion defects with a good concordance of 87-89 % of these cases. The learning curve, the qualitative analysis is jeopardized by fibrotic areas, and the attenuation are problems that they need to solve

  6. Molecular imaging with {sup 99m}Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison

    Giovanella, L.; Treglia, G.; Ceriani, L. [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona (Switzerland); Campenni, A. [Policlinico Universitario, Istituto di Medicina Nucleare, Messina (Italy); Verburg, F.A. [RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Trimboli, P. [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona (Switzerland); Ospedale Israelitico, Sezione di Endocrinologia e Diabetologia, Roma (Italy); Bongiovanni, M. [Centre Hopitalier Universitaire Vaudouise, Institut de Pathologie, Lausanne (Switzerland)

    2016-06-15

    To compare mutation analysis of cytology specimens and {sup 99m}Tc-MIBI thyroid scintigraphy for differentiating benign from malignant thyroid nodules in patients with a cytological reading of follicular neoplasm. Patients ≥18 years of age with a solitary hypofunctioning thyroid nodule (≥10 mm), normal thyrotropin and calcitonin levels, and a cytological diagnosis of follicular neoplasm were prospectively enrolled. Mutation analysis and {sup 99m}Tc-MIBI scintigraphy were performed and patients were subsequently operated on to confirm or exclude a malignant lesion. Mutations for KRAS, HRAS and NRAS and for BRAF and translocations of PAX8/PPARγ, RET/PTC1 and RET/PTC3 were investigated. Static thyroid scintigraphic images were acquired 10 and 60 min after intravenous injection of 200 MBq of {sup 99m}Tc-MIBI and visually assessed. Additionally, the MIBI washout index was calculated using a semiquantitative method. In our series, 26 % of nodules with a follicular pattern on cytology were malignant with a prevalence of follicular carcinomas. {sup 99m}Tc-MIBI scintigraphy was found to be significantly more accurate (positive likelihood ratio 4.56 for visual assessment and 12.35 for semiquantitative assessment) than mutation analysis (positive likelihood ratio 1.74). A negative {sup 99m}Tc-MIBI scan reliably excluded malignancy. In patients with a thyroid nodule cytologically diagnosed as a follicular proliferation, semiquantitative analysis of {sup 99m}Tc-MIBI scintigraphy should be the preferred method for differentiating benign from malignant nodules. It is superior to molecular testing for the presence of differentiated thyroid cancer-associated mutations in fine-needle aspiration cytology sample material. (orig.)

  7. Using 99mTc-MIBI to Evaluate the Effects of Chemosensitizer on P-glycoprotein in Multidrug-resistant Carcinoma Cells

    ZHANGZhenwei; ZHANGXuemei; WUHua; ZHAOMing; XIANYUZhiqun; ZHOUJian; LAIShiying

    2005-01-01

    Objective: To establish a method to evaluate the effects of chemosensitizer on P-glycoprotein using 99mTc-MIBI, and observe the changes of 99mTc-MIBI uptake kinetics and P-glycoprotein levels after using verapamil in MDR human breast cells MCF-7/Adr. Methods: MDR breast carcinoma cells, MCF-7/Adr, were incubated and different protocols were performed. Protocol I: a chemosensitizer, verapamil (10μmol/L), was added into cell culture medium, while in control group, the same volume of DMEM was given. Cells were harvested after 2 h incubation with 99mTc-MIBI. Protocol Ⅱ: Verapamil (10μmol/L) was added into cell culture medium and incubated for 20 min, 40 min, 60 rain, 80 min, 8 h, 24 h, 48 h and 72 h respectively. Cells were harvested after 2 h incubation with 99mTc-MIBI. The radioactivity of the cells was measured and P-glycoprotein expression levels were determined with immunohistochemical stain. Results: Protocol I: After 2h incubation with verapamil the cellular uptake of 99mTc-MIBI was remarkably higher than control group (t=2.33, P0.05). Protocol

  8. Impact of the parathyroid scintigraphy with MIBI -{sup 99m}Tc in the detection of an infra-centimetric parathyroid adenoma; Impact de la scintigraphie parathyroidienne au MIBI-99mTc dans la detection d'un adenome parathyroidien infracentimetrique

    Ben Ali, K.; Mortazavi-Jhanno, N.; Burg; Rouzet, F.; Lebtahi, R.; Le Guludec, D. [Service de medecine nucleaire, hopital Bichat, AP-HP, Paris, (France); Leghzali, H.; Besse, H.; Stievenart, J.L. [service de medecine nucleaire, hopital Beaujon, AP-HP, Paris, (France)

    2009-05-15

    The objective is to enlighten the contribution of the parathyroid scintigraphy with MIBI-{sup 99m}Tc in the detection of infra-centimetric parathyroid adenomas. Conclusions: the small low intense visible centres with a single time of scintigraphy can correspond to adenomas. The association parathyroid scintigraphy with MIBI-{sup 99m}Tc to a cervical echography contributes to raise the sensitivity in the detection of parathyroid infra-centimetric adenomas. (N.C.)

  9. The role of 99mTc-MIBI scintigraphy in the assessment of MDR1 overexpression in patients with musculoskeletal sarcomas: comparison with therapy response

    The occurrence of multidrug resistance (MDR), which is in part due to the overexpression of P-glycoprotein (Pgp), is a major problem in neoadjuvant therapy of malignant musculoskeletal tumours. The aim of this study was to investigate the role of technetium-99m hexakis-2-methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy for functional imaging of the MDR1 phenotype in patients with musculoskeletal sarcomas. We aimed to compare 99mTc-MIBI uptake and washout kinetics with the expression of Pgp and with chemotherapy response. Twenty-five patients (16 males and 9 females, aged between 8 and 65 years) with malignant musculoskeletal tumours were studied. After injection of 555-740 MBq 99mTc-MIBI, dynamic flow images of the involved area were obtained for 3 min, and planar images were acquired at 10 min and 1 h. From the dynamic images, a tumour perfusion index (TPI) was obtained using Patlak-Rutland analysis. Tumour to background (T/B) ratios of both early and delayed images and percent wash-out rate (WR%) of 99mTc-MIBI were calculated. Immunohistochemical analysis of Pgp was performed on biopsy specimens and the degree of expression was graded according to a semiquantitative scoring system, from 0 to 6. After neoadjuvant therapy, tumour response was assessed by examining the ratio of viable cells and by detecting percent necrosis. Scintigraphic results were compared with Pgp status and therapy response. Irrespective of the Pgp status, all patients showed significant perfusion and 99mTc-MIBI uptake in early images. There was not a significant correlation between T/B ratios of early and delayed images and Pgp expression. We observed a positive correlation between WR% and Pgp status (r=0.61, P99mTc-MIBI was significantly higher in patients with high Pgp expression than in those with a low Pgp score (33%±9% vs 17%±9%). Therapy response was determined in 21 of 25 patients, and in only 5 of 21 cases was the percent necrosis more than 90%. Neither Pgp expression rate nor WR

  10. The role of {sup 99m}Tc-MIBI scintigraphy in the assessment of MDR1 overexpression in patients with musculoskeletal sarcomas: comparison with therapy response

    Burak, Z.; Erinc, R.; Oezcan, Z.; Dirlik, A. [Dept. of Nuclear Medicine, Ege University Medical Faculty, Bornova (Turkey); Ersoy, Oe.; Basdemir, G. [Dept. of Pathology, Ege University Medical Faculty, Izmit (Turkey); Moretti, J.-L. [Service de Medecine Nucleaire et Biophysique, Univ. Paris 8 (France); Sabah, D. [Dept. of Orthopaedics, Ege University Medical Faculty, Izmir (Turkey)

    2001-09-01

    The occurrence of multidrug resistance (MDR), which is in part due to the overexpression of P-glycoprotein (Pgp), is a major problem in neoadjuvant therapy of malignant musculoskeletal tumours. The aim of this study was to investigate the role of technetium-99m hexakis-2-methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) scintigraphy for functional imaging of the MDR1 phenotype in patients with musculoskeletal sarcomas. We aimed to compare {sup 99m}Tc-MIBI uptake and washout kinetics with the expression of Pgp and with chemotherapy response. Twenty-five patients (16 males and 9 females, aged between 8 and 65 years) with malignant musculoskeletal tumours were studied. After injection of 555-740 MBq {sup 99m}Tc-MIBI, dynamic flow images of the involved area were obtained for 3 min, and planar images were acquired at 10 min and 1 h. From the dynamic images, a tumour perfusion index (TPI) was obtained using Patlak-Rutland analysis. Tumour to background (T/B) ratios of both early and delayed images and percent wash-out rate (WR%) of {sup 99m}Tc-MIBI were calculated. Immunohistochemical analysis of Pgp was performed on biopsy specimens and the degree of expression was graded according to a semiquantitative scoring system, from 0 to 6. After neoadjuvant therapy, tumour response was assessed by examining the ratio of viable cells and by detecting percent necrosis. Scintigraphic results were compared with Pgp status and therapy response. Irrespective of the Pgp status, all patients showed significant perfusion and {sup 99m}Tc-MIBI uptake in early images. There was not a significant correlation between T/B ratios of early and delayed images and Pgp expression. We observed a positive correlation between WR% and Pgp status (r=0.61, P<0.01), and the wash-out rate of {sup 99m}Tc-MIBI was significantly higher in patients with high Pgp expression than in those with a low Pgp score (33%{+-}9% vs 17%{+-}9%). Therapy response was determined in 21 of 25 patients, and in only 5 of 21 cases

  11. Using Tc-99m MIBI scintimammography to differentiate nodular lesions in breast and detect axillary lymph node metastases from breast cancer

    王景; 吴华; 周健; 胡健

    2003-01-01

    Objective To test the clinical value of using Tc-99m MIBI scintimammography (Tc-99m MIBI SMM) to differentiate nodular lesions in breasts and detect axillary lymph node metastases of breast cancer. Methods The subjects consisted of sixty female patients exhibiting unilateral palpable breast mass. The early and delay static acquisitions were undertaken in all subjects at 10 and 90 min after injection with Tc-99m MIBI. The acquisition included three positions: anterior supine, left lateral prone and right lateral prone. A special device for SMM which was developed by our laboratory was used. The ratio of [(T-B)/(NT-B)] was calculated as radioactivity of mass to that of opposite corresponding tissue, and [(T-B)/(NT-B)]≥1.21 was used as the cut-off for semi-quantitative discrimination of malignancy from benignity in semi-quantitative analysis. The final diagnosis was obtained from histology examination in all subjects. Results Using Tc-99m MIBI SMM to differentiate between nodular lesions in breasts, the diagnostic sensitivity and specificity were 92.9% and 90.6% respectively, the positive predictive value 89.7%, the negative predictive value 93.5%, and the accuracy 91.7%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained with Tc-99m MIBI SMM for detecting axillary lymph node metastases were 83.3%, 86.1%, 80%, 88.6% and 85% respectively. Conclusions It is suggested that Tc-99m MIBI SMM may be not only valuable in differentiating malignant lesions from benign nodular masses of breast, but also helpful in detecting axillary lymph node metastases of breast cancer.

  12. Comparison of 99mTc-MIBI scanning and sentinel node biopsy in the detection of occult melanoma lymph node metastases

    Aim: Sentinel node biopsy (SNB) is a highly accurate technique for detecting occult metastatic disease in the regional lymph nodes. Our group has reported that 99mTc-MIBI scintigraphy is an imaging technique that can detect clinically undetectable metastases. This prospective study shows preliminary results on the comparison of both techniques for the detection of lymph node invasion. Material and Methods: Twenty-two consecutive patients (15 women, 7 men; mean age, 55 years) with primary melanoma > 1.0 mm thick were enrolled (mean 2.6 mm). Patients underwent 99mTc-MIBI scintigraphy of regional lymph nodes 1-2 weeks before surgery, acquiring 10-minute planar images with a LFOV gamma camera. A preoperative lymphoscintigraphy using 99mTc-colloidal (Re) sulphide was performed the day before surgery, using a dose of 74-93 MBq. Radio guided SNB was performed with a hand-held gamma probe. Lymph nodes were examined histologically and immunostained for S-100 and HMB-45. Results: The sentinel node (SN) was identified in 21/22 patients. An average of 1.6 SN/lesion were harvested from melanomas located in the following regions: head and neck (n=3), trunk (n=6), extremities (n=12). All patients with negative SN (n=11) were also negative with MIBI. In 10 cases the SN demonstrated metastatic involvement, whereas 99mTc-MIBI was positive in 8 of them (80%). In cases with positive SN/negative 99mTc-MIBI, the pathology report revealed micro metastatic disease. Conclusion: These preliminary results suggest that 99mTc-MIBI scanning has the potential of selecting a group of patients who might benefit from a selective complete lymphadenectomy

  13. {sup 99m}Tc-MIBI SPECT in primary hyperparathyroidism. Influence of concomitant vitamin D deficiency for visualization of parathyroid adenomas

    Schmidt, M.; Thoma, N.; Dietlein, M.; Moka, D.; Eschner, W.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany); Faust, M. [Dept. of II of Internal Medicine (Endocrinology), Univ. of Cologne (Germany); Schroeder, W. [Dept. of Surgery, Univ. of Cologne (Germany); Huelst-Schlabrendorff, M. von; Ehses, W. [Dept. of Endocrinology Clinic, Univ. of Cologne (Germany)

    2008-07-01

    Aim of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of {sup 99m}Tc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT). Patients, methods: between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a {sup 99m}Tc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase {sup 99m}Tc-MIBI protocol with SPECT were compared with histopathology. Results: in 54 pts with normal vitamin D values late SPECT images identified more lesions (n = 51, sensitivity 91%) than early planar (n = 45, sensitivity 82%) or late planar images (n = 50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n = 13, sensitivity 72%) than early planar (n = 10, sensitivity 56%) or late planar images (n = 10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a {sup 99m}Tc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p = 0.1625; late planar: p = 0.0039; {sup 99m}Tc-MIBI SPECT: p = 0.1180. Conclusion: the likelihood of a pathological {sup 99m}Tc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency. (orig.)

  14. Comparison of thallium-201, Tc-99m MIBI and I-131 scan in the follow-up assessment after I-131 ablative therapy in differentiated thyroid cancer

    Kwon, Jae Sung; Lee, Sung Keun; Kim, Doe Min; Park, Sae Jong; Jang, Kyong Sun; Kim, Eun Sil; Kim, Chong Soon [Hanil General Hospital, Seoul (Korea, Republic of)

    1999-08-01

    We conducted a comparative study to evaluate the diagnostic values of Tl-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or more times of I-131 retreatment (33 cases). In all patients, Tl-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the results were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. Positive rates (PR) of Tc-99m MIBI, Tl-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant Tl-201 and I-131 scans were in the order of therapeutic 131 scan 71%, Tl-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between Tl-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. Tl-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these

  15. Role of pre-operative imaging using {sup 99m}Tc-MIBI and neck ultrasound in patients with secondary hyperparathyroidism who are candidates for subtotal parathyroidectomy

    Fuster, David; Ortin, Jaime; Setoain, Xavier; Paredes, Pilar; Duch, Joan; Pons, Francesca [Hospital Clinic, Nuclear Medicine Department, Barcelona (Spain); Ybarra, Juan; Torregrosa, Jose-Vicente [Hospital Clinic, Renal Transplant Unit, Barcelona (Spain); Gilabert, Rosa [Hospital Clinic, Radiology Department, Barcelona (Spain)

    2006-04-15

    The purpose of this study was to assess whether pre-operative {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) scintigraphy and neck ultrasound (US) are of value in improving the outcome of subtotal parathyroidectomy in patients with secondary hyperparathyroidism. Forty-eight consecutive haemodialysis patients with severe secondary hyperparathyroidism prospectively underwent ''blinded'' subtotal parathyroid surgery, with 1-year follow-up to establish cure or relapse of their secondary hyperparathyroidism. Double-phase {sup 99m}Tc-MIBI scintigraphy and neck US were performed pre-operatively in all patients. When the preserved gland showed {sup 99m}Tc-MIBI uptake or an abnormal size on US, it was considered that ''{sup 99m}Tc-MIBI advice'' and ''US advice'', respectively, had not been followed. Pre-operative and follow-up parathyroid hormone (PTH) levels were obtained in all patients. All data were evaluated on a patient by patient basis. Four parathyroid glands were identified in each patient at primary surgery, resulting in an operative success rate of 100%. Their weight ranged from 15 to 7,300 mg (mean 1,120{+-}900 mg). Nine of the 48 patients (19%) showed a recurrence of their secondary hyperparathyroidism. The recurrence rate was 2% (1/48) and 10% (5/48), respectively, when {sup 99m}Tc-MIBI and US advice was followed. The sensitivity, specificity, NPV and PPV for pre-operative imaging were 72%, 95%, 97% and 80% respectively for {sup 99m}Tc-MIBI, and 55%, 67%, 87% and 28% for US. {sup 99m}Tc-MIBI scintigraphy is a reliable non-invasive exploratory tool and its preoperative use results in a significant reduction in the number of recurrences in haemodialysis patients with secondary hyperparathyroidism who are candidates for subtotal parathyroidectomy. The use of neck US did not significantly improve the results obtained with {sup 99m}Tc-MIBI alone. (orig.)

  16. Evaluation of MS-209, a novel multidrug-resistance-reversing agent, in tumour-bearing mice by technetium-99m-MIBI imaging

    MS-209 is a newly synthesised multidrug-resistance (MDR)-reversing agent with few side-effects. In this study, we evaluated the effect of MS-209 on P-glycoprotein (Pgp)-positive tumours in mice by means of technetium-99m methoxyisobutylisonitrile (MIBI) imaging. Mice received Pgp-negative KB-3-1 or Pgp-positive KB-C1 cell xenografts. KB-3-1-bearing mice were administered 0 or 100 mg/kg of MS-209 (groups S0 and S100, respectively), and KB-C1-bearing mice 0, 50, 100 or 200 mg/kg (groups R0, R50, R100 and R200, respectively), 30 min before imaging studies. Dynamic 99mTc-MIBI images were acquired for 30 min, followed by biodistribution studies. Washout of 99mTc-MIBI from the tumours was faster in group R0 than in group S0 on visual analysis, and the washout half-time estimated by region of interest analysis was shorter in group R0 than in group S0. Biodistribution studies revealed that 99mTc-MIBI accumulation in tumours (expressed as %ID/g) was also lower in group R0 than in group S0. MS-209 delayed the 99mTc-MIBI washout from KB-C1 tumours. Washout half-time was longer in groups R50, R100 and R200 than in group R0. A higher %ID/g was observed in groups R100 and R200 than in group R0. In KB-3-1 tumours, MS-209 had no effect on the washout half-time or the %ID/g. This study demonstrated that MS-209 increases the 99mTc-MIBI accumulation in Pgp-positive tumours. The MDR-reversing effect of MS-209 could be effectively evaluated with 99mTc-MIBI visually and non-invasively in vivo. 99mTc-MIBI imaging with MS-209 prior to chemotherapy should contribute significantly to the treatment strategy in patients with multidrug-resistant tumours. (orig.)

  17. Evaluation of MS-209, a novel multidrug-resistance-reversing agent, in tumour-bearing mice by technetium-99m-MIBI imaging

    Tatsumi, Mitsuaki; Nishimura, Tsunehiko [Division of Tracer Kinetics, Osaka University Graduate School of Medicine (Japan); Tsuruo, Takashi [Department of Chemical Biology, Institute of Molecular and Cellular Biosciences, University of Tokyo (Japan)

    2002-03-01

    MS-209 is a newly synthesised multidrug-resistance (MDR)-reversing agent with few side-effects. In this study, we evaluated the effect of MS-209 on P-glycoprotein (Pgp)-positive tumours in mice by means of technetium-99m methoxyisobutylisonitrile (MIBI) imaging. Mice received Pgp-negative KB-3-1 or Pgp-positive KB-C1 cell xenografts. KB-3-1-bearing mice were administered 0 or 100 mg/kg of MS-209 (groups S0 and S100, respectively), and KB-C1-bearing mice 0, 50, 100 or 200 mg/kg (groups R0, R50, R100 and R200, respectively), 30 min before imaging studies. Dynamic {sup 99m}Tc-MIBI images were acquired for 30 min, followed by biodistribution studies. Washout of {sup 99m}Tc-MIBI from the tumours was faster in group R0 than in group S0 on visual analysis, and the washout half-time estimated by region of interest analysis was shorter in group R0 than in group S0. Biodistribution studies revealed that {sup 99m}Tc-MIBI accumulation in tumours (expressed as %ID/g) was also lower in group R0 than in group S0. MS-209 delayed the {sup 99m}Tc-MIBI washout from KB-C1 tumours. Washout half-time was longer in groups R50, R100 and R200 than in group R0. A higher %ID/g was observed in groups R100 and R200 than in group R0. In KB-3-1 tumours, MS-209 had no effect on the washout half-time or the %ID/g. This study demonstrated that MS-209 increases the {sup 99m}Tc-MIBI accumulation in Pgp-positive tumours. The MDR-reversing effect of MS-209 could be effectively evaluated with {sup 99m}Tc-MIBI visually and non-invasively in vivo. {sup 99m}Tc-MIBI imaging with MS-209 prior to chemotherapy should contribute significantly to the treatment strategy in patients with multidrug-resistant tumours. (orig.)

  18. Magnetic resonance Imaging (MRI) and technetium-99m-methoxyisonitrile (MIBI) scintigraphy to evaluate the abnormal parathyroid gland and PEIT efficacy for secondary hyperparathyroidism

    Wada, Akihiko; Sugihara, Masaki; Sugimura, Kazuro [Shimane Medical Univ., Izumo (Japan); Kuroda, Hiroyuki

    1999-08-01

    Percutaneous ethanol injection therapy (PEIT) of the abnormal parathyroid gland is an effective treatment in patients with chronic renal failure with dialysis that tends to be unresponsive to medication. To evaluate the efficacy of PEIT, we investigated the correlation between serum intact PTH (iPTH), and the findings of MR imaging and {sup 99m}Tc-MIBI scintigraphy. PEIT was performed 32 times in 24 patients with secondary hyperparathyroidism. Both MR imaging and MIBI scintigraphy were performed before and after PEIT. The detectability of parathyroid lesions was evaluated by MRI and MIBI scintigraphy with reference to ultrasound (B-mode) findings (as a standard) and the comparison of each treatment was done between imaging changes and serum iPTH levels. In the small parathyroid glands (<0.5 ml with US), MR images detected abnormal glands in 74.0% (20/27), and MIBI accumulation was observed in 40.7% of the cases. Whereas, MR images and MIBI showed similar detectability (95.0% vs. 90.0%) to large parathyroid glands ({>=}0.5 ml with US). After PEIT, glands in which ethanol was successfully injected showed decreased signal intensity on T2-weighted images and decreased accumulation of MIBI. MR imaging and MIBI scintigraphy showed almost equivalent high sensitivity in evaluating therapeutic changes (73.3% vs. 76.4%) according to our evaluation category of more than 30% reduction of iPTH as effective. However, the specificity of MR imaging was much higher (100%) than that of MIBI scintigraphy in evaluating therapeutic effects. In conclusion, MRI provided better detectability of abnormal parathyroid glands than {sup 99m}Tc-MIBI scintigraphy. The reduction of high signal intensity area after PEIT on T2-weighted MR images is considered an useful therapeutic evaluation guideline than the reduction of MIBI accumulation on scintigraphy. (author)

  19. Sympathetic reinnervation in cardiac transplants: 123I-MIBG and 201Tl/99mTc-MIBI scintigraphy

    Iodine-123 metaiodobenzylguanidine (123I-MIBG) is a norepinephrine (NE) analogue and taken up by myocardial sympathetic nerves. To determine whether cardiac sympathetic reinnervation occurs after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and 201T1/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 pts(M : F =10 : 5; mean ages = 34.67±12.92 yr; idiopathic: rheumatic=14:1) (10.80±11.88 (1-48) mo) after TPL. 123I-MIBG imagins were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of heart to mediastinal MIBG uptake (HMR). 12 subjects with 1 year after TPL whereas reinnervation is less likely to occur in pts with a pretransplantation diagnosis idiopathic cardiomyopathy

  20. The key role of 99mTc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report.

    Li, Qing; Pan, Jiemin; Luo, Quanyong; Wang, Yan; Bao, Yuqian; Jia, Weiping

    2015-06-01

    The concomitant occurrence of primary hyperparathyroidism (PHPT) due to parathyroid adenoma and papillary thyroid carcinoma (PTC) is not common. The co-occurrence of parathyroid tumors and thyroid diseases can lead to misdiagnosis owing to mutual interference of imaging in the early period of disease. The most commonly used imaging techniques for the preoperative localization of parathyroid and thyroid adenomas are technetium-99m sestamibi (99mTc-MIBI) scintigraphy and ultrasonography of the neck. Recently, 99mTc-MIBI single-photon emission computed tomography associated with computed tomography scintigraphy (SPECT/CT) has been used to detect PHPT, and its diagnostic value is being evaluated. Herein, we report a patient with an unusual co-occurrence of parathyroid adenoma and multiple thyroid diseases, including papillary thyroid carcinoma, thyroid adenoma and lymphocytic thyroiditis, which were localized with 99mTc-MIBI SPECT/CT and confirmed surgically. We suggest that 99mTc-MIBI SPECT/CT can play an important role in the diagnosis of parathyroid and thyroid lesions. PMID:26154096

  1. The key role of 99mTc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report

    The concomitant occurrence of primary hyperparathyroidism (PHPT) due to parathyroid adenoma and papillary thyroid carcinoma (PTC) is not common. The co-occurrence of parathyroid tumors and thyroid diseases can lead to misdiagnosis owing to mutual interference of imaging in the early period of disease. The most commonly used imaging techniques for the preoperative localization of parathyroid and thyroid adenomas are technetium-99m sestamibi (99mTc-MIBI) scintigraphy and ultrasonography of the neck. Recently, 99mTc-MIBI single-photon emission computed tomography associated with computed tomography scintigraphy (SPECT/CT) has been used to detect PHPT, and its diagnostic value is being evaluated. Herein, we report a patient with an unusual co-occurrence of parathyroid adenoma and multiple thyroid diseases, including papillary thyroid carcinoma, thyroid adenoma and lymphocytic thyroiditis, which were localized with 99mTc-MIBI SPECT/CT and confirmed surgically. We suggest that 99mTc-MIBI SPECT/CT can play an important role in the diagnosis of parathyroid and thyroid lesions. (author)

  2. The key role of {sup 99m}Tc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report

    Li, Qing; Pan, Jiemin; Luo, Quanyong; Wang, Yan; Bao, Yuqian; Jia, Weiping, E-mail: wpjia@sjtu.edu.cn, E-mail: wpjia@yahoo.com [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

    2015-06-15

    The concomitant occurrence of primary hyperparathyroidism (PHPT) due to parathyroid adenoma and papillary thyroid carcinoma (PTC) is not common. The co-occurrence of parathyroid tumors and thyroid diseases can lead to misdiagnosis owing to mutual interference of imaging in the early period of disease. The most commonly used imaging techniques for the preoperative localization of parathyroid and thyroid adenomas are technetium-99m sestamibi ({sup 99m}Tc-MIBI) scintigraphy and ultrasonography of the neck. Recently, {sup 99m}Tc-MIBI single-photon emission computed tomography associated with computed tomography scintigraphy (SPECT/CT) has been used to detect PHPT, and its diagnostic value is being evaluated. Herein, we report a patient with an unusual co-occurrence of parathyroid adenoma and multiple thyroid diseases, including papillary thyroid carcinoma, thyroid adenoma and lymphocytic thyroiditis, which were localized with {sup 99}mTc-MIBI SPECT/CT and confirmed surgically. We suggest that {sup 99m}Tc-MIBI SPECT/CT can play an important role in the diagnosis of parathyroid and thyroid lesions. (author)

  3. Frequency and severity of myocardial perfusion abnormalities using Tc-99m MIBI SPECT in cardiac syndrome X

    Cardiac syndrome X is defined by a typical angina pectoris with normal or near normal (stenosis <40%) coronary angiogram with or without electrocardiogram (ECG) change or atypical angina pectoris with normal or near normal coronary angiogram plus a positive none-invasive test (exercise tolerance test or myocardial perfusion scan) with or without ECG change. Studies with myocardial perfusion imaging on this syndrome have indicated some abnormal perfusion scan. We evaluated the role of myocardial perfusion imaging (MPI) and also the severity and extent of perfusion abnormality using Tc-99m MIBI Single Photon Emission Computed Tomography (SPECT) in these patients. The study group consisted of 36 patients with cardiac syndrome X. The semiquantitative perfusion analysis was performed using exercise Tc-99m MIBI SPECT. The MPI results were analyzed by the number, location and severity of perfusion defects. Abnormal perfusion defects were detected in 13 (36.10%) cases, while the remaining 23 (63.90%) had normal cardiac imaging. Five of 13 (38.4%) abnormal studies showed multiple perfusion defects. The defects were localized in the apex in 3, apical segments in 4, midventricular segments in 12 and basal segments in 6 cases. Fourteen (56%) of all abnormal segments revealed mild, 7(28%) moderate and 4 (16%) severe reduction of tracer uptake. No fixed defects were identified. The vessel territories were approximately the same in all subjects. The Exercise treadmill test (ETT) was positive in 25(69%) and negative in 11(30%) patients. There was no consistent pattern as related to the extent of MPI defects or exercise test results. Our study suggests that multiple perfusion abnormalities with different levels of severity are common in cardiac syndrome X, with more than 30 % of these patients having at least one abnormal perfusion segment. Our findings suggest that in these patients microvascular angina is probably more common than is generally believed

  4. Are there any differences in uptake of Tc-99m MIBI and tetrofosmin between cancer cells expressing P-glycoprotein and MDR-related protein?

    Uptake of Tc-99m MIBI and Tc-99m tetrofosmin(TF) in two multidrug resistance cells, human colon cancer HCT/CLO2 cells expressing P-glycoprotein(Pgp) and non-small cell lung cancer A549 cells showing multidrug-resistance related protein(MRP) in vivo. RT-PCR Western blot analysis and immunohistochemistry(IHC) were used to detect Pgp and MRP. Cellular uptake of MIBI and TF was measured with single cell suspension of HCR/CLO2 and 549 cells. Cells were inoculated in flanks of 24 nude mice. Group 1 (Gr1) and Gr3 mice were injected with only MIBI or TF, and Gr2 and Gr4 mice were treated with cyclosporin A(CsA) before injection of MIBI or TF. Mice were sacrificed at 10, 60 and 240-min after tracer injection. Radioactivities of organs and tumors were measured. 549 cells expressed MRPr1 protein detected by Western blot and IHC staining of tumor tissue at cell membrane but not Pgp, A549/CLO2 was vice versa. Cellular uptake and % increases with CsA were higher for MIBI than TF for both cells in vitro. Animal studies showed that MIBI and TF uptake were progressively increased by time in both Pgp(+) HCT/CLO2 tumor and MRP(+) A549 cells in both Gr1 and Gr3. There were no significant differences in tumoral uptake of MIBI and TF between Grl and Gr3 for both cells except higher MIBI uptake in Pgp cells at 60-min. % increases of MIBI (111% at 10 min, 220% at 60 min, 426% at 240 min) and TF uptake (186% at 10 min 579% at 60 min, 390% at 240 min) were progressively increased with time up to 240-min with CsA % increases of MIBI (114% at 10 min, 257% at 60 min 396% at 240 min) and TF uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were similar with those in HCT/CLO2 tumor. There were no differences in MIBI and TF uptake between Pgp and MRP tumors. Although MIBI showed better MDR reversal effect of modulator CsA than TF in vitro, there were no differences for both tumors in vivo. MIBI and TF are suitable tracers for imaging Pgp and MRP-mediated drug resistance in cancers

  5. Are there any differences in uptake of Tc-99m MIBI and tetrofosmin between cancer cells expressing P-glycoprotein and MDR-related protein?

    Seo, J. H.; Yoo, J. A.; Seo, M. R.; Bae, J. H.; Jeong, S. Y.; Ahn, B. C.; Lee, K. B.; Lee, J [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2004-07-01

    Uptake of Tc-99m MIBI and Tc-99m tetrofosmin(TF) in two multidrug resistance cells, human colon cancer HCT/CLO2 cells expressing P-glycoprotein(Pgp) and non-small cell lung cancer A549 cells showing multidrug-resistance related protein(MRP) in vivo. RT-PCR Western blot analysis and immunohistochemistry(IHC) were used to detect Pgp and MRP. Cellular uptake of MIBI and TF was measured with single cell suspension of HCR/CLO2 and 549 cells. Cells were inoculated in flanks of 24 nude mice. Group 1 (Gr1) and Gr3 mice were injected with only MIBI or TF, and Gr2 and Gr4 mice were treated with cyclosporin A(CsA) before injection of MIBI or TF. Mice were sacrificed at 10, 60 and 240-min after tracer injection. Radioactivities of organs and tumors were measured. 549 cells expressed MRPr1 protein detected by Western blot and IHC staining of tumor tissue at cell membrane but not Pgp, A549/CLO2 was vice versa. Cellular uptake and % increases with CsA were higher for MIBI than TF for both cells in vitro. Animal studies showed that MIBI and TF uptake were progressively increased by time in both Pgp(+) HCT/CLO2 tumor and MRP(+) A549 cells in both Gr1 and Gr3. There were no significant differences in tumoral uptake of MIBI and TF between Grl and Gr3 for both cells except higher MIBI uptake in Pgp cells at 60-min. % increases of MIBI (111% at 10 min, 220% at 60 min, 426% at 240 min) and TF uptake (186% at 10 min 579% at 60 min, 390% at 240 min) were progressively increased with time up to 240-min with CsA % increases of MIBI (114% at 10 min, 257% at 60 min 396% at 240 min) and TF uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were similar with those in HCT/CLO2 tumor. There were no differences in MIBI and TF uptake between Pgp and MRP tumors. Although MIBI showed better MDR reversal effect of modulator CsA than TF in vitro, there were no differences for both tumors in vivo. MIBI and TF are suitable tracers for imaging Pgp and MRP-mediated drug resistance in cancers.

  6. A comparative study of primary coronary stenting with intravenous thrombolysis for acute myocardial infarction using 99mTc-MIBI SPECT imaging

    To evaluate and compare the therapeutic effectiveness of primary coronary stenting with that of intravenous thrombolysis for acute myocardial infarction (AMI) using 99mTc-MIBI myocardial SPECT imaging. A total of 42 patients with AMI was undergoing primary coronary stenting (stenting group, 23 patients) or intravenous thrombolysis therapy (thrombolysis groups 19 patients). 99mTc-MIBI myocardium SPECT imaging was performed before and 1 week after stenting or thrombolysis therapy. The left ventricular myocardium of each patient was divided into 20 segments. The semiquantitative score of myocardial 99mTc-MIBI uptake was expressed with a five-point scoring system. The scores of scanning before stenting or intravenous thrombolysis was SBS. The scores of scarring after stenting or intravenous thrombolysis was SAS. Deducting SAS from SBS was SDS. Make a comparison between the SAS. stenting group and fhrombolysis group: SBS was 41.3±9.8 and 39.4±7.9 (t=1.2, P>0.05); SAS was 17.8±6.4 and 27.3±6.7 (t=5.8, P99mTc-MIBI myocardial SPECT imaging has been proved to be an objective parameter for evaluating the therapeutic effectiveness of the stenting and intravenous thrombolysis in treatment of AMI. At the same time;, the results indicate that primary coronary stenting seems to be more effective than intravenous thrombolysis

  7. Internal Dosimetry and the pharmacokinetic of the Cuban Kit of Methoxy-Isobutyl-Isonitrile (MIBI) marked with 99mTc

    The objective of the present work consisted on evaluating the Internal Dosimetry and the pharmacokinetic of the Cuban Kit of Methoxy-Isobutyl-Isonitrile (MIBI) marked with 99mTc. In the dosimetry studies and biodistribution five healthy volunteers were included and in the pharmacokinetic studies five patients were included with less than 5% of probability of suffering illness of artery coronary

  8. Clinical assessment of myocardial viability by stress-reinjection 201Tl/rest 99mTc-MIBI dual-isotope imaging strategy

    Objectives: To assess area and severity of myocardial ischemia and myocardial viability by dobutamine stress-reinjection 201Tl/ rest 99mTc-MIBI dual-isotope myocardial perfusion tomography. Methods: The study included 35 patients who underwent tress-reinjection 201Tl/ rest 99mTc-MIBI dual-isotope SPECT and coronary angiography (CAG). Dobutamine stress was carried out 20 min after 99mTc-MIBI was injected intravenously at rest, then 201Tl was administrated intravenously, and dual-isotope SPECT was performed instantly. Because both of stress 201Tl and rest 99mTc-MIBI imaging showed area of defect radioactivity, 1mCi 201Tl was reinjected at rest, dual-isotope SPECT was performed again 4 hours later. Results: (1) of 86 segments showing defected activity, 54 segments were fill with radioactivity and the other 32 segments were not improved after 201Tl was reinjected. (2) All of 35 patients, 9 patients were normal and 26 patients were abnormal by coronary angiography (one cronory artery stenosis in 2 patients, 2 coronary arteries stenosis in 7 patients, 3 coronary arteries stenosis in 17 patients.). There were 17 patients with 50-75% coronary stenosis, 3 patients with 75-85% coronary stenosis and 15 patients with more than 85% coronary stenosis. The stenosis coronary arteries detected by coronary angiography were consistent with those detected by tress-reinjection 201Tl/ rest 99mTc-MIBI dual-isotope SPECT. (3) Assessed by stress-reinjection 201Tl/ rest 99mTc-MIBI dual-isotope SPECT, all ischemic cardiac muscles in 26 patients with CAD were viable. Of 26 CAD patients, 2 patients underwent PTCA, 2 patients underwent PCI, 6 patients underwent CABG in two or more vessels, 1 patient was treated with thrombolysis, the other 15 patients received medical treatment. (4) 14 segments with defect activity were detected by myocardial imaging in 9 normal patients by CAG. Of them, 5 segments were in lateral wall, 3 segments in anterior wall, 7 segments in septal wall near basement. 11

  9. Diagnostic accuracy of quantitative 99mTc-MIBI scintimammography according to ROC curve analysis

    Kim, J. H.; Lee, H. K.; Seo, J. W.; Cho, N. S.; Cha, K. H.; Lee, T. H. [Gachon Medical College, Gil Medical Center, Inchon (Korea, Republic of)

    1998-07-01

    99mTc-sestamibi scintimammography (SMM) has been shown to be a useful diagnostic test in the detection of breast cancer and the receiver operating characteristic (ROC) curve analysis provides detailed information of a diagnostic test. The purpose of this study was to evaluate the feasibility and efficacy of quantitative indices of SMM in the detection of malignant breast lesions according to ROC analysis. Prone anterior, lateral planar and supine SPECT imagings were performed on 75 female patients (mean age=43.4 yr) with breast mass (size{>=}0.8cm) after intravenous injection of 20-30 mCi 99mTc-sestamibi. 45 Malignant (Invasive ductal ca(36), Inv lobular ca(5), Inv duc + lob (1), Inv tubular ca (3)) and 30 benign (fibroadenoma (13), fib cyst(12), Fat necrosis(3), papilloma(1), paraffinoma (1)) lesions were histologically proven. Data were analyzed by creating three regions of interest (ROIs) over designated areas: lesion, normal breast and right chest wall. Lesion to normal (L/NL) and lesion to chest wall (L/CW) ratios were calculated for each patient both on the planar and SPECT. The area under the ROC curve (AUC) was calculated and compared among four semiquantitative indices and an average scintimammographic index (SMM(mean)) from arithmatic mean. ROC curve analysis revealed planar L/N, SPECT L/N and L/CW ratios provide comparable better diagnostic accuracies for detection of breast cancer than planar L/CW ratio (p<0.05), respectively. For quantitative SMM of 75 lesions, malignancy rate was 60%, and Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Accuracy were 0.78, 0.77, 0.84, 0.72 and 0.77, respectively. Quantitative SMM is an useful objective method for differentiating malignant from benign breast lesions.

  10. Assessment of the efficiency of ECG-Gated99mTc-MIBI SPECT for the evaluation of myocardial viability

    In the field of nuclear cardiology, various methods have been employed to evaluate myocardial viability. It is more challenging when one wants to evaluate viability in the hibernating myocardium. Electrocardiographic (ECG)-gated Tc-MIBI SPECT has the unique capability of evaluating both perfusion and ventricular function (wall motion and thickness), simultaneously. We studied forty patients with coronary artery disease who had positive previous history of myocardial infraction. They all underwent ECG-gated99mTc-MIBI SPECT before and 2-3 months after coronary artery bypass rafting (CAB G). Global ejection fraction, segmental myocardial perfusion and ventricular wall motion were compared before and after operation. Assessment of perfusion, alone, in some myocardial segments such as apical, mid and basal segments of septum-demonstrated no statistical meaningful difference. There was no significant changes in septal wall motion. The pre and post operative mean ventricular ejection (E F) were 51.35% and 51%, respectively. (p=0/85). Regarding the severity of perfusion defeat as the only criterion for viability, a number of the myocardial segments were preoperatively evaluated as non-viable, that was not in agreement with the post-operative results, (in other words the myocardial viability was underestimated). Based on dual criteria (perfusion and wall motion) all the myocardial walls were viable on both pre and post operative scintigrams. We concluded that severity of myocardial perfusion defect was not a perfectly accurate rit erion for myocardial viability. Also ejection fraction was not appropriate for the evaluation of ventricular functional improvement after CAB G

  11. Evaluation of parathyroid imaging methods with {sup 99m}Tc-MIBI. The comparison of planar images obtained using a pinhole collimator and a parallel-hole collimator

    Fujii, Hirofumi; Iwasaki, Ryuichiro; Hashimoto, Jun; Nakamura, Kayoko; Kunieda, Etsuo; Sanmiya, Toshikazu; Kubo, Atsushi [Keio Univ., Tokyo (Japan). School of Medicine; Ogawa, Koichi; Inagaki, Kazutoshi

    1999-07-01

    Parathyroid scintigraphy with {sup 99m}Tc-MIBI was performed using two kinds of collimators, namely, a pinhole one and a parallel-hole one, to evaluate which one was more suitable for the detection of hyperfunctioning parathyroid lesions. In the studies using {sup 99m}Tc source, the pinhole collimator showed better efficiency and spatial resolution in the distance where the parathyroid scan are actually performed. In the phantom study, the nodular activities modeling parathyroid lesions were visualized better on the images obtained using the pinhole collimator. In clinical studies for 30 patients suspicious of hyperparathyroidism, hyperfunctioning parathyroid nodules were better detected when the pinhole collimator was used. In conclusion, the pinhole collimator was thought to be more suitable for parathyroid scintigraphy with {sup 99m}Tc-MIBI than the parallel-hole collimator. (author)

  12. Quantitative comparison of dobutamine and exercise stress 99mTc-MIBI myocardial SPECT in diagnosis of coronary artery disease

    Aim: To compare the value of dobutamine and exercise stress 99mTc-MIBI myocardial imaging in diagnosis of coronary heart disease (CHD). Material and Methods: The subjects included twenty-one patients, in whom 18 were suspected with CHD and 3 were clinically diagnosed with myocardial infarction. The final diagnosis in all patients was confirmed by coronary angiography. Both dobutamine stress (DOB-ST) and bicycle exercise stress (EX-ST) 99mTc-MIBI myocardial perfusion SPECT were undertaken in every patient. The two stress imaging in one patient were performed within three days. Results: Twenty-four vessels in fourteen patients were diagnosed with coronary artery disease. There were no significant difference between DOB-ST and EX-ST in overall sensitivity (92.8% vs 92.8%), specificity (71.4 vs 85.7%), positive predictive value (86.7% vs 92.9%) and negative predictive value (83.3 vs 85.7%). There were also no significant difference in the sensitivity and specificity for detecting single or multiple vessel disease and for detecting specified vessel lesions (LDA, RCA, LCX). However, in 69 segments which related to the diseased vessels DOB-ST revealed 47 ischemic segments and EX-ST found 30 ischemic segments (P<0.05). The ischemic size which was expressed by the percentage of black-out area in polar map were bigger in DOB-ST image than that in EX-ST image (22.8±11.4% vs 17.5±12.3%, P<0.01) and, average radioactivity uptake ratio of ischemic region in DOB-ST image was lower than that in EX-ST image (43.2±13.8% vs 57.4±14.6%, P<0.01). Conclusion: DOB-ST demonstrated similar diagnostic efficacy to EX-ST in detecting coronary artery disease, thus it may be a feasible intervention for myocardial perfusion imaging. Whether DOB-ST is more sensitive to detect mild ischemia than EX-ST remains to be further investigated

  13. Radionuclide assessment of lower limb perfusion using 99mTc-MIBI in early stages of atherosclerosis

    The aim of the work was a scintigraphic evaluation of regional blood supply of thigh and calf muscles using 99mTc-MIBI as a radiopharmaceutical, in early stages of atherosclerosis revealed during ultrasonographic examination of lower limbs, in patients without typical clinical symptoms of chronic ischaemia of lower limbs and with preserved normal Doppler spectrum of blood flow. Moreover, basic relations between early signs of lower limb atherosclerosis and abnormal myocardial perfusion, as well as asymptomatic hypoperfusion of lower limbs, were analysed. Stress and rest radionuclide study of lower limb muscles and myocardium using 99mTc-MIBI was performed in 47 men, who were divided into two groups based on ultrasonography results. The first group (group I) comprised 22 patients with early atherosclerotic changes in peripheral vessels and the second (group II) comprised 25 people with normal arteries. For the purposes of quantification of study results normal values of regional blood supply and indices of asymmetry at levels of thighs and calves, as proposed by Segall et al., were applied. Myocardial scintigrams were evaluated according to widely accepted rules (visual and semi quantitative ? normative analysis). Mean values of stress and rest perfusion indices of thighs as well as calves in gr. I were statistically significantly lower (p < 0.001) than in gr. II. Incidence of asymmetry in the stress perfusion of calves and thighs was statistically significantly higher (p = 0.04) in patients with atherosclerotic changes as compared with the control group. Abnormal myocardial perfusion was found in 77% of patients from group I and in 28% from group II (p = 0.001). Reversible, stress induced ischaemia was found in 59% and 16%, resp. (p = 0.01). 1. Radionuclide study revealed a reduced stress as well as rest perfusion of lower limb muscles in clinically asymptomatic patients with atherosclerotic changes of lower limb vessels of low degree and a preserved normal Doppler

  14. Scintimammography with 99mTc-MIBI and magnetic resonance imaging in the evaluation of breast cancer

    This study was performed to evaluate the sensitivity and specificity of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintimammography (SMM) and contrast-enhanced magnetic resonance imaging (MRI) in patients with breast masses, using the histological findings as the gold standard. Forty-five consecutive patients with a breast lesion, detected by self-examination, physical examination or screening mammography, underwent SMM and MRI. In 38 cases (84.5%), the histopathology was malignant; the breast cancers ranged from 3 to 100 mm in diameter (mean 22 mm). In the overall patient group, MRI showed a slightly higher sensitivity than SMM (92% vs 84%), but SMM showed a better specificity: 71% vs 42%. The accuracy was 82% and 84% for SMM and MRI respectively. To evaluate the influence of lesion size on the results, patients with lesions ≤20 mm and ≤15 mm were examined. In patients with lesions ≤20 mm, the sensitivity of SMM and MRI decreased to 64% and 82% respectively, while SMM again displayed considerably better specificity: 83% vs 50% for MRI. The accuracy of SMM and MRI was 64% and 82% respectively. In patients with lesions ≤15 mm, SMM again showed better specificity (75% vs 50%), while MRI displayed better sensitivity and accuracy (sensitivity, 81% vs 62%; accuracy, 75% vs 65%). In this study the specificity of SMM in patients with breast lesions was thus superior to that of MRI. The combination of SMM and MRI may be used in those patients with equivocal findings at mammography and ultrasound to reduce the number of unnecessary surgical biopsies. (orig.)

  15. Prediction of response to chemotherapy in locally advanced breast cancer patients using Tc-99m MIBI scintimammography

    Locally advanced breast cancer is a common presentation in our part of the world. Down staging of the disease followed by surgery and further therapy has shown to prolong survival in such patients. Early prediction of response to therapy and chemo-resistance is of vital importance to ensure better outcome. The study was done to evaluate the possible role of Tc-99m MIBI scintimammography (MSM) in reliable and early prediction of response to therapy through tracer dynamics of the tumor. Response assessment through clinical criteria and other available modalities was also compared. 16 female patients were evaluated through dynamic and static prone MSM performed before and after two cycles of chemotherapy. Decay corrected washout curves were generated by drawing regions of interest (ROIs) all around the tumor. The tracer washout kinetics of the tumor were studied through half life estimation and tracer retention at 60 minute with reference to peak activity on pre and post therapy studies. Results were subjected to statistical analysis. There was a good correlation between the clinical assessment and dynamic MSM findings in good responders while the dynamic MSM was able to provide better information in poor responders. The results conclude that using tracer kinetics of MSM, early and reliable prediction of response to therapy and chemo-resistance may be possible

  16. Evaluation of portal circulation in animal model experiments using {sup 99m}Tc-MIBI per rectum

    Xu Lanwen; Chen Shaoliang; Chen Xuefen; Jin Gang; Zhao Huiyang; Qing Xingyu [Shanghai Medical Univ., SH (China); Tonami, Norihisa

    1995-03-01

    A series of animal models for portal hypertension was prepared using the method of portal vein constriction. Four New Zealand domestic rabbits and six dogs were given portal imaging by per-rectal administration of {sup 99m}Tc-MIBI and characteristics of quantitative portal hypertension were investigated. When the portal of domestic rabbits were constricted to 1/2, the heart/liver value (H/L) rose from 0.10{+-}0.04 to 0.57{+-}0.11, and the heart shunt index (S.I.h) rose from 0.08{+-}0.03 to 0.36{+-}0.09. These differences have significant meanings (p<0.05). The shunt index for whole organs (S.I.w), however, only changed slightly. When the portal veins of the dogs were constricted to 1/3, 1/2 and 2/3 of their original widths, their H/L, S.I.h and S.I.w values rose in proportion respectively, and their correlation with the portal pressure measured during operation was very good. Immediately after the operation, the main feature observed was the compensational swelling of the spleen. One month later, image of the heart became even more conspicuous, demonstrating formation and establishment of the collateral circulation. (author).

  17. Scintimammography with {sup 99m}Tc-MIBI versus dynamic MRI for non-invasive characterization of breast masses

    Imbriaco, M.; Del Vecchio, S.; Pace, L. [Nuclear Medicine Center of the National Research Council (CNR), University Napoli (Italy); Riccardi, A.; Di Salle, F.; Di Gennaro, F.; Salvatore, M.; Sodano, A. [Department of Biomorphological and Functional Sciences, University ' ' Federico II' ' , Napoli (Italy)

    2001-01-01

    Although mammography remains the technique of choice for the early detection of breast cancer, several imaging techniques, including scintimammography and magnetic resonance imaging (MRI), have recently been proposed as adjuncts for this purpose and included in many diagnostic protocols. This study was undertaken to assess the clinical accuracy of scintimammography with technetium-99m methoxyisobutylisonitrile (MIBI) and contrast-enhanced MRI in the detection of primary breast carcinoma in patients with equivocal mammographic findings. Forty-nine patients with a suspicious breast mass detected either by physical examination or by mammography and ultrasound (US) were studied. All patients underwent scintimammography and dynamic contrast-enhanced MRI 1 week apart. The results of the two techniques were compared and correlated to the final diagnoses. Two independent readers reported the scans using a four-point confidence scale. The areas under the receiver operator characteristic (ROC) curves were obtained. Scintimammography showed an accuracy for tumour detection of 84%, with a sensitivity of 80% and a specificity of 88%. MRI showed an accuracy of 86%, with a sensitivity and specificity of 96% and 75%, respectively. Comparison of the two areas under the ROC curves showed no significant differences between MRI, 0.91{+-}0.05 (mean{+-}SD), and scintimammography, 0.88{+-}0.05 (P=0.9). It is concluded that dynamic MRI and scintimammography possess comparable accuracy in the diagnosis of primary breast carcinoma in patients with equivocal mammographic or US findings. (orig.)

  18. Myocardial perfusion scintigraphy with technetium 99m-MIBI in the diagnosis of coronary artery disease in women

    The results of technetium 99m - methoxy-isobutyl-isonitrile scintigraphy in a one-day protocol: rest - physical or combined stress bicycle plus endovenoous dipyridamole were compared with those of coronary angiography in 20 women referred for the evaluation of pre cordial pain and of the usefulness of myocardial perfusion scintigraphy. The uptake of the radio drug under stress and at rest varied from 93 +-9 to 94 +- 7 % in the 204 segments with normal uptake under stress, from 67 He articulates it analyzes the reasons or utility of the employment of the radioactive iodine in the diagnosis and treatment of the thyroid affections +- 9 to 75 +- 17 % in the 89 with moderate reduction, and from 33 +- 9 to 64 +-28 % in the 27 with severe reduction. The qualitative and quantitative uptake analyses coincided in 18 patients. The perfusion scintigraphy and the angiography agreed in 70 % of the patients. It was concluded that the myocardial perfusion scintigraphy with technetium 99-MIBI contributes to the diagnosis of the coronary artery disease in women

  19. A trial for the quantification of regional myocardial blood flow with continuous infusion of Tc-99m MIBI and dynamic SPECT

    We propose a new method to quantify regional myocardial blood flow (rMBF) by continuous infusion of Tc-99m MIBI and dynamic SPECT. Five patients with old myocardial infarction were studied. During continuous infusion of MIBI (approximately 740 MBq) with a syringe pump in 10 min, dynamic SPECT scan was performed every minute and lasted 20 min after the start of infusion to identify myocardial uptake of MIBI. Input function was obtained from the radioactivity in the left ventricle (LV) in dynamic SPECT images. Spillover fraction between LV and myocardium (M) was corrected with phantom data. The influx constant (Ku) was calculated by Patlak plot graphical analysis, and compared with rMBF measured by PET (F) with N-13 ammonia based on Patlak plot analysis with correction for the extraction fraction. To correct the limited first-pass extraction of MIBI, linearization correction by means of the permeability-surface area (PS) product value was also applied. Spillover fractions of MIBI were 0.169±0.056 from LV to M, and 0.042±0.021 from M to LV. Ku was well correlated with F (Ku=0.057+0.220F, r=0.83, pMIBI=-0.131+0.858F, r=0.94, p<0.01). The proposed method has the potential to be a clinically feasible tool for quantitative measurement of rMBF. (author)

  20. Localization of parathyroid adenoma by echography and scintigraphy with {sup 99m}Tc-MIBI: the influence of lesion`s weight; Localisation de l`adenome parathyroidien par echographie et scintigraphie au {sup 99m}Tc-MIBI: influence du poids de la lesion

    Venault, S.; Denizot, B.; Morel, O.; Le Jeune, J.J.; Jallet, P. [Service de Medecine Nucleaire du CHU d`Angers (France)

    1997-12-31

    In the examination for pre-surgery localization of a primary hyperparathyroidism (HPT I), the size of parathyroid lesion constitutes the main factor limiting the diagnostic efficiency of different imaging techniques. We have tried to test this hypothesis by echography and scintigraphy with MIBI for the detection of unique adenomas. The study covered 16 patients explored pre-surgically by echography and scintigraphy with {sup 99m}Tc-MIBI for a HPT I as referred to a unique cervical adenoma (reference = surgery + anatomical-pathological examination). The scintigraphy with MIBI is achieved and interpreted by the `double phase` technique proposed by Taillefer with pin-hole acquisition of 15 and 120 minutes after injection of around 370 MBq of {sup 99m}Tc-MIBI. The average weight of adenoma is 3180 mg (218 to 22000). The echography localizes correctly the adenoma in 8 cases, in a wrong position, in 2 cases and does not find images evoking abnormal parathyroid in 6 patients. The MIBI visualizes properly the adenoma in 15 cases and in an incorrect position, in 1 patient. A table is given presenting the echography and MIBI-scintigraphy sensitivities as a function of adenoma weights. In conclusion, in our study the MIBI appear to be more sensitive than the echography in localizing the parathyroid adenoma. The diagnostic value of the two examinations appears to be independent of its weight; however, the results should be confirmed on larger batches

  1. Dual-phase 99mTc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism. Correlation with clinical or pathological variables

    The purpose of this study was to assess the relationship between 99mTc-MIBI and 99mTc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT. Dual phase 99mTc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent 99mTc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing 99mTc-MIBI scintigraphy and 99mTc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive 99mTc-MIBI and 99mTc-MDP bone scintigraphy were evaluated using ROC analysis. Among 244 patients, 174 (71.31%) patients with 181 foci had a positive 99mTc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the 99mTc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69%) patients had a negative 99mTc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive 9mTc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, 99mTc-MDP bone scintigraphy showed positive finding in 80 (51.61%) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive 99mTc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥150 ng/L were statistically significant in predicting positive 99mTc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.96 cm and 163.85 ng

  2. Thyroid nodules with indeterminate cytology: molecular imaging with {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) is more cost-effective than the Afirma registered gene expression classifier

    Heinzel, Alexander [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen, Pauwelsstrasse 30 (Germany); Institute for Neuroscience and Medicine (INM-4), Research Centre, Juelich (Germany); Mueller, Dirk [University of Cologne, Institute for Health Economics and Clinical Epidemiology, Cologne (Germany); Behrendt, Florian F. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen, Pauwelsstrasse 30 (Germany); Giovanella, Luca [Institute of Southern Switzerland, Department of Nuclear Medicine Oncology, Belinzona (Switzerland); Mottaghy, Felix M.; Verburg, Frederik A. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen, Pauwelsstrasse 30 (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands)

    2014-08-15

    To compare the cost-effectiveness of {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) thyroid scintigraphy and the Afirma registered gene expression classifier for the assessment of cytologically indeterminate thyroid nodules. A decision tree model was used. Costs were calculated from the perspective of the German health insurance system. The robustness of the results was assessed with probabilistic sensitivity analyses using a Monte Carlo simulation. Life expectancy was 34.3 years (estimated costs per patient EUR1,459 - EUR2,224) for the MIBI scan and 34.1 years (estimated costs EUR3,560 - EUR4,071) for the molecular test. These results were confirmed by the Monte Carlo simulation. MIBI thyroid scintigraphy is more cost-effective than the gene expression classifier. (orig.)

  3. Thyroid nodules with indeterminate cytology: molecular imaging with 99mTc-methoxyisobutylisonitrile (MIBI) is more cost-effective than the Afirma registered gene expression classifier

    To compare the cost-effectiveness of 99mTc-methoxyisobutylisonitrile (MIBI) thyroid scintigraphy and the Afirma registered gene expression classifier for the assessment of cytologically indeterminate thyroid nodules. A decision tree model was used. Costs were calculated from the perspective of the German health insurance system. The robustness of the results was assessed with probabilistic sensitivity analyses using a Monte Carlo simulation. Life expectancy was 34.3 years (estimated costs per patient EUR1,459 - EUR2,224) for the MIBI scan and 34.1 years (estimated costs EUR3,560 - EUR4,071) for the molecular test. These results were confirmed by the Monte Carlo simulation. MIBI thyroid scintigraphy is more cost-effective than the gene expression classifier. (orig.)

  4. Relationship Between Adenosine - Induced ST Segment Depression During 99mTc-MIBI Scintigraphy and The Severity of Coronary Artery Disease

    Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent, coronary vasodilator with rapid onset of action, short half life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during 99mTc-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed 99m-MIBI imaging after intravenous infusion of adenosine in 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during 99mTc-MIIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused intravenously at a dose of 0.14 mg/kg per minute for 6 minutes and 99MmTc-MIB1 was injected at 3 minute. We then compared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased 90 ± 19 beats/minute in the group with ST depression compared with 80 ±16 beats/minute in the group without ST depression(p9mTc-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p99mTc-MIBI myocardial perfusion scintigraphy with intravenous adenosine is related to the severity of coronary artery disease.

  5. assessment of the clinical role of simultaneous 99mTc-MIBI and 201Tl dual-isotopic myocardial perfusion SPECT imaging in the patients wit hypertension

    Objective: To study the clinical role of Simultaneous rest technetium-99m sestamibi (99mTc-MIBI) and stress thallium-201 (201Tl) Dual-isotopic myocardial perfusion SPECT imaging in the patients with hypertension. Methods: 116 patients with high blood pressure underwent simultaneous dual-isotopic myocardial perfusion SPECT imaging with 99mTc-MIBI and 201Tl. 99mTc-MIBI was injected at rest, 15 min later dobutamine was instilled into vein begin with 5 mg/kg/min, before and after instilling the base ECG, blood pressure, heart rate was recorded. when the maximal dose of Dobutamine was achieved, thallium-201 was injected, the dual-isotopic simultaneously SPECT imagine was performed. The stress and rest imagine was obtained. After tomographic reconstruction, the images were interpreted by two experienced observers without previous knowledge of results of other studies. Coronary angiography was performed in two weeks. All of 116 patients were found normal. Results: (1) All of 116 patients with high blood pressure were divided as three group by the course of disease: A group (20 year), 15. The heart/lung ratios of A, B, C group were 2.651±0.246, 2.546±0.231, 2.490±0.36 (mean±SD)respectively, no significant difference was noted among three group. Normal heart/lung ratios is 2.50±0.28 among of control group of 20. (2) The overall sensitivity for the dual-isotopic simultaneously myocardial SPECT imagine of high blood pressure was 46.55%(54/116). (3) Anterior, lateral, inferior, apex, interventricular septal segment were regarded as a whole segment, 111 segments display abnormal 201Tl uptake. 63, 30, 18 segments were in A, B, C group respectively, and no significant difference was noted among three group. 4 85 segments reveal reduced stressing 201Tl uptake and no typical redistribution was observed in the delay 201Tl imagines. 20, 24, 14, 12, 15 segments were in anterior, lateral, inferior, apex, interventricular septal segment respectively. 26 segments display inverse 201

  6. A comparison of radionuclide thyroid angiography, {sup 99m}Tc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules

    Demirel, Koray; Kapucu, Oezlem [Department of Nuclear Medicine, Gazi University School of Medicine, Ankara (Turkey); Yuecel, Cem; Oezdemir, Hakan [Department of Radiology, Gazi University School of Medicine, Ankara (Turkey); Ayvaz, Goeksun [Department of Endocrinology and Metabolic Diseases, Gazi University School of Medicine, Ankara (Turkey); Taneri, Ferit [Department of Surgery, Gazi University School of Medicine, Ankara (Turkey)

    2003-05-01

    We prospectively studied 43 patients with solitary cold thyroid nodules greater than 1.5 cm in diameter to determine the comparative diagnostic value of radionuclide thyroid angiography (RTA), technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) scintigraphy and power Doppler ultrasonography (PDUS) in the differentiation of benign and malignant thyroid nodules. Perfusion of the nodules in RTA was compared with the perfusion in the surrounding normal thyroid tissue and classified as follows: 0, avascular; 1, hypovascular; 2, isovascular; 3, hypervascular. {sup 99m}Tc-MIBI uptake in the nodules compared with that in surrounding thyroid tissue was scored for both early and delayed images as follows: 0, cold; 1, decreased; 2, equal; 3, increased. PDUS patterns were classified as nodule vascularisation patterns. The malignancy criteria were set as follows: hypervascular nodule with rapid washout in RTA; complex ring sign with anarchic structure or delta sign in PDUS, and positive retention and increased uptake in the nodule in the early and delayed {sup 99m}Tc-MIBI images. These data were compared with the histopathological results. Histology revealed thyroid carcinoma in nine patients (five cases of papillary carcinoma, three of follicular carcinoma and one of medullary carcinoma) and benign conditions in 34 patients (30 cases of nodular goitre, three of lymphocytic thyroiditis and one of follicular adenoma). Sensitivity, specificity and accuracy were, respectively, 0.89, 1.00 and 0.97 for RTA, 1.00, 0.76 and 0.81 for PDUS, and 0.67, 0.91 and 0.86 for {sup 99m}Tc-MIBI scintigraphy (when nodules with increased uptake in both the early and the delayed images and a positive retention index were considered as malignant). RTA, {sup 99m}Tc-MIBI scintigraphy and PDUS could be helpful in the preoperative assessment of solitary cold thyroid nodules. In this study, RTA was found to be the most accurate and specific method for differentiation of malignant from benign

  7. Planar scintimammography 99mTc-MIBI in breast cancer. Part 1. Review of literature and studies in healthy women

    After reviewing of the literature concerning 99mTc-MIBI and scintimammography (SCM) using this tracer, the results of planar technique obtained in 40 ''healthy'' women chosen from the candidates for myocardial perfusion study are presented. The aim of the study was to assess the normalcy rate, e.g. the percentage of normal images in women with minimal risk of breast cancer and the analysis the sources of potential overdiagnosis changes caused by this disease. Two observers an oncologists and a nuclear medicine physician) reviewed scintigrams of both sides of the chest (80 images) focusing on the regions where changes caused by breast cancer may happen to occur. Positive approval as normal met 95% images of the breast and subclavicular region, 82.5% of the axilla, 97% of the supraclavicular region and 96% of the parasternal region. In 2 women prominent ductal pattern was noted. In 7 cases focal uptake in the axilla was observed (on 4 in the same side as injection) and in further 7 patients increased accumulation in the infero-external part of the axilla was shown (the muscles?). In 3 patients foci of increased uptake were noted in the parasternal region. Two cases of symmetrically increased activity in suclavicular region and 1 in supraclavicular region were recognized as due to overexpression. Planar SCM is specific enough to be used in the breast cancer patients, although avoiding of overexpression of the images and caution in interpretation of the results (especially for the axilla) is recommended. Nonspecific accumulation of the tracer in various conditions may lead to false positive diagnosis, therefore an interview about trauma and possible inflammatory or vasculary changes is mandatory with the analysis of other additional results. (author)

  8. Usefulness of 99mTc-MIBI stress myocardial SPECT Bull's-eye quantification incoronary artery disease

    99mTc-methoxy-isobutyl isonitrile (MIBI) myocardial SPECT quantification performed using a Bull's-eye polar map, was evaluated and compared with visual analysis in 120 patients with proven or suspected CAD. The study series comprised 106 men and 14 women, age 37-75 years, 68 of whom had had a prior myocardial infarction. Coronary angiography was taken as the gold standard. Forty age-matched subjecs, with less than a 5% chance of having CAD, were enrolled to establish the normal database for males and females. ROC analysis was used to calculate the optimal thresholds for the definition of the disease extension in each vascular territory of the Bull's-eye polar map. Bull's-eye analysis agreed with visual analysis in 296/360 vessels. Two and three-vessel disease were most frequently observed using the Bull's-eye approach. However, a greater number of false positive (FP) cases were found with Bull's-eye than with visual analysis (28 versus 3 cases): FP cases were detected principally (21/28) in patients with previous myocardial infarction. It is interesting to note that this phenomenon, commonly observed in the LCX or RCA territory, was almost always correctly interpreted as a FP case by visual analysis. In conclusion, it is found the sensitivity and specificity for CAD diagnosis with the Bull's-eye approach to be similar to that of visual analysis, but the former method seems to be somewhat more sensitive for the localization of LAD and LCX disease. However, particular attention should be paid to patients with previous myocardial infarction, as FP cases are not infrequently observed with quantitative analysis, especially in the LCX and RCA territories

  9. Comparison of myocardial blood flows using 99mTc-MIBI myocardial SPECT and 15O-water PET

    Myocardial SPECT is widely used in the diagnosis and evaluation of coronary artery disease (CAD). However. due to the results expressed as relative values, myocardial SPECT has limitation in multi-vessel disease and diffuse CAD. Water PET is used in estimating the coronary blood flow non-invasively. In this study, we investigated the coronary blood flow relationship between myocardial SPECT and water PET. 99mTc-MIBI myocardial SPECT and 15O-water PET were done in 15 patients with suspected CAD (M:F=10:5, Mean age 61±8yrs) under conditions of rest and adenosine stress, respectively. SPECT scan was performed using low energy high resolution collimator dual head SPECT camera (Vertex EPIC, Philips-ADAC Labs, Milpitas, USA) and images were analyzed using automated software (AutoQUANT, ADAC Labs., CA, U.S.A.). PET scan was performed using ECAT EXACT camera (CTI, Knoxville, TN/ Siemens Medical System, Inc., Hoffman Estates, IL, USA). Left myocardium was extracted using ensemble independent component analysis, and the 9 ROIs were drawn (apex, 4 mid walls and 4 basal walls). Fourteen segments of myocardial SPECT excluding basal segments were matched with 9 PET segments. No correlation was found between myocardial SPECT and water PET in both rest and stress, in the analysis of a total of 135 segments. However, in the analysis of segments with myocardial blood flow under or equal to 1 ml/g/min in the stress water PET (n=22), there were statistically significant correlation between myocardial SPECT and water PET in both rest (Pearson correlation=0.58. p<0.01) and stress (Pearson correlation=0.58. p<0.01), respectively. In segments with decreased myocardial blood flow in the stress water PET, there were statistically significant correlation between myocardial SPECT and water PET, in both rest and stress

  10. Assessment of cardiac outcome in pancreas kidney transplant recipients using 99mTc-MIBI myocardial perfusion scintigraphy

    Full text: Simultaneous pancreas-kidney transplantation (SPK) in diabetic patients (patients) 99mTc-MIBI myocardial perfusion scintigraphy (MPI) in predicting cardiac outcome post SPK. One hundred and forty patients underwent SPK at our institution over a 15-year period. Sixty-six subjects were excluded because of incomplete follow-up (n=54) or death from non-cardiac causes (n=12). Seventy-four patients (44 men, 30 women) with age 44.3+/-7.4 yrs (range: 31-62yrs) were followed for up to 14 yrs post SPK. The mean interval between SPK and MPI was 48.1+/-37.1 months (median: 37.5, range: 6-132 months). MPI was performed using a standard two-day protocol with Adenosine or Dipyridamole and a dual-head gamma camera using 900 configuration, attenuation and scatter correction and resolution recovery. Images were reported by at least one experienced observer using standard software. MPI were classified as normal (n=33), infarct (n=4), small (n=32) or large (n=2) areas of impaired coronary flow reserve (CFR) or a combination of infarct and impaired CFR (n=3). Cardiac events were considered if infarct, angina, death or coronary revascularisation occurred. Two patients underwent coronary artery bypass surgery five yrs post SPK (both two yrs post MPI) and one patient developed angina six yrs post SPK (three yrs post MPI). In these patients, MPI showed only small areas of impaired CFR. The negative and positive predictive values for MPI were 100 and 9%, respectively. In summary, MPI has excellent NPV post SPK. The PPV is poor, suggesting that myocardial perfusion defects correlate only weakly with overall atherosclerotic risk profile post SPK. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. Lack of correlation between Tc-99m-sestaMIBI uptake and cadherin expression in infiltrating ductal breast carcinoma as prognostic indicators

    Despite using various kinds of prognostic indicators, it is still not possible to predict the biological behavior of breast cancer in all patients. Tc-99m-sestaMIBI (MIBI) uptake determined by breast scintigraphy and cadherin expression of tumor tissue revealed by immunohistochemistry are suggested as potential agents for this purpose. We hypothesize that there can be a correlation between MIBI whose cellular mitochondrial content is claimed to play a significant role in its tumor uptake and cadherin whose downregulation causes an increase in mitochondrial activity in human mammary carcinoma cell lines. The aim of this study was to assess the relationship between the degree of MIBI tumor uptake and cadherin expression in infiltrating ductal breast carcinoma. Correlation with response to chemotherapy and some known prognostic factors of breast cancer such as tumor size, number of metastatic axillary lymph nodes and microscopic grading was also done. Fourteen patients who underwent scintimammography and subsequent surgical excisional biopsy that revealed infiltrating ductal carcinoma were enrolled in this study. Statistical analysis did not show any correlation between MIBI uptake and cadherin expression (p>0.05). Also, no statistically significant correlation was noted between MIBI uptake and tumor size, number of metastatic lymph nodes, microscopic grade, stage of the disease or response to chemotherapy. Similarly, there was no statistically significant correlation between cadherin expression and tumor size, number of metastatic lymph nodes, microscopic grade, stage of the disease or chemotherapy response. The results of this study imply that there is no correlation between MIBI tumor uptake and cadherin expression with neither of them good enough to be used as prognostic indicators for breast cancer. (author)

  12. Relation between expression p-glycoprotein and the findings of the centellography with Tc-99m MIBI in patients with advanced mammary cancer

    We have previously shown that pre-treatment tumor uptake of 99mTc-MIBI, a transport substrate of P-glycoprotein (Pgp), is correlated to clinical response to doxorubicin-based chemotherapy in advanced breast cancer (ABC) patients. The aim of this study was to investigate the possible association between Pgp expression, MIBI uptake and clinical response to chemotherapy in breast cancer lesions. Twenty-seven lesions from 26 patients with ABC were included in the study. Pre-chemotherapy Pgp expression was investigated by immunocytochemistry. MIBI scintigraphy was performed 2-8 days prior chemotherapy. Images were acquired 10 minutes (early phase) and 60 minutes (delayed phase) post injection of 740-1110 MBq of 99mTc-MIBI. Tumor-to-normal background tissue uptake ratios were calculated in the early (T/Be) and delayed (T/Bd) phase of the study. Both ratios were significantly higher (p< 0.05) in Pgp negative (n=21) than in Pgp positive lesions (n=6). Furthermore, both ratios were higher in responder compared to non-responder lesions (T/Be 2.2 vs 1.4; T/Bd 1.8 vs 1.4; p< 0.05). All lesions with a T/Be ratio higher than 1.5 were classified as responders. No significant association was found between Pgp expression and response to chemotherapy. We concluded that MIBI scintigraphy may predict MDR1 phenotype and response to doxorubicin-based chemotherapy in ABC. Pgp expression would not be useful for predicting chemotherapy response (Au)

  13. Sympathetic reinnervation in cardiac transplants: 123I-MIBG and 201Tl/99mTc-MIBI scintigraphy

    The purpose was to evaluate cardiac sympathetic reinnervation and hemodynamic changes after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and rest 201Tl/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 patients (M:F=10:5;mean ages=34.5±13.0 yr; idiopathic:rheumatic=14:1; one heart lung TPL)(10.80 ±11.88 (1-48) mo) after TPL 123I-MIBG imagings were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of heart to mediastinal MIBG uptake (HMR) Compared to HMR on 15 min images (1.48 ± 0.28), neither four nor 24 hour delayed images (1.26 ± 0.23 vs. 1.06 ± 0.26: p<0.05, respectively, ANOVA) showed definite delayed localization of MIBG. 12 subjects with <13 (4.9 ±3.7) months after TPL had no visible 123I-MIBG uptake on early 15 min imaging however, 12 subjects with 13 to 48(28.6±12.8) months had visible cardiac 123I-MIBG uptake (HMR: 1.65±0.21 vs. 1.32±0.26; p=0.002). One-year followup 123I-MIBG scintigraphy in nine pts showed significantly increased HMR(1.40±0.31 to 1.61±0.16, p<0.05) but a plateau was reached at HMR value of 2.0, which was still lower than 3.0 in normal controls. Plasma NE was increased according to I-123 MIBG myocardial uptake. Annual G-MPS detected an allograft atherosclerosis in one pt and showed progressive normalization of tachycardia and significant deterioration of LVEF and cardiac indices according to severity of rejection. To dipyridamole stress, transplant heats showed significant subnormal hemodynamic responses. Partial sympathetic late reinnervation can occur <1 year after TPL, and reached a plateau of two-third of normal value. G-MPS seems to be a useful screening test for the detection of allograft atherosclerosis and rejection

  14. Sensitivity of parathyroid scintigraphy with Tc99m-MIBI (two phase) for localization of parathyroid adenoma

    Hyperparathyroidism is caused by increment of serum parathyroid Hormone and parathyroid adenoma is the underling pathology in 85 to 90% of cases. In 9 to 15% of cases etiology is parathyroid Hyperplasia. Treatment is surgical resection of abnormal gland. Nuclear medicine method is one of the best methods for localization of abnormal parathyroid gland. All patients who referred for parathyroid scan to nuclear medicine department were studied. After complete history and thyroid examination, the patients were injected with 20 mCi-Tc-99m-MIBI intravenously and imaging were performed in 2 seconds intervals for 2 minutes than one minute images for 10 minutes and another 10 minutes image was recorded. Also delayed image was down at 2 hours. Forty eight patients were studied. Parathyroid scan was negative in 26 patients and positive in 22 patients. Chief complaint was general malaise in 37.8% of patients. From 14 patients who have adenoma in pathology, in 11 patients adenoma were accurately localized and 3 patients had negative scan. From 4 cases with parathyroid hyperplasia only one case had positive scan and 3 foci was detected in scintigraphy. Sensitivity of scan for diagnosis and localization of parathyroid adenoma was 78.5% and sensitivity for diagnosis of hyperplasia was only 33.3%. Serum Ca level was significantly higher inpatients with parathyroid adenoma (10.4 mg/d L) in scintigraphy compared with scan negative patients (9.5 mg/d L). (P=0.02) Respectively serum phosphorus level was 2.5 mg/d L in patients with adenoma and 3.4 mg/dl in other patients. (P=0.003). Serum T H level was 316.2 I U in patients with adenoma and 191.4 I U in other patients which was statistically significant (P=0.03). Conclusion: Parathyroid scan is recommended for all patients undergoing parathyroid surgery with respect high sensitivity for localization of parathyroid adenoma and fairly low cost. The mean serum Ca in patients with parathyroid adenoma was 10.4 mg/d L which is far less than

  15. Sympathetic reinnervation in cardiac transplants: 123I-MIBG and 201Tl/99mTc-MIBI scintigraphy

    Kim, J. H.; Oh, S. J.; Son, M. S.; Son, J. W.; Koh, K. K.; Choi, I. S.; Shin, E. K.; Park, K. Y. [Gachon Medical College, Gil Heart Center, Inchon (Korea, Republic of)

    1998-07-01

    Iodine-123 metaiodobenzylguanidine (123I-MIBG) is a norepinephrine (NE) analogue and taken up by myocardial sympathetic nerves. To determine whether cardiac sympathetic reinnervation occurs after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and 201T1/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 pts(M : F =10 : 5; mean ages = 34.67{+-}12.92 yr; idiopathic: rheumatic=14:1) (10.80{+-}11.88 (1-48) mo) after TPL. 123I-MIBG imagins were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of heart to mediastinal MIBG uptake (HMR). 12 subjects with < 13 (4.91{+-}3.67) months after TPL had no visible 123I-MIBG uptake on early 15 min imaging however, 12 subjects with 13 to 48(28.58{+-}12.77) months had visible cardiac 123I-MIBG uptake (HMR: 1.65 {+-}0.21 vs. 1.32{+-}0.26 p=0.002). Correlation was found between plasma NE concentration and HMR ( r=0.80: p<0.05). Compared to HMR on 15 min images (1.48{+-}0.28), neither four nor 24 hour delayed images (1.26{+-}0.23 vs. 1.06{+-}0.10 : p<0.05, respectively, ANOVA) showed definite delayed localization of MIBG. To dipyridamole stress, transplant hearts showed significant subnormal hemodynamic responses of HR, s-BP, d-BP, and rate pressure product (90.9{+-}14.9 to 102.2{+-}15.3, 136.5{+-}17.3 to 124.9{+-}13.3, 83.3{+-}12.5 to 74.7{+-}15.6, 123.2{+-}19.4 to 127.4{+-}21.8 p<0.05, respectively). One-year followup 123I-MIBG scintigraphy in nine pts showed increased HMR (1.50{+-}0,37 to 1.61{+-}0.15, p=ns) but couldnt reach the statistical significance. Out of nine followup patients, five showed increased HMR but four didnt. gMPS performed at post-TPL 48 months in one patient complaining vague chest pain whose HMR value 1.73 to 1.62 showed an apicoanterior wall reversible perfusion defect which confirmed as 90% distal left anterior descending artery stenosis by

  16. Assessing Response Using Tc99m-MIBI Early after Interstitial Chemotherapy with Carmustine-Loaded Polymers in Glioblastoma Multiforme: Preliminary Results

    D. Cecchin

    2014-01-01

    Full Text Available Introduction. Early signs of response after applying wafers of carmustine-loaded polymers (gliadel are difficult to assess with imaging because of time-related imaging changes. Tc99m-sestamibi (MIBI brain single-photon emission tomography (SPET has reportedly been used to reveal areas of cellularity distinguishing recurrent neoplasm from radionecrosis. Our aim was to explore the role of MIBI SPET in assessing response soon after gliadel application in glioblastoma multiforme (GBM. Methods. We retrospectively reviewed the charts on 28 consecutive patients with a radiological diagnosis of GBM who underwent MIBI SPET/CT before surgery (with intracavitary gliadel placement in 17 patients, soon after surgery, and at 4 months. The area of uptake was selected using a volume of interest that was then mirrored contralaterally to obtain a semiquantitative ratio. Results. After adjusting for ratio at the baseline, the effect of treatment (gliadel versus non-gliadel was not statistically significant. Soon after surgery, however, 100% of patients treated with gliadel had a decreased ratio, as opposed to 62.5% of patients in the non-gliadel group P=0.0316. The difference between ratios of patients with radical versus partial resection reached statistical significance by a small margin P=0.0528. Conclusions. These data seem to suggest that the MIBI ratio could be a valuable tool for monitoring the effect of gliadel early after surgery.

  17. Reversal of multidrug resistance with KR-30035: evaluated with biodistribution of Tc-99m MIBI in nude mice bearing human tumor xenografts

    Kim, Jung Kyun; Lee, Jae Tae; Lee, Byung Ho [Kyungpook National Univ. Hospital, Taegu (Korea, Republic of)] [and others

    2001-06-01

    KR-30035 (KR), a new MDR reversing agent, has been found to produce a similar degree of increased Tc-99m MIBI uptake in cultured tumor cells over-expressing mdr1 mRNA compared to verapamil (VP), with less cardiovascular effects. We assessed the MDR-reversing ability of KR in vivo, and effects of various doses of KR on MIBI uptake in nude mice bearing P-glycoprotein (P-gp) positive (+) and P-gp negative (-) human tumor xenografts. P-gp (+) HCT15/CLO2 colorectal and P-gp (-) A549 non-small cell cancer cells were inoculated in each flank of 120 nude mice (20 mice x 6 groups). Group 1 (Gr1) mice received 10mg/kg Kr i.p. 3 times (x3); Gr2, 10mg/kg VP i.p. x3; Gr3, 10mg/kg KR i.p. x2 + 25mg/kg KR i.p. x1; Gr4, 10mg/kg KR i.p. x 2 + 50mg/kg i.p. x1; Gr5, 10mg/kg Kr i.p. x2 + 25mg/kg KR i.v. x1, GrC, controls. The mice were then injected with Tc-99m MIBI and sacrificed after 10 min, 30 min, 90 min and 240 min. Tumor uptake of MIBI (TU) in each group was compared. Tu in P-gp (+) and (-)tumors were both higher in Gr1 than Gr2. Washout rate between the 10 min and 4 hours was lower in Gr5 of P-gp (+) cell (0.93) than the control. Percentage increases in Tu were higher in P-gp (+) than P-gp (-) tumors with all KR doses. Pgp (+) TU were highest at 10 min (173% of GrC) and persisted up to 240 min (144%) in Gr3. Larger doses of KR resulted in a lesser degree of increase in P-gp (+) TU at 10 min (130% in Gr4 and 117% in Gr5) and 30 min (178%, 129%), but TU increased by time up to 240 min (177%, 196%). Heart and lung uptakes were markedly increased in Gr4 and Gr5 at 10 and 3C min, likely due to cardiovascular effects. No mice died. These data further suggest that KR that has significantly lower cardiovascular toxicity than verapamil can be used as an active inhibitor of MDR. Even a relatively low dose of KR significantly increased Tc-99m MIBI uptake in P-gp (+) tumors in vivo.

  18. Early detection of radiation-induced heart disease using 99mTc-MIBI SPECT gated myocardial perfusion imaging in patients with oesophageal cancer during radiotherapy

    Background and purpose: The primary aim of this prospective study was to investigate the value of 99mTc-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) gated myocardial perfusion imaging (GMPI) in the detection of radiation-induced heart disease (RIHD) as early as during radiotherapy (RT) for oesophageal cancer (EC). The second aim was to analyse the correlation between cardiac toxicity and the dose–volume factors. Materials and methods: The 99mTc-MIBI SPECT GMPI was performed both pre-RT and during RT (40 Gray). The results of the SPECT were quantitatively analysed with QGS/QPS software and read by two experienced nuclear medicine physicians. The correlation between the changes in the SPECT parameters and the RT dosimetric data was analysed. Results: Eighteen patients with locally advanced EC were enrolled in the study. Compared with the baseline, the imaging during RT showed not only significant decreases in the wall motion (WM) (1/20 segments), wall thickening (WT) (2/20 segments), end-diastolic perfusion (EDP) (5/20 segments) and end-systolic perfusion (ESP) (8/20 segments) (p < 0.05) but also a significant increase in the heart rate (74.63 ± 7.79 vs 81.49 ± 9.90, p = 0.036). New myocardial perfusion defects were observed in 8 of the 18 patients. The V37–V40 was significantly higher (p < 0.05) in the patients with the new perfusion defects during RT than in the patients who did not exhibit these defects. Conclusions: Radiotherapy for EC induces cardiac damage from an early stage. 99mTc-MIBI SPECT GMPI can detect the occurrence of cardiac impairment during RT. The WM, WT, EDP and ESP may be valuable as early indicators of RIHD. The percentage of the heart volume that receives a high dose is an important factor that is correlated with RIHD

  19. Is technetium-99m-MIBI taken up by the normal pituitary gland? A comparison of normal pituitary glands and pituitary adenomas

    The aim of this study was to compare the behavioral uptake of a normal gland and a pituitary adenoma and to assess the ability to diagnose pituitary adenoma by means of technetium-99m-hexakis-2-methoxy-isobutyl-isonitrile (MIBI) single photon emission computed tomography (SPECT). The study included 15 patients with pituitary adenomas (mean age=44.0 years, range 19-63) and 15 control subjects (mean age=50.7 years, range 20-67). SPECT was performed 15 minutes after an intravenous injection of MIBI 600 MBq. The shape and location of MIBI uptake were evaluated on a magnetic resonance (MR) imaging/SPECT registration image. The shape patterns and location were classified as follows: Shape C (circular); LO (longitudinal oval); T/R (triangular or rectangular) and location P (pituitary gland or adenoma); D/C (dorsum sellae and/or clivus). Analysis of the uptake showed that 10 (67%) adenomas were C, and 5 (33%) were LO. Of the controls, 5 (33%) were C, and 10 (69%) were T/R. With regard to location, all patients with pituitary adenomas were classified as P, and all control subjects (93%) but one showed uptake in the dorsum sellae and clivus (D/C). MIBI was taken up in the dorsum sellae or clivus but not the normal pituitary gland and had a strong affinity for the pituitary adenoma. This result implies that MIBI SPECT may be a useful new auxiliary examination technique for the location diagnosis of pituitary adenoma. (author)

  20. Solitary pulmonary nodules: Tc99m-MIBI to discriminate between malignant and benign lesions in a region with a high prevalence of tuberculosis

    Full text: A solitary pulmonary nodule (SPN) is defined as a single circumscribed lung lesion surrounded by aerated lung without atelectasis, satellite lesions or cavity. The generally accepted definition of such nodules includes lesions up to 3 cm in diameter. Some studies include larger lesions of up to 6 cm. Most SPN are due to primary bronchogenic carcinoma or benign granulomas. South Africa has a high incidence of tuberculosis, which often presents as SPN. Assessment of pulmonary nodules is important to differentiate benign and malignant lesions. Radiological imaging is often inconclusive in determining the presence of malignancy. F-18 FDG PET is useful in the evaluation but is expensive and not available in South Africa. Tc-99m MIBI has been used in the evaluation of various malignancies, including lung cancers for diagnosis and staging. The aim of our study was to evaluate Tc-99m MIBI scintigraphy as a non-invasive diagnostic tool to differentiate whether the SPN is malignant or benign. The study group included thirty patients, 19 men and 11 women, with a mean age of 53 years (range 19-90 years). The nodule size ranged between 1 and 5 cm in diameter, with a mean size of 2 cm. All the patients were referred from the Lung Unit of Tygerberg Hospital. The inclusion criteria were a recent chest X-ray and a planned or available CT scan of the chest. Pregnant patients were not included in the study. Imaging was performed after the administration of Tc-99m MIBI intravenously in the arm opposite to the SPN. Planar views and SPECT of the chest area were obtained. Final diagnosis was obtained by means of: bronchoscopy with histology, cytology, microbiology or thoracotomy, fine needle aspiration cytology (image guided) or serial CXR follow-up (documenting 2 year lesion stability). Two experienced nuclear physicians who were blinded to the aetiology of the SPN evaluated MIBI scans. All-malignant lesions showed uptake of MIBI. There were three false positive scans in the

  1. Evaluation of the influence of percent labeling of 99mTc-MIBI on nuclear medicine procedures in Recife, Pernambuco State, Brazil

    The aim of this work was to evaluate the influence of percent labeling of the radiopharmaceutical 99mTc-MIBI on the procedures adopted by the nuclear medicine clinics in Recife, Pernambuco State, Brazil, and their possible interference with image quality in myocardial perfusion examinations. This work was performed at two nuclear medicine services in Recife that use pharmaceuticals provided by two different manufacturers: Cardiolite, provided by Dupont and Cardiosyd, provided by SYDMA. The pH, percent labeling and stability of samples of 99mTc-MIBI and the percent uptake in heart and liver of a number of patients were evaluated. The results showed that the pH values measured in all samples of both radiopharmaceuticals were within the limits recommended. In 48% of the Cardiolite samples, the percent labeling was less than 90%, which is the minimum recommended limit. On the other hand, 87,5% of the Cardiosyd samples measured values above 98%. Both radiopharmaceuticals had good labeling stability, even in samples with low percent labeling efficiencies. In spite of the higher percent labeling of Cardiosyd its heart uptake is similar to that observed with the Cardiolite, even when the percent labeling is lower than 90%. On the other hand, the image quality, according to physicians, evaluation was poorer for Cardiosyd images, due to high noise and poor sharpness. (author)

  2. The value of serial 99mTc-MIBI myocardial SPECT imaging in animal models of acute myocardial ischemia and reperfusion

    The purpose is to evaluate acute ischemia and reperfusion in canine models by serial 99mTc-MIBI myocardial SPECT studies. In 24 dogs, myocardial ischemia was induced by dilated balloon inserted in LAD or LCX, followed by reperfusion at 1h (Group I), 4h (Group II) later, and permanent ischemia by copper coil (Group III). The first and second imaging was taken after ischemia and after reperfusion. The 3rd, 4th and 5th SPECT were at 7, 14 and 28 days later. Defect fraction (DF), and ischemic fraction (IF) was obtained from the Bull's-eye images. The first DFs in all 3 groups correlated well with the myocardium at risk (IF) measured by pathological study. DF in group I decreased consistently since the second SPECT, in Group II DF had some decrease, while in Group III no decrease of DF was measured. The SF in all animals showed the same trend. The last DF was correlated with the real size of infarct foci (NF) determined by TTC staining by pathological study. 99mTc-MIBI SPECT was sensitive and accurate in revealing myocardial damage after acute ischemia and its response to reperfusion. The first (before), second (right after), and the last SPECT (4 weeks after reperfusion) were the most informative and clinically useful

  3. The value of Dedicated Tc-99m MIBI Scintimammography in the Evaluation of Patients with Palpable Breast Lesions in Comparison with Mammography: Preliminary Result

    There are few studies evaluating the usefulness of dedicated high-resolution scintimammography and no studies using delayed washout with this dedicated high resolution scintimammography for the evaluation of breast lesions. We underwent this study to evaluate the clinical usefulness of Tc-99m MIBI in evaluating patients with palpable breast lesions using dedicated high-resolution scintimammography. This study included 19 patients with 23 palpable breast lesions who underwent mammography. Tc-99m MIBI was taken to further characterize these lesions. Scintimammography images were acquired with standard craniocaudal and mediolateral oblique views and delayed images were additionally taken. Final conclusions were based on histopathology, either by biopsy or mastectomy results. Eighteen lesions were malignant and five were benign. Mammography was indeterminate for thirteen lesions, nine of those were malignant. Mammography also categorized one lesion as benign in a dense breast, but scintimammography and pathology results showed malignancy. Of the five benign lesions, two were visible on scintimammography, but delayed images showed washout. Based on our preliminary results, dedicated high resolution scintimammography seems to be very useful in characterizing palpable lesions that were indeterminate or negative on mammography

  4. Potential roles of 99m-Tc-MIBI and [18F]-FDG in the management of breast cancer

    MIBI scinti-mammography and FDG-PET are non invasive and accurate techniques for the characterization of breast lesions larger than 1 cm. They are not indicated as first line tools but can be useful when diagnosis is difficult. Their sensitivity is too low for lymphatic staging but they can reveal supraclavicular of internal mammary chains secondary locations not detectable by any other technique. FDG-PET also allows the visualization of regional and distant metastases, as well as the early assessment of treatment efficacy. MIBI mammo-scintigraphy can be useful for the prediction of MDR mediated resistance to chemotherapy. The clinical impact of these techniques in the management of breast cancer remains to be evaluated. (authors)

  5. Long-term prognostic value of exercise {sup 99m}Tc-MIBI SPET myocardial perfusion imaging in patients after percutaneous coronary intervention

    Zhang, Xiaoli; Liu, Xiujie; He, Zuo-Xiang; Shi, Rongfang; Yang, Minfu; Gao, Runlin; Chen, Jilin; Yang, Yuejin; Fang, Wei [Cardiovascular Institute and Fu Wai Hospital, PUMC and CAMS, A 167 Beilishilu, 100037, Beijing (China)

    2004-05-01

    The purpose of this study was to evaluate the long-term prognostic value of exercise technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) single-photon emission tomography (SPET) imaging in patients after percutaneous coronary intervention (PCI). Three hundred and eighteen consecutive post-PCI patients who underwent exercise and rest {sup 99m}Tc-MIBI SPET myocardial perfusion imaging (MPI) were followed up for 38{+-}27 months. Patients with early revascularisation (<3 months after MPI) were excluded. A semiquantitative visual analysis employing a 20-segment and four-point scoring system was used to define the summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS). Death and non-fatal myocardial infarction (MI) were considered as hard events, and late revascularisation procedures ({>=}3 months after MPI) as soft events. Fifty-one patients (16.0%) suffered from cardiac events during follow-up, including 1 (0.3%) death, 13 (4.1%) non-fatal MIs, 9 (2.8%) coronary artery bypass grafting procedures and 28 (8.8%) PCIs. According to the SPET results, patients were classified into three groups: patients with normal MPI (SSS=0, n=153), patients with irreversible defects (SDS<3 and SRS>1, n=100) and patients with reversible defects (SDS{>=}3, n=65). The annual hard cardiac event rate in patients with reversible defects was 3.9%, which was significantly higher than that in patients with normal MPI (0.2%, {chi}{sup 2}=7.71; P<0.01). The annual soft cardiac event rate in patients with reversible defects was 10.7%, which was significantly higher than that in patients with irreversible defects (2.5% {chi}{sup 2}=17.69; P<0.001), and also significantly higher than that in patients with normal MPI (1.5%, {chi}{sup 2}=33.89; P<0.001). In patients with normal and reversible defects, there was no significant difference in soft and hard cardiac event rates according to whether patients were symptomatic or asymptomatic (P>0.05). However, the annual

  6. Invasive ductal carcinoma arising from dense accessory breast visualized with 99mTc-MIBI breast-specific γ imaging.

    Yoon, Hai-Jeon; Sung, Sun Hee; Moon, Byung In; Kim, Bom Sahn

    2014-08-01

    Primary accessory breast cancer is extremely rare, and the diagnostic efficacy of Tc-MIBI breast-specific γ imaging (BSGI) has not been reported elsewhere. We present a case of primary carcinoma arising from dense accessory breast that was visualized with BSGI. A 43-year-old female patient with a palpable axillary mass underwent mammography, which showed dense parenchyma on both of the anatomic and accessory breasts with no abnormality. Subsequent BSGI showed no abnormal uptake in bilateral anatomic breasts, but focal abnormal uptake was noted in the accessory breast. Permanent pathologic evaluation confirmed invasive ductal carcinoma (not otherwise specified type) of the accessory breast. PMID:24445272

  7. Low-dose dobutamine stress test for the evaluation of cardiac function using ECG-gated SPECT scintigraphy with 99mTc-MIBI

    Although 201TlCl myocardial scintigraphy has so far been widely used for the evaluation of the viability of the myocardial infarcted area, functional evaluation using low dose dobutamine (DOB) loaded echography also became recently available. We performed 99mTc-MIBI gated SPECT on eight cases of myocardial infarction at rest and low dose (4-6μg/kg/min) DOB-loading and related data were collected. Next, we calculated myocardial count increase rate (%WT=ES-ED/ED x 100) with left ventricular contraction from end-diastolic (ED) and end-systolic (ES) pictures in short-axial image, and made a comparative examination of regional contractilities at rest and DOB-loading. DOB-loaded echography performed on the same cases at the same dose revealed 15 segments as infarcted area (WM(+)) presenting improvement in wall movement at loading and 5 segments as infarcted area (WM(-)) presenting no such improvement, and %WT at rest and loading were 29.1±6.2 and 33.2±2.4 for (WM(-)) and 26.8±9.8 and 40.0±12.3 for (WM(+)), indicating a significant increase (p<0.05) at loading. Contractility analysis using MIBI gated SPECT in combined use of DOB-loading was considered as a useful method of examination in view of its reflectionality in the evaluation of the wall movement in DOB-loaded echography and of its high quantitativity. (author)

  8. Comparison of relative 18FDG uptake to metabolic rate (MRGlucose) in the myocardium in CAD, classified by 99mTc MIBI

    In 55 non-diabetic patients with CAD, relative myocardial perfusion (99mTc MIBI SPECT at rest) and relative 18FDG uptake (PET after glucose load) were used to separate for various flow/metabolism constellations. In addition, regional glucose metabolic rate (rMRGlu in μmol/100 g/min; dynamic-graphic analysis from Gambhir/Patlak) was determined in 13 segments of the left ventricle each (i.e., in a total of 715 segments). rMRGlu revealed wide standard deviations (up to 51%). It decreased from normal (52.7±27.3 μmol/100 g/min), mismatch (45.3±17.3) and intermediate (35.2±12.4) to match ('non viable'; 26.7±13.3) significantly (p18FDG uptake. Thus, the higher efforts employed to compute rMRGlu do not yield diagnostic advantage. The segmental perfusion maximum, used for normalization of relative 18FDG uptake (100% MIBI uptake=100% FDG uptake) was reliable in euglycemic patients even with 3-vessel disease. (orig.)

  9. The role of 99mTc-SestaMIBI in predicting post-revascularization recovery in patients with chronic coronary artery disease and LV dysfunction: a meta-analysis

    The utility of 99mTc-Sesta (MIBI) as a marker of myocardial viability is still a controversial topic. A perusal of the different published studies was therefore done to address this issue by looking at the ability of this tracer to predict recovery or non-recovery of a dysfunctional myocardium after revascularization based on MIBI uptake. Literature search was done using the Index Medicus, MEDLINE and cross-reference on the use of 99mTc-SestaMIBI in thrombolytic therapy, revascularization and viability assessment. Only studies in human were included. A qualitative and quantitative (visual) uptake was studied. These segments are supposedly expected to have no recovery even after revascularization. Eventual revascularization was done however on their corresponding coronary vessels. 57% (78/136) showed recovery in function while only 43% (58/136) were identified correctly (p>0.05=ns). Quantitative analysis of uptake were done on these segments with poor visual uptake. One study (Marzullo et.al.) divided these segments into those with MIBI uptake above and below 55%. His findings revealed that 35/45 segments with uptake >55% had improved function after revascularization (PPV=78%) while 14/21 segments with uptake 50% showed functional improvement while 61% (NPV) of segments with uptake 99mTc-SestaMIBI is primarily a perfusion agent. Attempts therefore to use this tracer to asses myocardial viability should be made with caution and if ever, must be done quantitatively. (author)

  10. Evaluation of the quality of the radiopharmaceutical 99mTc-MIBI and its influence on image quality in myocardial perfusion scintigraphy

    This study evaluated the quality of the 99mTc-MIBI radiopharmaceutical from different manufacturers, used in three nuclear medicine services (NMS) in Recife-PE, through labeling procedure of each service. It was observed their biodistribution by quantifying the activity present in the organs of interest (heart / liver), the influence and interference in image quality and in myocardial scintigraphy diagnosis exam. In these NMS (A, B and C) were done quality controls in the eluates of 99Mo/99mTc generators (radionuclidic, chemical and radiochemical purity and pH) and of the 99mTc-MIBI radiopharmaceutical (radiochemical purity and pH) used in myocardial scintigraphy exam. In the case of radiochemical purity (RCP), was used the thin layer chromatography technique; after the chromatographic ran on, the plates were analyzed both in the dose calibrator, and in scintillation camera of each NMS. The radiopharmaceutical biodistribution was evaluated through the activities present in the heart and liver images in 60 patients, using the technique of combined images counting. Five nuclear physicians analyzed 24 images through myocardial perfusion visual interpretation during stress, it was verified the agreement degree among them. The results of the quality control showed that all eluate samples were in agreement with the manufacturers in relation to radionuclidic purity and pH. In relation to chemical purity, 10% of the services samples B and C showed Al+3 values above 10 ppm. In the RCP, it was observed that using the scintillation camera, only 22% of the samples would be discarded, while with dose calibrator would be 78%, indicating that the scintillation camera is more sensitive in chromatographic pale analysis. For the labeled radiopharmaceutical, the services B and C presented respectively one and three samples with RCP percentage below 90%. However, C service presented the lowest medium to liver/heart proportions, showing that this factor does not depends on the labeling

  11. Comparison of the kinetics of active efflux of Tc-99m-MIBI in cells with P-glycoprotein-mediated and multidrug-resistance protein-associated multidrug-resistance phenotypes

    Vergote, J; Moretti, JL; De Vries, EGE; Garnier-Suillerot, A

    1998-01-01

    The overexpression of two membrane glycoproteins, P-glycoprotein and multidrug-resistance protein (MRP1) is a major cause of resistance to chemotherapeutic agents in the treatment of human cancers. Both proteins confer a similar multidrug-resistant (MDR) phenotype. Tc-99m-MIBI, a myocardial imaging

  12. Evaluation of the influence of percent labeling of {sup 99m}Tc-MIBI on nuclear medicine procedures in Recife, Pernambuco State, Brazil; Avaliacao da influencia do percentual de marcacao do {sup 99m}Tc-MIBI em procedimentos de medicina nuclear em Recife, PE

    Pereira, Jucilene Maria

    2003-08-15

    The aim of this work was to evaluate the influence of percent labeling of the radiopharmaceutical {sup 99m}Tc-MIBI on the procedures adopted by the nuclear medicine clinics in Recife, Pernambuco State, Brazil, and their possible interference with image quality in myocardial perfusion examinations. This work was performed at two nuclear medicine services in Recife that use pharmaceuticals provided by two different manufacturers: Cardiolite, provided by Dupont and Cardiosyd, provided by SYDMA. The pH, percent labeling and stability of samples of {sup 99m}Tc-MIBI and the percent uptake in heart and liver of a number of patients were evaluated. The results showed that the pH values measured in all samples of both radiopharmaceuticals were within the limits recommended. In 48% of the Cardiolite samples, the percent labeling was less than 90%, which is the minimum recommended limit. On the other hand, 87,5% of the Cardiosyd samples measured values above 98%. Both radiopharmaceuticals had good labeling stability, even in samples with low percent labeling efficiencies. In spite of the higher percent labeling of Cardiosyd its heart uptake is similar to that observed with the Cardiolite, even when the percent labeling is lower than 90%. On the other hand, the image quality, according to physicians, evaluation was poorer for Cardiosyd images, due to high noise and poor sharpness. (author)

  13. Parathyroid ectopia evidenced by {sup 99m}Tc-sestamibi scintigraphy: Case report; Ectopie parathyroidienne objectivee par la scintigraphie au {sup 99m}Tc-MIBI: a propos d'un cas

    Ghfir, I.; Ben Rais, N. [Hopital Ibn-Sina, Service de Medecine Nucleaire (Morocco)

    2007-08-15

    Introduction The presence of an ectopic parathyroid gland is the most frequent cause of persistent hyperparathyroidism. Its detection constitutes a source of topographic diagnostic difficulties particularly for purely morphological explorations. The goal of this work is to elucidate the interest of scintigraphy using {sup 99m}Tc-sestamibi in the diagnosis and the therapeutic orientation of ectopic parathyroid. Case report A 50-year-old patient was followed for persistent hyperparathyroidism after subtotal para thyroidectomy. The clinical examination was without particularity contrasting with an always high parathormone rate. Echography, computed tomography and magnetic resonance imaging were not conclusive. Scintigraphy carried out after intravenous injection of 740 MBq of sestamibi-Tc{sup 99m} with acquisition of static images at 20 min and 2 h showed an area of high uptake in projection of the right upper mediastinum. The diagnosis of an ectopic parathyroid localization was retained. Resection and pathologic examination of the surgical specimen revealed parathyroid adenoma tissue. The evolution was marked by a normalisation of the rate of parathormone. Discussion {sup 99m}Tc-sestamibi scintigraphy is a functional exploration with a higher sensitivity than the other morphological imaging techniques for preoperative topographic determination of ectopic parathyroid. It significantly contributes to an elective and more rapid surgical resection of these lesions. (authors)

  14. Left ventricular function behavior in patients with inducible ischaemia evaluated with gated SPECT with mibi-Tc 99M

    Introduction: Gated SPECT allows the evaluation of left ventricular function (LVF), both at rest and in the immediate post exercise. However, recent studies in patients with inducible ischemia suggest that LVF in the immediate post exercise does not reflect LVF at rest. Objectives: To assess LVF (ejection fraction EF), end systolic volume (ESV), end diastolic volume (EDV), and motility score (SSPM), both at rest and in the immediate post exercise, in patients with inducible ischemia. Methods: One hundred and four patients were evaluated with the Bruce protocol in which a gated SPECT with Tc99m sestamibi was done. Patients were divided in two groups: G1 (inducible ischemia present) and G2 (control patients) according to the results of the perfusion scans. Results: EF post exercise in G1 was significantly lower than EF at rest (48 ± 1.43 vs 52 ± 1.29; p < 0.01). There were no changes of EF in G2 (62 ± 0.93 vs 61 ± 1.03; p = NS). In G1, ESV post exercise increased significantly compared to ESV at rest (57 ± 3.57 vs 51 ± 2.86; p < 0.01). Again, there were no changes of these parameters in G2 (32 ± 1.44 vs 33 ± 2.05; p = NS). In G1, SSMP increased during the post exercise vs SSMP at rest (4.9 ± 0.6 vs 1.8 ± 0.4; p < 0.01). In G2, SSMP was 0 both post exercise and at rest. Conclusion: Patients with inducible ischemia had a depressed EF, higher end systolic volumes and alterations in motility score immediately post exercise compared to rest images. In contrast, there were no changes of these parameters in control patients. These different results could be explained to the presence of stunned myocardium in ischemic patients. (author)

  15. Synthesis of the compound tetrakis (2- methoxy isobutyl isonitrile) copper (I) tetrafluoroborate -(Cu[MIBI]4BF4): substance used in the production of the radiopharmaceutical sestamibi 99m Tc

    The radiopharmaceutical SESTAMIBI-99mTc presents interest and application in the clinical routine in Nuclear Medicine, especially for evaluation of the myocardium function and in the diagnosis of some tumors types, and the Center of Radiopharmacy of the IPEN has interest in the development of this radiopharmaceutical for attendance of the nuclear medicine class necessities. In this work it was demonstrated the synthesis and characterization of the active compound tetrakis (2- methoxy isobutyl isonitrile) copper (I) tetrafluoroborate - Cu[MIBI]4BF4- to be used in the preparation of lyophilized reagents for labeling with technetium-99m as well as labeling studies and biological distribution. The synthesis of the reagent Cu[MIBI]4BF4 was carried out in accordance with previously described procedures, in 5 steps and the compounds were characterized for infra-red, magnetic nuclear resonance, melting point and thin layer chromatography. The characterization of the chelate of MIBI -Cu[MIBI]4BF4 - was carried out using high performance liquid chromatography, compared with a standard sample of the product and presented similar results, as described in literature. The lyophilized reagent was prepared and labeled with technetium-99m, showing high radiochemical purity, higher than 97%, with high stability. Biological distribution in different animals showed good uptake in the heart, in time compatible with the acquisition of scintigraphy images, demonstrating the applicability of the reagent synthesized in the attainment of cardiac scintigraphy images. (author)

  16. A comparison of 99mTc-MIBI myocardial perfusion imaging and electron beam CT in detection of CAD in patients without myocardial infarction

    Our previous researches have demonstrated that 99mTc-MIBI myocardial tomography (SPECT) has higher specificity in detection of coronary artery disease (CAD) than that of coronary artery calcification (CAC) assessed by cardial electron beam CT(EBCT). However, these researches involved patients with myocardial infarction, which may be in favor of obtaining high accuracy for detection of CAD by SPECT.The purpose of this study was to compare SPECT with EBCT in detection of CAD in patents without myocardial infarction history. Seventy-three patients (55 male, 18 female, 52.6 ± 10.6 yrs old) without myocardial infarction underwent stress-rest SPECT, cardiac EBCT and coronary angiography (CAG) within one month. CAC as CT value ≥ 130 HU within the boundary of coronary artery on EBCT, and ≥50% coronary narrowing was considered as diagnostic standard of CAD. There were 35 patients and 38 patients with and without ≥ 50% coronary stenosis, respectively. Ninety-six percent (23/24) patients with abnormal SPECT and CAC detected by EBCT had coronary arteries with ≥ 50% stenosis, and 90.5% (19/21) patients with normal SPECT and EBCT had normal CAG or 45 yrs old the specificity f SPECt (94.3%) was significantly

  17. Detection of DCIS using 99mTc-MIBI scintimammography in patients with suspected primary breast cancer, comparison with conventional mammography

    Background: Scintimammography using Tc-99m MIBI (SMM) is often used clinically as a second line diagnostic test for the detection of breast cancer in cases where there is concern about the results of x-ray mammography (XMM) and ultrasound. Both of these methods, but particularly XMM, may miss a significant proportion of ductal carcinoma in situ (DCIS). MATERIAL AND METHODS: This study was performed to determine the possible accuracy of SMM in finding DCIS and comparing this with the accuracy of XMM in the same patient. Over a 3 year period 353 patients with no previous history of breast cancer were imaged with both XMM and SMM. The histology of any suspect area was verified by pathological examination of biopsy material. There were 203 malignant breast tumours. RESULTS: In those 203 cancers there were 15 pure DCIS cancers. SMM correctly diagnosed 12 of these (sensitivity was 80%). XMM diagnosed correctly 8 DCIS (sensitivity 53%) and was equivocal in 2. Combining of both SMM and XMM provided the best result with all but one DCIS identified (sensitivity 93%). CONCLUSIONS: This study shows that the SMM is helpful in detecting DCIS in those cases where XMM failed to detect DCIS or was equivocal. The combination of the two techniques produces a higher sensitivity result than either modality alone. (author)

  18. Noninvasive stress testing of myocardial ischemia: comparison of GRE-MRI perfusion and wall motion analysis to 99mTc-MIBI-SPECT, relation to coronary angiography

    In the evaluation of ischemic heart disease only MR imaging seems to have the potential to assess myocardial perfusion, function, and coronary morphology on a single instrument. The aim of this study was to assess the feasibility of a stress test with dipyridamole (0.56 mg/kg) to analyze myocardial perfusion by Gd first-pass enhancement in ultrafast gradient-recalled-echo MRI (perf-MRI), and wall motion by cine gradient-recalled-echo MRI (Cine-MRI) in one imaging session. Twelve patients underwent complete rest and stress studies; satisfactory MR images were acquired in 10 patients. By 99mTc-MIBI-SPECT sensitivities to detect ischemic segments were 66.7 % with Perf-MRI, 80.0 % with WM-MRI and 86.7 % for Perf-WM-MRI (Perf-MRI vs Perf-WM-MRI; p = 0.03). Scar was equally detected with a sensitivity of 91.6 % with either MRI technique. Thus, Perf-Cine-MRI provides complementary information for the management of ischemic heart disease and has a higher sensitivity than Perf-MRI alone. (orig.). With 3 figs., 2 tabs

  19. Initial and delayed stress phase imaging in a single-injection double-acquisition SPECT. The potential value of early 99mTc-MIBI redistribution in assessment of myocardial perfusion reversibility in patients with coronary artery disease

    Some studies reported that 99mTc-MIBI may redistribute in ischaemic myocardium and this phenomenon may have potential role for better assessment of viability by delayed 99mTc-MIBI imaging. Some studies also suggested that infusion of low dose dobutamine during delayed imaging may enhance the value of 99mTc-MIBI imaging for evaluation of viability. The aim of this study is to determine whether the observed changes of perfusion defects on delayed images are caused by early radiotracer redistribution or as a result of reversal partial volume effect secondary to inotropic stimulation. Patients, methods: 89 patients with angiographically proven coronary artery disease (CAD) were enrolled in this randomized clinical trial study. In all cases, gated-SPECT images were obtained 60 minutes after stress with dipyridamole injection. Subsequently the patients were randomly allocated in two groups and the second imaging was performed at 120th minute during low dose dobutamine (dobutamine group; 45 cases) or placebo infusion (placebo group; 44 cases). Difference between summed stress score of the first (SSS1) and second (SSS2) stress images (ΔSSS) was considered as a marker of reversibility in single-injection double-acquisition (SIDA) protocol. Also summed difference score (SDS) was recorded as a marker of reversibility in standard stress/rest, double-injection double-acquisition (DIDA) protocol. ΔSSS of the two studied groups were compared. Also the correlation and agreement between ΔSSS and SDS were analyzed. Results: A significant difference was found between SSS1 (median 15, range 0-48) and SSS2 (median 11, range 0-42) in total patients (p 99mTc-MIBI injection in the stress phase imaging. These changes correlate well and are in agreement with perfusion improvement on the rest images. This phenomenon may be independent of improvement in myocardial function, in more delayed imaging or following inotropic augmentation, and thus is likely due to 99mTc-MIBI redistribution

  20. Comparison of whole-body {sup 18}F-FDG PET, {sup 99m}Tc-MIBI SPET, and post-therapeutic {sup 131}I-Na scintigraphy in the detection of metastatic thyroid cancer

    Iwata, Masahiro [Department of Radiology, Hikone Municipal Hospital, 1882 Hassakacho, 522-8539, Hikone, Shiga (Japan); Kasagi, Kanji [Department of Nuclear Medicine, Takamatsu Red Cross Hospital, Takamatsu (Japan); Misaki, Takashi [Radioisotope Center, Tenri Hospital, Tenri (Japan); Matsumoto, Keiichi; Nakamoto, Yuji [Institute of Biomedical Research and Innovation, Kobe (Japan); Iida, Yasuhiro; Ishimori, Takayoshi; Higashi, Tatsuya; Saga, Tsuneo; Konishi, Junji [Department of Nuclear Medicine and Diagnostic Imaging, Kyoto Graduate School of Medicine, Kyoto (Japan)

    2004-04-01

    The usefulness of fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in differentiated thyroid cancer (DTC) has been demonstrated by many investigators, but in only a small number of studies have FDG-PET images been compared with those obtained using other non-iodine tumour-seeking radiopharmaceuticals. In most of the studies, planar imaging was performed for comparison using thallium-201 chloride or technetium-99m 2-methoxyisobutylisonitrile ({sup 99m}Tc-MIBI). Furthermore, FDG-PET studies were not always performed in the hypothyroid state with increased levels of thyroid stimulating hormone (TSH), which are known to increase FDG uptake by DTC. The aim of this study was to compare the ability of FDG-PET to detect metastatic DTC with that of {sup 99m}Tc-MIBI whole-body single-photon emission tomography (SPET) and post-therapeutic iodine-131 scintigraphy, evaluated under TSH stimulation. Nineteen patients (8 men, 11 women; age range, 38-72 years, mean 60 years; 17 thyroidectomised and 2 inoperable patients following {sup 131}I ablation of the remaining thyroid tissue; 16 papillary and 3 follicular carcinomas) with metastatic DTC underwent FDG-PET whole-body scan (WBS) and {sup 99m}Tc-MIBI SPET WBS at an interval of less than 1 week, followed by {sup 131}I therapy. The SPET images were reconstructed using the maximum likelihood expectation maximisation (ML-EM) method. All patients were hypothyroid at the time of each scan. {sup 131}I WBS was performed 3-5 days after oral administration of the therapeutic dose. A total of 32 lesions [10 lymph node (LN), 15 lung, 6 bone, 1 muscle] were diagnosed as metastases, as confirmed by histopathology and/or other imaging modalities (X-ray, US, CT, MRI, bone, {sup 201}Tl and {sup 131}I scans). FDG-PET, {sup 99m}Tc-MIBI SPET and post-therapeutic {sup 131}I scintigraphy respectively revealed a total of 26 (81.3%), 20 (62.5%) and 22 (68.8%) lesions. These techniques respectively demonstrated nine (90.0%), eight

  1. Comparison of relative {sup 18}FDG uptake to metabolic rate (MRGlucose) in the myocardium in CAD, classified by {sup 99m}Tc MIBI; Vergleich von relativer {sup 18}FDG-Aufnahme mit metabolischer Rate (MRGlukose) im Myokard bei KHK, klassifiziert mit {sup 99m}Tc-MIBI

    Buell, U. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Foroutan, Y. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Hellwig, D. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Kaiser, H.J. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Schulz, G. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Sabri, O. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Schreckenberger, M. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Vom Dahl, J. [RWTH, Klinikum Aachen (Germany). Medizinische Klinik 1

    1995-12-01

    In 55 non-diabetic patients with CAD, relative myocardial perfusion ({sup 99m}Tc MIBI SPECT at rest) and relative {sup 18}FDG uptake (PET after glucose load) were used to separate for various flow/metabolism constellations. In addition, regional glucose metabolic rate (rMRGlu in {mu}mol/100 g/min; dynamic-graphic analysis from Gambhir/Patlak) was determined in 13 segments of the left ventricle each (i.e., in a total of 715 segments). rMRGlu revealed wide standard deviations (up to 51%). It decreased from normal (52.7{+-}27.3 {mu}mol/100 g/min), mismatch (45.3{+-}17.3) and intermediate (35.2{+-}12.4) to match (`non viable`; 26.7{+-}13.3) significantly (p<0.01). In 26% of the perfusion maxima, MRGlu was <40 {mu}mol/100 g/min. Out of these, only in five patients (of 28) with 3-vesell disease, it was even smaller (<30 {mu}mol). In three out of the latter, glucose blood levels were below euglycemia. rMRGlu in CAD revealed an identical perfusion/metabolism pattern as relative {sup 18}FDG uptake. Thus, the higher efforts employed to compute rMRGlu do not yield diagnostic advantage. The segmental perfusion maximum, used for normalization of relative {sup 18}FDG uptake (100% MIBI uptake=100% FDG uptake) was reliable in euglycemic patients even with 3-vessel disease. (orig.) [Deutsch] Bei 55 Patienten mit KHK wurden die relative myokardiale Speicherung von {sup 99m}Tc-MB (in Ruhe; SPECT) und von {sup 18}FDG (nach Glukoseladung, PET) vergleichend zu rMRGlu (in {mu}mol/100 g/min) in je 13 Segmenten des linken Ventrikels (insgesamt 715 Segmente) bestimmt. Die rMRGlu zeigte Streubreiten von bis zu 51%. Sie nahm in der Reihenfolge normal (52,7{+-}27,3 {mu}mol/100 g/min), mismatch (p<0,01) ab. In 26% der Perfusionsmaxima war MRGlu <40 {mu}mol/100 g/min, darunter nur bei fuenf Dreigefaesserkrankungen (von 28) <30 {mu}mol. Die Serumglukosewerte zeigten bei drei dieser fuenf Patienten eine ungenuegende Antwort auf die orale Glukosebelastung. rMRGlu erbrachte bei KHK die gleichen

  2. Validation of 4D-MSPECT and QGS for quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPET: comparison with cardiac magnetic resonance imaging

    The main aim of this study was to validate the accuracy of 4D-MSPECT in the assessment of left ventricular (LV) end-diastolic/end-systolic volumes (EDV, ESV) and ejection fraction (LVEF) from gated technetium-99m methoxyisobutylisonitrile single-photon emission tomography (99mTc-MIBI SPET), using cardiac magnetic resonance imaging (cMRI) as the reference method. By further comparing 4D-MSPECT and QGS with cMRI, the software-specific characteristics were analysed to elucidate clinical applicability. Fifty-four patients with suspected or proven coronary artery disease (CAD) were examined with gated 99mTc-MIBI SPET (8 gates/cardiac cycle) about 60 min after tracer injection at rest. LV EDV, ESV and LVEF were calculated from gated 99mTc-MIBI SPET using 4D-MSPECT and QGS. On the same day, cMRI (20 gates/cardiac cycle) was performed, with LV EDV, ESV and LVEF calculated using Simpson's rule. Both algorithms worked with all data sets. Correlation between the results of gated 99mTc-MIBI SPET and cMRI was high for EDV [R=0.89 (4D-MSPECT), R=0.92 (QGS)], ESV [R=0.96 (4D-MSPECT), R=0.96 (QGS)] and LVEF [R=0.89 (4D-MSPECT), R=0.90 (QGS)]. In contrast to ESV, EDV was significantly underestimated by 4D-MSPECT and QGS compared to cMRI [130±45 ml (4D-MSPECT), 122±41 ml (QGS), 139±36 ml (cMRI)]. For LVEF, 4D-MSPECT and cMRI revealed no significant differences, whereas QGS yielded significantly lower values than cMRI [57.5%±13.7% (4D-MSPECT), 52.2%±12.4% (QGS), 60.0%±15.8% (cMRI)]. In conclusion, agreement between gated 99mTc-MIBI SPET and cMRI is good across a wide range of clinically relevant LV volume and LVEF values assessed by 4D-MSPECT and QGS. However, algorithm-varying underestimation of LVEF should be accounted for in the clinical context and limits interchangeable use of software. (orig.)

  3. Evaluation of the quality of the radiopharmaceutical 99mTc-MIBI and its influence on image quality in myocardial perfusion scintigraphy; Avaliacao da qualidade do radiofarmaco {sup 99m}Tc-MIBI e sua influencia na qualidade da imagem em cintilografia de perfusao do miocardio

    Santos, Poliane Angelo de Lucena

    2013-07-01

    This study evaluated the quality of the {sup 99m}Tc-MIBI radiopharmaceutical from different manufacturers, used in three nuclear medicine services (NMS) in Recife-PE, through labeling procedure of each service. It was observed their biodistribution by quantifying the activity present in the organs of interest (heart / liver), the influence and interference in image quality and in myocardial scintigraphy diagnosis exam. In these NMS (A, B and C) were done quality controls in the eluates of {sup 99}Mo/{sup 99m}Tc generators (radionuclidic, chemical and radiochemical purity and pH) and of the {sup 99m}Tc-MIBI radiopharmaceutical (radiochemical purity and pH) used in myocardial scintigraphy exam. In the case of radiochemical purity (RCP), was used the thin layer chromatography technique; after the chromatographic ran on, the plates were analyzed both in the dose calibrator, and in scintillation camera of each NMS. The radiopharmaceutical biodistribution was evaluated through the activities present in the heart and liver images in 60 patients, using the technique of combined images counting. Five nuclear physicians analyzed 24 images through myocardial perfusion visual interpretation during stress, it was verified the agreement degree among them. The results of the quality control showed that all eluate samples were in agreement with the manufacturers in relation to radionuclidic purity and pH. In relation to chemical purity, 10% of the services samples B and C showed Al{sup +3} values above 10 ppm. In the RCP, it was observed that using the scintillation camera, only 22% of the samples would be discarded, while with dose calibrator would be 78%, indicating that the scintillation camera is more sensitive in chromatographic pale analysis. For the labeled radiopharmaceutical, the services B and C presented respectively one and three samples with RCP percentage below 90%. However, C service presented the lowest medium to liver/heart proportions, showing that this factor

  4. Sympathetic reinnervation in cardiac transplants: {sup 123}I-MIBG and {sup 201}Tl/{sup 99m}Tc-MIBI scintigraphy

    Kim, J. H.; Oh, S. J.; Son, M. S.; Son, J. W.; Choi, I. S.; Shin, E. K.; Park, C. H. [Gachon Medical School, Gil Heart Cener, Inchon (Korea, Republic of)

    2000-07-01

    The purpose was to evaluate cardiac sympathetic reinnervation and hemodynamic changes after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and rest 201Tl/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 patients (M:F=10:5;mean ages=34.5{+-}13.0 yr; idiopathic:rheumatic=14:1; one heart lung TPL)(10.80 {+-}11.88 (1-48) mo) after TPL 123I-MIBG imagings were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of heart to mediastinal MIBG uptake (HMR) Compared to HMR on 15 min images (1.48 {+-} 0.28), neither four nor 24 hour delayed images (1.26 {+-} 0.23 vs. 1.06 {+-} 0.26: p<0.05, respectively, ANOVA) showed definite delayed localization of MIBG. 12 subjects with <13 (4.9 {+-}3.7) months after TPL had no visible 123I-MIBG uptake on early 15 min imaging however, 12 subjects with 13 to 48(28.6{+-}12.8) months had visible cardiac 123I-MIBG uptake (HMR: 1.65{+-}0.21 vs. 1.32{+-}0.26; p=0.002). One-year followup 123I-MIBG scintigraphy in nine pts showed significantly increased HMR(1.40{+-}0.31 to 1.61{+-}0.16, p<0.05) but a plateau was reached at HMR value of 2.0, which was still lower than 3.0 in normal controls. Plasma NE was increased according to I-123 MIBG myocardial uptake. Annual G-MPS detected an allograft atherosclerosis in one pt and showed progressive normalization of tachycardia and significant deterioration of LVEF and cardiac indices according to severity of rejection. To dipyridamole stress, transplant heats showed significant subnormal hemodynamic responses. Partial sympathetic late reinnervation can occur <1 year after TPL, and reached a plateau of two-third of normal value. G-MPS seems to be a useful screening test for the detection of allograft atherosclerosis and rejection.

  5. Labelling, biodistribution and compartmental analysis of N-acetylcysteine labelled with Tc-99m. Comparative investigation with with sup 9 sup 9 sup m Tc-MIBI in an in vivo tumoral model

    Faintuch, B L

    1997-01-01

    Labelling and biodistribution studies were done with two different ligands, respectively Methoxy isobutyl isonitrile (MIBI) and N-acetylcysteine (NAC), employing Tc-99m as a tracer. The main objective was to assess the pharmacokinetic properties of the second substance, aiming at its possible application in cancer diagnosis. To this purpose an in vivo investigation was done using healthy and tumor-bearing rats with experimental cancer. Images of tumor-bearing rats registered in a scintillation camera indicated that with sup 9 sup 9 sup m Tc-MIBI none of the two selected times was adequate for visualization of the cancer mass. In contrast, sup 9 sup 9 sup m Tc-NAC permitted clear identification of the humor, four hours after injection. The results have demonstrated that sup 9 sup 9 sup m Tc-NAC is a radiopharmaceutical with affinity for cancer tissue and promising for further investigation concerning imaging diagnosis of tumors.

  6. Initial and delayed stress phase imaging in a single-injection double-acquisition SPECT. The potential value of early {sup 99m}Tc-MIBI redistribution in assessment of myocardial perfusion reversibility in patients with coronary artery disease

    Beiki, D. [Research Inst. for Nuclear Medicine, Tehran Univ. of Medical Sciences, Tehran (Iran); Dept. of Nuclear Pharmacy, Tehran Univ. of Medical Sciences, Tehran (Iran); Fallahi, B.; Fard-Esfahani, A.; Eftekhari, M. [Research Inst. for Nuclear Medicine, Tehran Univ. of Medical Sciences, Tehran (Iran); Mohseni, Z.; Khalaj, A. [Dept. of Nuclear Pharmacy, Tehran Univ. of Medical Sciences, Tehran (Iran)

    2010-07-01

    Some studies reported that {sup 99m}Tc-MIBI may redistribute in ischaemic myocardium and this phenomenon may have potential role for better assessment of viability by delayed {sup 99m}Tc-MIBI imaging. Some studies also suggested that infusion of low dose dobutamine during delayed imaging may enhance the value of {sup 99m}Tc-MIBI imaging for evaluation of viability. The aim of this study is to determine whether the observed changes of perfusion defects on delayed images are caused by early radiotracer redistribution or as a result of reversal partial volume effect secondary to inotropic stimulation. Patients, methods: 89 patients with angiographically proven coronary artery disease (CAD) were enrolled in this randomized clinical trial study. In all cases, gated-SPECT images were obtained 60 minutes after stress with dipyridamole injection. Subsequently the patients were randomly allocated in two groups and the second imaging was performed at 120{sup th} minute during low dose dobutamine (dobutamine group; 45 cases) or placebo infusion (placebo group; 44 cases). Difference between summed stress score of the first (SSS{sub 1}) and second (SSS{sub 2}) stress images ({delta}SSS) was considered as a marker of reversibility in single-injection double-acquisition (SIDA) protocol. Also summed difference score (SDS) was recorded as a marker of reversibility in standard stress/rest, double-injection double-acquisition (DIDA) protocol. {delta}SSS of the two studied groups were compared. Also the correlation and agreement between {delta}SSS and SDS were analyzed. Results: A significant difference was found between SSS{sub 1} (median 15, range 0-48) and SSS{sub 2} (median 11, range 0-42) in total patients (p < 0.0001). A significant correlation was noted between {delta}SSS and SDS in dobutamine group (r = 0.58, p = 0.002) as well as in placebo group (r = 0.57, p < 0.0001). Considering DIDA protocol as a standard reference method, the influence of dobutamine infusion was not

  7. Clinical role of {sup 99m}TcO{sub 4}/MIBI scan, ultrasound and intra-operative gamma probe in the performance of unilateral and minimally invasive surgery in primary hyperparathyroidism

    Casara, D.; Rubello, D. [Dept. of Radiotherapy, Regional Hospital of Padova (Italy); Pelizzo, M.R. [Dept. of Surgery, University of Padova, Padova (Italy); Shapiro, B. [Dept. of Radiology, University of Michigan Medical Center, Ann Arbor (United States)

    2001-09-01

    One hundred and forty-three consecutive patients with primary HPT were enrolled in the study. We used a modified {sup 99m}TcO{sub 4}/MIBI scintigraphic procedure which included the oral administration of potassium perchlorate to cause rapid {sup 99m}TcO{sub 4} washout from the thyroid tissue, thereby permitting the acquisition of high-quality early MIBI images. A single-photon emission tomography (SPET) acquisition was also obtained in 21 patients, of whom seven had an enlarged parathyroid gland (EPG) in the mediastinum at planar scintigraphy and 14 had discordant scan/US findings for the presence of a cervical EPG. Neck US was performed in the same session as scintigraphy using a small-parts, high-resolution 10-MHz transducer. All patients were then operated on by the same surgical team. Quick PTH assay (QPTH) was used to measure PTH intraoperatively to confirm successful parathyroidectomy. In patients with scan/US evidence of a solitary EPG and with a normal thyroid gland, limited, unilateral neck surgery or, more recently, MIRS was planned (n=91). In patients with scan/US evidence of multiglandular disease (MGD) (n=21) or concomitant nodular goitre (n=24) or in patients with a negative scan/US evaluation (n=7), extensive bilateral neck exploration was planned (n=52). In 87 of the 91 patients (95.6%) in whom preoperative imaging indicated the presence of a solitary EPG and a normal thyroid gland, a single parathyroid adenoma was found at surgery, and these patients were treated by unilateral neck exploration or MIRS. In the remaining four patients of this group, conversion to bilateral neck exploration was required because parathyroid carcinoma (n=3) or MGD (n=1) was diagnosed at operation. In some cases SPET was helpful in better localising the EPG. In particular, in 5 of the 21 patients evaluated, SPET localised an EPG deep in the neck or mediastinum and at surgery a parathyroid adenoma was found in the paratracheal or para-oesophageal space. In 43 of the 46

  8. Value of I-123-subtraction and single-photon emission computed tomography in addition to planar Tc-99m-MIBI scintigraphy before parathyroid surgery

    Jorna, Francisca H.; Jager, Pieter L.; Que, Tjin H.; Lemstra, Clara; Plukker, John T. M.

    2007-01-01

    Purpose. To find out if single-photon emission computed tomography (SPECT) and I-123-subtraction can enhance the findings of Tc-99-methoxyisobutylisonitrile (MIBI) scintigraphy for the preoperative localization of parathyroid (PT) tumors. Methods. Among the 111 consecutive patients who underwent pre

  9. Normative values of 99mTc-MIBI distribution in myocardium in males and females, as a basis for quantitative planar scintigraphic method for detection of coronary artery disease in patients of both sexes

    Radionuclide perfusion studies of myocardium are being performed using planar and tomographic (SPECT) procedures. The latter method enables better detection as well as assessment of localisation and severity of scintigraphically visualised perfusion defects. On the other hand, lower cost of planar procedures using 99mTc-MIBI as the tracer and their much wider availability in countries of Central and Eastern Europe could significantly increase the diagnostic potential of nuclear cardiology in this region.The aim of the study was an assessment of normal distribution of 99mTc-MIBI in the myocardium and generation of normative basis for quantitative planar scintigraphic procedure, aiming at detection of CAD in patients of both sexes.The study was based on 250 patients. The reference (control) group consisted of 53 individuals (29 men, 24 women) with the low (0 and LAO 700). These mean curves differed significantly between both sexes. In LAO 450 projection the differences affected mostly the region of the septum and postero-lateral wall of the left ventricle (LV). In LAO 700 projection differences were most pronounced in the antero-septal wall of the LV. Sensitivity, specificity and accuracy of CAD detection using the elaborated method, taking into account inter-sex differences, amounted to 86, 87 and 86% respectively in males, and correspondingly 81, 84 and 83% in females. The differences between corresponding indices for two sexes were statistically insignificant. For the whole group of patients the sensitivity, specificity and accuracy was 85, 86 and 85%, respectively. (author)

  10. Evaluation of occult lymph node metastases by means of 99mTc-MIBI scintigraphy and sentinel node biopsy with RT-PCR multi-marker assay in early-stage melanoma patients

    Early diagnosis of regional lymph node metastasis is a key step in the management of melanoma patients. This enables the identification of those patients who are candidates for adjuvant therapy and early therapeutic lymph node dissection. PET using FDG, has been shown to be effective in detecting recurrent melanoma lesions. However, this technique has no proved to offer any significant advantage in diagnostic sensitivity for pre-treatment nodal staging. Lymphoscintigraphy along with intraoperative probe detection of the sentinel node (SN) has become widely accepted for regional lymph node staging. Serial sectioning and immuno-histochemistry (IHC) have been shown to improve the detection of occult melanoma cells, compared with conventional hematoxylin and eosin (H and E) staining alone. More recently, mRNA multi-marker RT-PCR assays have been used to detect micro metastases in lymph nodes where disease was not found by either H and E or IHC techniques. During the last few years, our group has been studying the clinical value of 99mTc-MIBI scintigraphy for the evaluation of melanoma lesions. The technique was found to have the potential of detecting sub clinical recurrent disease including lymph node metastases. Therefore, the aim of the study was to compare the sensitivity of 99mTc-MIBI with that of sentinel node biopsy (SNB) with histopathological and molecular analysis, for the detection of sub clinical nodal disease

  11. Technetium-99m Sestamibi in Multiple Myeloma

    Technetium-99m 2-methoxy - isobutyl - isonitrile (99mTc-MIBI) has been reported to be useful in evaluating patients with multiple myeloma. The aim of this study is to evaluate the role of technetium-99m sestamibi (99mTc-MIBI) scintigraphy in the diagnosis. staging and follow-up of patients with multiple myeloma. Methods and Materials: twenty-five consecutive patients with multiple myeloma were studied using 99mTc- MIBI. Of the 25 patients included in this study, 6 were in stage I, II in stage II and 8 in stage III. Anterior and posterior whole-body imaging were obtained 20 min after I.V. injection of 740 MBq of 99mTc-MIBI. Four different MIBI patterns could be described in our patients: physiological (P), diffuse (D), focal (F) and combined diffuse and focal (D+F). All patients in stages II and III as well as 3 patients in stage I were treated with chemotherapy (cyclophosphamide and prednisone) then 99mTc-MlBI scans were repeated after 6 courses. Results: in comparison to conventional X-ray skeletal survey, 99mTc-MIBI scans showed a higher number of myeloma bone disease at diagnosis. All patients with stage II and III multiple myeloma were positive with 99mTc-MlBl scans at diagnosis. The pattern of positive MIBI accumulation was diffuse in 13 (52%) patients, focal in 4 (16%) and combined focal and diffuse in 6 (24%) patients. The intensity of 99mTc-MIBI correlated with disease activity as determined by lactate dehydrogenase (LDH), number of plasma cells in bone marrow and serum electrophoresis. There was a direct correlation between 99mTc-MIBI scan result and clinical outcome of patients following 6 courses of chemotherapy. Sensitivity and specificity of 99mTc-MIBI scintigraphy in detecting myeloma bone lesions were 92% and 90% respectively. Conclusion: 99mTc-MIBI scintigraphy is a reliable method to evaluate bone marrow activity in patients with multiple myeloma and follow-up of myeloma bone lesions

  12. Surgical management of primary hyperparathyroidism guided by double-phase Tc-99m-MIBI scintigraphy%Tc-99m-MIBI双时相显像在原发性甲状旁腺功能亢进症手术治疗中的价值

    Abdel Hamid Hussein Ezzat; Tarek El. Baradie; Amr Attia; Magdy Kotb; Ahmad Zaher; Iman Gouda

    2012-01-01

    Objective: The aim of this work was to study the clinicopathological features of cases with primary hyperparathyroidism (PHPT) referred to National Cancer Institute (NCI), Cairo University in the last six years and to study the role of nuclear medicine techniques in the initial diagnosis and preoperative localization directing surgical management of these cases. Methods: This study included 27 patients with PHPT properly diagnosed and treated in the NCI, Cairo University from January 2005 to December 2010. Preoperative neck U/S and Tc-99m-MIBI scintigraphy were done in all cases. If preoperative localization detected a single lesion, unilateral exploration was done. Bilateral exploration was done if multiple foci of active parathyroid glands or no lesions were detected. Results: This study included 27 patients (8 males and 19 females). The median age was 43 years (range from 19 to 68 years). All cases presented with bone disease in the form of bony pain in 23 patients, bony swellings in 15 patients and pathological fractures in 6 cases. Twenty one patients (77.8%) had single adenoma, 5 cases (18.5%) had parathyroid hyperplasia, and only one case had double adenomas. The sensitivity of neck U/S in detecting single adenoma was 61.9% (13/21), with 81% positive predictive value (PPV) while the sensitivity of Tc-99m- MIBI scintigraphy was 90.5% (19/21) with 100% PPV. Based on preoperative localization tests, unilateral exploration was done in 19 patients with solitary adenomas. All cases in this group were cured with no reported case of persistent or recurrent hypercalcemia. Conclusion: Presentation of PHPT may mimic malignant bone tumors but fortunately these patients were correctly diagnosed with bone scan which confirm the presence of metabolic bone disease rather than bone metastases. This was followed by estimation of serum calcium and parathormone levels for confirmation. Unilateral exploration based on the combination of ultrasound and preoperative localization

  13. {sup 99m}Tc-M.I.B.I. pinhole SPECT in primary hyperparathyroidism; Tomographie stenopeique au {sup 99m}Tc-MIBI dans l'hyperparathyroidie primaire

    Oudoux, A.; Carlier, T.; Bodet-Milin, C.; Kraeber-Bodere, F.; Ansquer, C. [Centre Hospitalier Universitaire, Service de Medecine Nucleaire, Hotel-Dieu, 44 - Nantes (France); Mirallie, E. [Centre Hospitalier Universitaire, Service de Chirurgie, Hotel-Dieu, 44 - Nantes (France); Seret, A. [Liege Univ. (Belgium). Inst. de Physique; Aubron, F.; Daumy, I. [Centre d' Echographie de l' ile Gloriette, 44 - Nantes (France); Leux, C. [Centre Hospitalier Universitaire, PIMESP, Hopital Saint-Jacques, 44 - Nantes (France)

    2007-10-15

    Purpose: this prospective study was conducted to determine the interest of 99 mTc-M.I.B.I. pinhole SPECT compared with conventional SPECT, planar scintigraphy and ultrasonography, for the preoperative localization of parathyroid lesions in primary hyperparathyroidism. Methods: fifty-one patients cured after surgery were studied. Pinhole SPECT was reconstructed with a dedicated O.S.E.M. algorithm. Scintigraphies were analyzed visually. A diagnostic confidence score (C.S.) was assigned to each procedure considering intensity and extra thyroidal location of suspected lesions and was defined as follows: 0 = negative, 1 = doubtful, 2 = moderately positive, 3 positive. Results: surgery revealed 55 lesions. Sensitivity of ultrasonography, planar imaging, conventional SPECT and pinhole SPECT were respectively, 51, 76, 82 and 87%. Five glands were only detected by pinhole SPECT. Combination of ultrasonography, planar and pinhole SPECT showed the highest sensitivity (94.5%). The mean C.S. of the 55 pathologic glands was significantly higher with pinhole SPECT compared with planar imaging and conventional SPECT (p < 0.0001). Compared with planar imaging and conventional SPECT, pinhole SPECT increased C.S. for 42 and 53% of parathyroid lesions, respectively, and contributed to markedly reduce the number of uncertain results. Nevertheless, planar imaging and ultrasonography were useful to analyze thyroid morphology and to detect some ectopic glands. Conclusion: the use of pinhole SPECT increases sensitivity and C.S. of scintigraphy. Combination of ultrasonography, planar and pinhole SPECT appears the optimal preoperative imaging procedure in primary hyperparathyroidism. (authors)

  14. Comparison study among methodologies of planar chromatography for radiochemical control of technetium-99m; Estudo comparativo entre metodologias de cromatografia planar para controle radioquimico de radiofarmacos de tecnecio-99m

    Monteiro, Elisiane de Godoy

    2012-07-01

    Radiopharmaceuticals are substances that have radioisotopes in their composition. About 95% of the procedures performed in nuclear medicine use radiopharmaceuticals with diagnostic purposes, and the Lyophilized Reagents (LR) labeled with Technetium-99m ({sup 99}mTc), obtained from {sup 99}Mo/{sup 99}mTc generator, are the most one used. Quality Control represents the set of assays to be performed to assure that the product is adequate to its purpose. An important feature to be evaluated in {sup 99m}Tc radiopharmaceuticals is the radiochemical purity (% RqP) to quantify free pertechnetate ({sup 99}mTcO{sub 4}{sup -}) and technetium colloidal (99mTcO{sub 2}) mainly by paper chromatography (PC), thin layer (TLC) and High Performance Liquid Chromatography (HPLC). The objective of this work was to perform the comparison among the radiochemical control methodologies of LR labeled with {sup 99m}Tc, described in the United States Pharmacopoeia (USP) and European Pharmacopoeia (EP) and those used by IPEN. {sup 99m}TcO{sub 4}{sup -} eluate and DISIDA, DMSA, DTPA, EC, ECD, GHA, MIBI, MDP, PIRO, SAH and Sn Coloidal LR were provided by IPEN-CNEN/SP. TLC-cellulose, TLC-SG.TLC-SG reverse phase, HPTLC-cellulose, HPTLC-SG (Merck) and ITLC-SG (Pall Corporation), W1MM, W3MM, W17M e W31ET (Whatman) chromatographic plates were used. The measurement of the radioactivity was done in a Perkin Elmer Cobra D-5002 gamma counter. LR were labeled to obtain 55,0 MBq mL{sup 1} (1,5 mCi mL{sup 1}) of final radioactive concentration. The %{sup 99m}TcO{sub 4}{sup -}, %{sup 99m}TcO{sub 2} and % RqP were determined up to 4 hour labeling. From 11 LR, only EC and GHA have no radiochemical control methods in USP and EP. In USP and/or EP, DTPA, MDP, PIRO, SAH and Sn Coloidal methods use ITLC-SG; IPEN uses this chromatography plate in DISIDA, EC, ECD, GHA, PIRO, MIBI and SAH. As ITLC-SG had been out of production (recommended in 40, 70 and 41% of the USP, EP and IPEN methodologies, respectively), it was

  15. Transient prolonged stunning by dipyridamole stress proved by post-stress (1 hour) and 24 hour Tc-99m-MIBI gated SPECT

    We performed 1st day Tc-99m-sestamibi gated SPECT with dipyridamole/rest Tl-201 SPECT and 2nd day 24 hour delay Tl-201 SPECT/rest Tc-99m-sestamibi gated SPECT in 27 patients with coronary artery disease (24) or having chest pain(3). Stress and rest Tc-99m-sestamibi gated SPECT was acquired at 60min post-injection. A 4-point scoring system (0 to 3 for normal to absent tracer uptake) for 17 segments was used. Wall motion was scored on another 4 point scale (0 to 3 for normal to dyskinesia) in the 1st day post-stress gated and the 2nd day rest gated SPECT. Post-stress gated SPECT showed wall motion abnormality in 94 segments (20%). Fifty-five segments among these 94 showed the same wall motion between post-stress and rest gated SPECT : i.e. 1-1 : 23 segment, 2-2 : 29 segments, 3-3 : 3 segments. Remaining 39 segments (41.5%) showed different wall motion between post-stress and rest Tc-99m-sestamibi gated SPECT. Twenty one segments with wall motion abnormality had normal perfusion (rest : 15 segments, 24 hour delay : 6 segments) at either rest or 24 hour delay. Fifteen among these 21 segments showed persistent post-stress and the 2nd day rest wall motion abnormality (persistent stunning). However, in 6 segments with prolonged (1 hour after stress) stunning, abnormal wall motion did improve in the 2nd day rest Tc-99m-sestamibi gated SPECT (transient prolonged stunning). These 6 segments had normal perfusion at rest (n=4) or at 24 hour delay (n=2). Post stress wall motions showed significantly higher scores in persistent stunning than in prolonged transient stunning (P value<0.05). It was concluded that we could find stunned myocardium with gated Tc-99m-sestamibi SPECT at either post-stress or rest and that some myocardial walls of post-stress 1 hour gated SPECT did not show truly rest wall motion. So, we should be cautious if we use post-stress Tc-99m-sestamibi wall motion to asses rest wall motion

  16. Nude mice multi-drug resistance model of orthotopic transplantation of liver neoplasm and Tc-99m MIBI SPECT on p-glycoprotein

    Yu Han; Xiao-Ping Chen; Zhi-Yong Huang; Hong Zhu

    2005-01-01

    AIM: To establish a model of drug-resistant neoplasms using a nude mice model, orthotopic transplantation of liver neoplasm and sporadic abdominal chemotherapy.METHODS: Hepatocellular carcinoma cells HepG2 were cultured and injected subdermally to form the tumorsupplying mice. The orthotopic drug-resistant tumors were formed by implanting the tumor bits under the envelope of the mice liver and induced by abdominal chemotherapy with Pharmorubicin. Physical examination, ultrasonography, spiral CT and visual inspection were used to examine tumor progression. RT-PCR and immunohistochemistry wereused to detect expression of mdr1 mRNA and its encodedprotein p-glycoprotein (p-gp). Tc-99m sestamibi scintigraphy was performed by obtaining planar abdominal images at 20 min after injection, and the liver/heart ratios werecalculated.RESULTS: Post-implantation mortality was 0% (0/25),tumor implantation success was 90% (22/25), and the rate of implanting successfully for the second time was 100% (3/3). Tumor induction using Pharmorubicin was 80% (16/20). The mdr1 mRNA expression of the induced group was 23 times higher than that of the control group, and p-gp protein expression was 13-fold higher compared to the control group. The liver/heart ratio (as assessed in vivo, using Tc-99m radiography) was decreased significantly in the induced group as compared to the control group. CONCLUSION: We have established an in vivo model of mdr1 in nude mice by orthotopic transplantation of liver neoplasm coupled to chemotherapy. We propose that identification of drug resistance as characterized by decreased 99mTc-ppm radiography due to enhanced clearance by p-gp may be useful in detecting in vivo drug resistance, as well as a useful tool in designing more effective therapies.

  17. Significance of reverse redistribution perfusion abnormality using a standard Tl-201 rest/Tc-99m MIBI stress myocardial perfusion study protocol - correlation with angiographic findings and review of the literature

    Full text: 'Reverse redistribution' (RR) refers to worsening of a perfusion abnormality or the appearance of a new perfusion defect on rest imaging when compared to stress. Opinion remains conjectural regarding the patho-physiological mechanism of this phenomenon and its clinical and prognostic implications. Of the current data, most studies employ a standard one-day thallium stress/ redistribution protocol with no literature available regarding the significance of RR in dual isotope imaging, using the commonly employed one-day Tl-201 rest/ Tc-99m MIBI stress protocol. We reviewed retrospectively all cases of RR reported at Sir Charles Gairdner Hospital from January 1997 to January 2002, using such a protocol in patients who underwent both myocardial perfusion imaging and coronary angiography within a six-month time frame. Semi-quantitative evaluation was performed on the myocardial perfusion studies using a twenty segment, five-grade model, with RR defined as a reduction in perfusion on the rest images by at least one grade relative to the stress image. In total, twelve patients were found, with RR observed in 88 segments. We correlated the scintigraphic findings of these twelve patients to their angiographic results to determine the relationship of RR to angiographically proven coronary stenoses. Comparison of our findings to historical series using single isotope (thallium or MIBI) studies has been made and the findings are similar. This suggests a common underlying patho-physiological mechanism for this phenomenon in both single and dual isotope studies. RR in dual isotope studies has not been previously reported to our knowledge and the available literature is reviewed. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  18. Clinical Value of Double-phase 99mTc-MIBI Scintigraphy in the Diagnosis of Hyperparathyroidism%99mTc-MIBI双时相法诊断甲状旁腺功能亢进症的临床价值

    唐玲; 马云川; 王荣福; 付占立; 范岩

    2008-01-01

    目的 探讨核素99mTc-甲氧基异丁基异腈(99mTc-MIBI)双时相法显像在诊断甲状旁腺功能亢进症(hyper-parathyroidism,HPT)中的作用,并与其他影像检查方法进行比较.方法 65例临床考虑为HPT的患者均分别进行了核素显像及超声检查, 20例做了CT检查,11例做了MRI检查. 核素显像采用99mTc-MIBI双时相法.比较几种影像检查的灵敏度、特异性,分析其对HPT的诊断价值.结果 65例患者中,甲状旁腺激素(PTH)增高36例,以PTH结果为诊断标准.核素检查阳性34例,阴性2例,灵敏度94.4%,特异性100%,准确性96.9%;超声检出32例,阴性4例,假阳性2例,其灵敏度88.9%,特异性93.1%,准确性90.8%;CT阳性17例,MRI阳性8例.结论 核素99mTc-MIBI双时相法甲状旁腺显像是一种简便有效的检查方法,可提高甲状旁腺瘤术前定位诊断的准确率.临床高度怀疑原发性甲状旁腺功能亢进症的病人,若超声检查阴性应进一步行核素检查除外甲状旁腺瘤.

  19. Effect of the reverse redistribution pattern on the left ventricular ejection fraction in the Tc- 99m MIBI SPECT myocardial perfusion scintigraphy

    Bekir Taşdemir

    2015-09-01

    Full Text Available Objective: The causes and prognostic significance of the reverse redistribution pattern (RRP is not clear yet. In this study, we aimed to evaluate the RRP effect on the left ventricular ejection fraction (EF. Methods: Imaging of the patients whose technetium-99m sestamibi myocardial perfusion scintigraphy was carried out and reported as normal were retrospectively examined. One-day protocol and/or pharmacologic stress testing applied patients were excluded. 21 patients with RRP met the inclusion criteria. All of these patients were included in the study as RRP group. Randomly selected 21 patients with non-RRP were included in the study as control group. Transient ischemic dilation (TID scores and EF values were automatically calculated with the Quantitative Gated SPECT (QGS program. Results: While a statistically significant difference was not found between the RRP and control groups in terms of age, sex, hypertension, family history, hyperlipidemia, and diabetes (p>0.05, there was a statistically significant difference in terms of smoking (p=0.019. TID scores in the RRP group were significantly lower compared to the control group (p<0.001. In addition, a statistically significant decrease was determined in the EF values in the rest images compared to the stress images in the RRP group (p=0.002. Furthermore, this decrease was significantly higher than in the control group (p= 0.034. Conclusion: The results related to the TID scores and EF values are suggesting the existence of an ischemic cause in the background of the RRP. Additionally, the relationship found between smoking and RRP may be associated with the tachycardia and / or coronary spasm-inducing effect of smoking. J Clin Exp Invest 2015; 6 (3: 286-290

  20. Marcaje de ciprofloxacina con 99mTc para el diagnóstico de infección activa.

    Abel Hernández Cairo

    2005-01-01

    Full Text Available Introducción: La 99mTc-Ciprofloxacina, es un radiofármaco eficaz para el diagnóstico gammagráfico de infecciones que sólo detecta la presencia de bacterias vivas, ventaja que la distingue de los productos ya conocidos. Radiomarcarla con 99mTc, estudiar su actividad biológica in vivo y su biodistribución en ratas, fueron los objetivos propuestos en esta investigación. Materiales y Métodos: Para marcar con 99mTc se estudiaron varias relaciones molares Ciprofloxacina: Fluoruro de Estaño (SnF2, manteniendo fija la cantidad de fármaco y la actividad. Se controló la pureza por cromatografía en TLC silica gel. Se realizó modelo de absceso con Staphilococcus Aureus (SA y Escherichia coli (EC y los estudios biocinéticos se realizaron en ratas Wistar. Se administró 666-740 MBq/kg de 99mTc-Ciprofloxacina y se midió el porciento de dosis inyectada en diferentes órganos. Se colectó toda la orina durante 24 horas en 4 ratas. Resultados: La mayor pureza radioquímica se obtuvo cuando se utilizó 19.1¿g del reductor (92.5 ± 2.5%. El marcaje fue >90% por más de 10 horas. La relación lesión/ fondo en el modelo animal se mantuvo en aumento durante 20 horas. El momento óptimo para la adquisición resulto ser a las 4 horas de la inyección del radiofármaco. La biodistribución mostró marcada acumulación en hígado, riñones y en intestinos todo el tiempo. Por vía renal se eliminó el 41±1% de la dosis. Conclusiones: Con esta técnica se logró un alto rendimiento de 99mTc-Ciprofloxacina con adecuada estabilidad. El radiofármaco fue capaz de reconocer abscesos activos en zonas músculo-esqueléticas de ratas Wistar y presentó una biocinética favorable para los propósitos perseguidos en la clínica. La técnica es simple y perfectamente reproducible.

  1. 99mTc-MIBISPECT-CT显像在纵隔内异位甲状旁腺诊治中的应用价值%Application value of 99m Tc-MIBI SPECT-CT scintigraphy in diagnosis and treatment of mediastinal ectopic parathyroid

    李征

    2015-01-01

    Objective To analyze the application value of single photon emission computed tomography (SPECT)‐CT 99m Tc‐methoxyisobutylisonitrile(MIBI) scintigraphy in the diagnosis and treatment of mediastinal ec‐topic parathyroid .Methods 100 cases of secondary hyperparathyroidism in the Beijing Shijitan Hospital from Aug . 2013 to Feb .2013 were selected as the research subjects and performed the 99m Tc‐MIBI dual‐phase scintigraphy , plane and SPECT and CT imaging with the same machine .The fused images of mediastinal abnormal radioactive high uptake lesions were analyzed .And the relationship between T/NT radioactivity ratio and intact parathyroid hormone (iPTH) level and pathological results were also analyzed .Results Among 100 cases ,mediastinal ectopic parathyroid appeared in 2 cases (2 .0% ) ,in which 1 case was given the parathyroidectomy before imaging and the postoperative iPTH was increased again;another case was treated by medication .These two cases showed the ectopic parathyroid imaging by postoperative SPECT‐CT imaging ,which located in the sternoclavicular joint .The plane ,SPECT and CT imaging with the same machine showed that the highest T/NT radioactivity ratio of parathyroid was positively corre‐lated with the iPT H level before imagine(r=0 .419 ,P0 .05) .Conclusion 99m Tc‐MIBI SPECT‐CT scintigraphy could effectively fuse the anatomical im‐ages and functional images ,may have the extremely high specificity ,sensitivity and accuracy for the diagnosis of hy‐perparathyroidism ,at the same time could accurately localize the lesions ,increase the operation efficiency and make the operation to reach the satisfactory effect .%目的:分析99mTc‐甲氧基异丁基异腈(MIBI)单光子发射计算机断层显像(SPECT)‐CT显像在纵隔内异位甲状旁腺诊治中的应用价值。方法以2013年8月至2014年2月北京世纪坛医院收治的100例继发性甲状旁腺功能亢进症(SHPT)患者为研究

  2. Study on Effect of Shenmai Injection Protecting Myocardium against Ischemia-Reperfusion Injury in Thrombolytic Therapy with Urokinase for Acute Myocardial Infarction Patient Evaluated by 99mTc-MIBI Myocardial Imaging

    2001-01-01

    Objective: To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were divided into two groups randomly. The SMI group (n=292) was treated with thrombolytictreatment plus SMI and the control group (n=245) with thrombolytic treatment solely. Single photon emission computed tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The infarction related area (IRA) of reperfusion rate in the two groups was not different significantly (72.26% vs 72.65%, P >0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion:Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.

  3. Study on Effect of Shenmai Injection Protecting Myocardium against Ischemia-Reperfusion Injury in Thrombolytic Therapy with Urokinase for Acute Myocardial Infarction Patient Evaluated by 99mTc-MIBI Myocardial Imaging

    郭松鹏; 张言镇

    2001-01-01

    Objective: To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were divided into two groups randomly. The SMI group (n=292) was treated with thrombolytictreatment plus SMI and the control group (n=245) with thrombolytic treatment solely. Single photon emission computed tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The infarction related area (IRA) of reperfusion rate in the two groups was not different significantly (72.26% vs 72.65%, P >0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion:Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.

  4. Cintilografia do miocárdio com tecnécio 99m-MIBI e administração de adenosina em portadores de doença arterial coronária: correlação dos resultados com a angiografia coronária e o ultra-som intracoronário Adenosine myocardial perfusion SPECT with Tc-99m-MIBI in patients with obstructive coronary artery disease: correlation between quantitative coronary angiography and intravascular ultrasound measurements

    Luiz Eduardo Mastrocolla

    2006-01-01

    Full Text Available OBJETIVO: Estabelecer a correlação da cintilografia de perfusão do miocárdio (CPM com Tecnécio 99m-MIBI (MIBI e injeção de adenosina, empregando a angiografia coronária quantitativa (ACQ e o ultra-som intracoronário (UIC como comparação. MÉTODOS: Estudo de 70 pacientes com doença arterial coronária (DAC, encaminhados à CPM com MIBI e adenosina. As manifestações clínicas, do eletrocardiograma (ECG e os resultados das imagens foram correlacionadas às variáveis da análise visual e quantitativa da angiografia, bem como ao UIC. RESULTADOS: A média de idades foi de 60,6 anos, com 39 pacientes do sexo masculino. A angiografia coronária evidenciou estenose do diâmetro da luz (E% de 49,94% em 105 artérias, com reavaliação à ACQ em 83 artérias (79% e média de 44,20%, pOBJECTIVE: To correlate myocardial perfusion scintigraphy (MPS with Tc-99m-MIBI and adenosine infusion using quantitative coronary angiography (QCA and intravascular ultrasound (IVUS. METHODS: Seventy patients with coronary artery disease (CAD referred for myocardial perfusion scintigraphy (MPS with MIBI and adenosine were studied. Clinical, electrocardiographic (ECG, and scintigraphic findings were correlated with variables of visual and quantitative angiographic analysis, as well as to those of IVUS. RESULTS: The mean age of patients was 60.6 years, and 39 were male. Coronary angiography showed percentage of diameter stenosis (% DS of 49.94% in 105 arteries, 83 of which were re-evaluated by QCA (79%, mean of 44.20%, p<0.05. ST-segment depression during adenosine infusion was associated with higher degrees of % DS (55.0% vs. 47.8%, p<0.05. Scintigraphic ischemia was correlated with greater cross-sectional area of lumen obstruction by IVUS (% CSA. Clinical, ECG, and IVUS findings were considered together and expressed as global ischemic versus non-ischemic responses. Ischemia was associated with lower values of minimal lumen diameter (MLD and minimal lumen area

  5. 99mTc-MIBI运动后早期门控心肌显像诊断冠心病的价值%Diagnostic value of ECG-gated early post-exercise 99mTc-MIBI myocardial perfusion imaging in coronary artery disease

    李殿富; 黄峻; 冯建林; 李建华; 程旭; 杨志建; 朱铁兵; 曹克将

    2006-01-01

    目的:比较99mTc-MIBI门控心肌显像(G-MPI)与传统的非门控心肌显像(NG-MPI)对冠心病(CHD)的诊断价值.方法:215例同期1个月内做负荷(运动后15~20 min)/静息2日法99mTc-MIBI G-MPI和冠状动脉造影的CHD患者,以冠状动脉直径狭窄≥50%为诊断标准,比较NG-MPI和G-MPI的诊断价值. 结果:心电图运动试验(ETT)、NG-MPI和G-MPI诊断CHD的敏感性分别为:58.0%,88.3%,90.7%;特异性分别为:67.9%,79.2%,88.7%.NG-MPI和G-MPI的敏感性与ETT相比均差异有统计学意义(P<0.01).G-MPI的诊断敏感性比NG-MPI有增高趋势 ,但两者比较差异无统计学意义(P>0.05).在诊断特异性方面,G-MPI与ETT相比差异有统计学意义 (P<0.01);对男、女2个性别的特异性分析发现,G-MPI对女性诊断特异性的增加尤其显著.对于严重CHD(狭窄≥70%), G-MPI对严重3支病变的诊断敏感性显著高于NG-MPI(100%:92.2%,P<0.05).结论:G-MPI对诊断CHD的价值显著优越于ETT,也优于NG-MPI.

  6. 99mTc-sestamibi and 99mTc-tetrofosmin scintigraphy in myeloma bone disease

    Full text: Evaluation of the role of scintigraphy with 99mTc-Sestamibi (99mTc-MIBI) and 99mTc-Tetrofosmin (99mTc-TF) in the detection of bone marrow involvement in patients (pts) with multiple myeloma (MM) and in follow-up. 62 pts with MM and 38 pts with monoclonal gammopathy of undetermined significance (MGUS) were enrolled in this study. Forty-seven out sixty-two MM pts had active disease (AD), 10/62 were in complete remission (CR) and 5/62 in partial remission (PR) after chemotherapy. Whole-body scans were obtained 10 min after the i.v. injection of 740 MBq of 99mTc-MIBI in anterior and posterior view. The scans were scored semiquantitatively according to extension and intensity of tracer uptake. All 38 MGUS pts had a negative 99mTc-MIBI scan. As to the MM pts, 49/62 pts (44 with AD, 4 with PR and 1 with CR) had a positive 99mTc-MIBI scan, while the 99mTc-MIBI scan was negative in 13/62 pts (9 with CR, 1 with PR and 3 with AD). The overall sensitivity of the scintigraphic procedure was 92 % while specificity was 97 %. A total of 42 follow-up scans with 99mTc-MIBI were performed in 30 MM pts after high-dose chemotherapy, with an average follow-up duration of 14.6 ± 8.9. The follow-up 99mTc-MIBI scintigraphy was positive in 14/15 of the AD pts, while 6/8 negative scans were observed in the CR pts; the seven PR pts exhibited in five cases a negative scan and in two a mild scintigrafic positivity. The overall sensitivity and specificity of the follow-up scan were, respectively, 86 % and 75 %. In six patients, one at the diagnosis and five showing a positive 99mTc-MIBI scan during the follow-up, 740 MBq of 99mTc-TF was administered within two days with the same acquisition protocol. The scans provided substantially identical information. 99mTc-TF provided a mildly higher contrast between lesion and background activities. The results obtained in this study provide additional evidence indicating that 99mTc-MIBI scintigraphy closely reflects myeloma disease activity in

  7. Is Brown Adipose Tissue Visualization Reliable on 99mTc-Methoxyisobutylisonitrile Diagnostic SPECT Scintigraphy?

    Haghighatafshar, Mahdi; Farhoudi, Farinaz

    2016-01-01

    Abstract The 99mTc-MIBI has been used with great value as a diagnostic technique in patients with primary hyperparathyroidism. False-positive scans may occur due to misinterpretation of the physiologic distribution of the 99mTc-MIBI. Reviewing consecutive SPECT scans, we evaluated this possibility and assessed how frequently brown adipose tissue (BAT) is seen on 99mTc-MIBI scintigraphy. Here, we retrospectively reviewed scans of consecutive patients who were evaluated for parathyroid adenomas...

  8. Synthesis, formulation and quality control of methoxy isobutyl isonitrile as a 99m Tc radiopharmaceutical kit for myocardial perfusion scintigraphy

    99m Tc - MIBI is a lipophile cationic 99m Tc complex which has been found to accumulate in viable myocardial tissue. The chemical structure of Isonitriles in particular Methoxy Isobutyl Isonitrile (MIBI) as well as the procedures of synthesis, formulation of kit and labelling with 99m Tc is discussed. Investigation of effective factors and finding the optimum parameters to obtain the highest labelling efficiency and radiochemical purity of 99m Tc - MIBI complex is also included in this research work

  9. Technetium-99m Radiopharmaceuticals for Monitoring Drug Resistance. Chapter 12

    Resistance to chemotherapy constitutes a major obstacle to cancer cures. Cellular mechanisms of resistance involve efflux pumps, P-glycoprotein (Pgp), the product of the MDR1 gene and the related membrane glycoprotein, multidrug resistance associated protein 1 (MRP1). Multidrug resistant cell lines overexpressing Pgp are resistant to a structurally and functionally diverse group of chemotherapeutic agents. Many of these drugs tend to be lipophilic and positively charged at neutral pH. This suggested the application of the two lipophilic cationic 99mTc radiopharmaceuticals currently used for myocardial perfusion, 99mTc-MIBI and 99mTc-Tetrofosmin. Efforts were also made to develop specific 99mTc labelled substrates for Pgp based on lipophilic cationic 99mTc complexes. A large number of studies indicated that 99mTc-MIBI, 99mTc-Tetrofosmin and some related 99mTc compounds are substrates for Pgp. However, it remains uncertain whether these 99mTc labelled compounds are substrates for MRP1. Thus, both 99mTc-MIBI and 99mTc-Tetrofosmin would be general probes of transporter mediated multidrug resistance in tumour cells. (author)

  10. Technetium-99m Sestamibi and [F18]Fluorodeoxyglucose (FDG) PET in assessing patients with multiple myeloma

    Full text: The aim of the study is to evaluate the diagnostic and prognostic value of 99mTc-Sestamibi (MIBI) in the detection on bone marrow involvement in patients suffering from Multiple Myeloma (MM), its possible role in the follow-up and comparison of 99mTc-MIBI and [F18]FDG PET imaging. We present the results, for patients at our institution, that have undergone 99mTc-MIBI scans to assess MM. We considered patients (pts) with MM (in active disease, partial and chronic remission) and with monoclonal gammopathy of undetermined significance (MGUS). A subgroup of patients with MM repeated a 99mTc-MIBI scintigraphic study at least 2 months after high-dose chemotherapy. All the scans were scored semi-quantitatively according to extension and intensity of tracer uptake. Twelve patients had concurrent 99mTc-MIBI and [F18]FDG PET. The overall sensitivity of the 99mTc-MIBI scintigraphy was 92%, specificity was 96%. In the follow up of the pts treated with chemotherapy 99mTc-sestamibi closely paralleled the activity of myeloma bone disease. A multivariate analysis showed that 99mTc-MIBI uptake pattern has an added value in relation to known prognostic variables. In another study, patients showing disease progression at restaging had higher washout of 99mTc-MIBI (10 and 60 minutes) than patients in remission; disease free survival was significantly better in patients with lower washout in absence of differences in therapeutic regimen and stage of disease at admission. [F18]FDG-PET and MIBI were concordant in seven of 12 cases (58%); only in one case FDG detected bone marrow sites in addition to those detected by 99mTc-MIBI. Our experience indicates that 99mTc-MIBI scintigraphy closely reflects myeloma disease activity in the bone marrow, and that a negative 99mTc-MIBI scan in pts with suspected MM indicates absence of disease or clinical remission. The results of these studies suggest a potential role of 99mTc-MIBI washout in predicting response to chemotherapy in

  11. A Pilot Comparison of 18F-fluorocholine PET/CT, Ultrasonography and 123I/99mTc-sestaMIBI Dual-Phase Dual-Isotope Scintigraphy in the Preoperative Localization of Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism

    Michaud, Laure; Balogova, Sona; Burgess, Alice; Ohnona, Jessica; Huchet, Virginie; Kerrou, Khaldoun; Lefèvre, Marine; Tassart, Marc; Montravers, Françoise; Périé, Sophie; Talbot, Jean-Noël

    2015-01-01

    Abstract We compared 18F-fluorocholine hybrid positron emission tomography/X-ray computed tomography (FCH-PET/CT) with ultrasonography (US) and scintigraphy in patients with hyperparathyroidism and discordant, or equivocal results of US and 123I/99mTc-sesta-methoxyisobutylisonitrile (sestaMIBI) dual-phase parathyroid scintigraphy. FCH-PET/CT was performed in 17 patients with primary (n = 11) lithium induced (n = 1) or secondary hyperparathyroidism (1 dialyzed, 4 renal-transplanted). The refer...

  12. Preparation and assessment of [{sup 99m}Tc]technetium aquacarbonyl complexes with 1,2-diaminoethane-N-substituted ligands for tumor detection; Preparo e avaliacao de complexos de [{sup 99m}Tc]tecnecio aquacarbonil com ligantes 1,2-diaminoetano-N-substituidos para deteccao de tumores

    Radin, Adriano

    2010-07-01

    Over least 15 years the complex [[{sup 99m}Tc](H{sub 2}0){sub 3}(CO){sub 3}]{sup +} has been used as an intermediary to obtain technetium radiopharmaceuticals for applications in cardiology, neurology and oncology. Two important characteristics of this molecule are: the facility for obtaining that compound from aqueous solutions and the easiness of substituting H{sub 2}O molecules by atoms of other ligand molecules. In this project we prepared new complexes [[{sup 99m}Tc](CMN{sup S001-3})(H{sub 2}O)(CO){sub 3}]{sup +}, where (CMNS001) = N-[(4-methoxy) benzyl]-1,2-diaminoethane, (CMNS003) = N,N'-bis-[(4-methoxy)benzyl]-1,2-diaminoethane, and assessed the uptake of these complexes in murine melanoma cancer cell B16F10 and breast cells MCF-7 and MDA-MD-231, and compared with [[{sup 99m}](MIBI){sub 6}]{sup +} uptake. In vitro uptake for both new technetium complex reached values close to 5%, for all cell lines, whereas the [[{sup 99m}Tc](MIBI){sub 6}]{sup +} uptake was close to 1 %. The assessment of subcellular distribution showed high accumulation of the new complex in the membrane fraction, for MDAMB-231, while for B16F10 accumulation occurred both in membrane and cytoplasm; the concentration of [[{sup 99m}Tc](MIBI){sub 6}]{sup +} was mainly in the cytoplasm portion. Biodistribution study in mice allowed to observe the capture of up to 1.6% of the administered dose per gram of tumor tissue for the complex [[{sup 99m}Tc](CMNS001)(H{sub 2}O)(CO){sub 3}]{sup +}, whereas other organs such as heart, lung and muscle, showed uptake of about 5.6%, 6.4% and 2%, respectively. The complexes in this work showed a high rate of uptake in vitro, but was not reproduced in vivo model, which can be related to low concentration of the complexes inside the cells and reduced vascularity of tumor tissue, with lower intake of complex through the blood system. (author)

  13. Are P.T.H. plasma levels useful for the selection of patients with secondary hyperparathyroidism for preoperative MIBI ({sup 99m}Tc)/{sup 123}I dual-isotope scintigraphy?;La concentration plasmatique de PTH permet-elle de selectionner les patients atteints d'hyperparathyroidie secondaire pour beneficier de la scintigraphie double isotope MIBI ({sup 99m}Tc)/{sup 123}I preoperatoire?

    Balogova, S.; Sauer, A.M.; Dudczak, J.; Pascal, O.; Kerrou, K.; Huchet, V.; Montravers, F.; Talbot, J.N. [Universite Pierre-et-Marie-Curie, Service de medecine nucleaire, hopital Tenon, 75 - Paris (France); Perie, S.; Lacau St-Guily, J. [Universite Pierre-et-Marie-Curie, ORL, hopital Tenon, 75 - Paris (France); Nataf, V. [Universite Pierre-et-Marie-Curie, hopital Tenon, Service de radiopharmacie, 75 - Paris (France); Balogova, S. [Faculte de medecine, universite Comenius, Bratislava (Slovakia)

    2010-07-15

    The utility of preoperative scintigraphy in case of secondary hyperparathyroidism is questioned by some authors. Obviously, an imaging modality that will detect all hyperplastic glands, including the ectopic ones, would be of interest in those patients at high risk for surgery. However, scintigraphy has a limited detection rate in some patients. We investigated whether one of the following parameters would identify a subgroup of patients in whom the detection rate would be optimal: age, gender, hemodialysis and duration since its onset, and plasma levels of parathyrin (P.T.H.). Methods: Retrospective series of 38 patients referred for preoperative parathyroid scintigraphy due to secondary hyperparathyroidism who then underwent para thyroidectomy. Scintigraphy was performed 20 min and then 3 h after injection of 8 MBq/kg of sestamibi ({sup 99m}Tc) with a previous ingestion of 0.1 MBq/kg iodine-123, 3 h before. Result: No significant correlation was observed between the number of glands detected on scintigraphy (and confirmed by postoperative histology) and plasma P.T.H. levels (r = -0.17). A weak positive correlation (r = +0.34) was noted in the group of six non-hemo dialysed patients. No significant relationship between this number of detected glands and a clinical parameter was observed. Conclusion: In our experience, these parameters do not permit to select, among patients with secondary hyperparathyroidism and scheduled for para thyroidectomy, those who will better benefit from parathyroid scintigraphy. (authors)

  14. A Pilot Comparison of 18F-fluorocholine PET/CT, Ultrasonography and 123I/99mTc-sestaMIBI Dual-Phase Dual-Isotope Scintigraphy in the Preoperative Localization of Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism: Influence of Thyroid Anomalies.

    Michaud, Laure; Balogova, Sona; Burgess, Alice; Ohnona, Jessica; Huchet, Virginie; Kerrou, Khaldoun; Lefèvre, Marine; Tassart, Marc; Montravers, Françoise; Périé, Sophie; Talbot, Jean-Noël

    2015-10-01

    We compared (18)F-fluorocholine hybrid positron emission tomography/X-ray computed tomography (FCH-PET/CT) with ultrasonography (US) and scintigraphy in patients with hyperparathyroidism and discordant, or equivocal results of US and (123)I/(99m)Tc-sesta-methoxyisobutylisonitrile (sestaMIBI) dual-phase parathyroid scintigraphy. FCH-PET/CT was performed in 17 patients with primary (n = 11) lithium induced (n = 1) or secondary hyperparathyroidism (1 dialyzed, 4 renal-transplanted).The reference standard was based on results of surgical exploration and histopathological examination. The results of imaging modalities were evaluated, on site and by masked reading, on per-patient and per-lesion bases.In a first approach, equivocal images/foci were considered as negative. On a per-patient level, the sensitivity was for US 38%, for scintigraphy 69% by open and 94% by masked reading, and for FCH-PET/CT 88% by open and 94% by masked reading. On a per-lesion level, sensitivity was for US 42%, for scintigraphy 58% by open and 83% by masked reading, and for FCH-PET/CT 88% by open and 96% by masked reading. One ectopic adenoma was missed by the 3 imaging modalities. Considering equivocal images/foci as positive increased the accuracy of the open reading of scintigraphy or of FCH-PET/CT, but not of US. FCH-PET/CT was significantly superior to US in all approaches, whereas it was more sensitive than scintigraphy only for open reading considering equivocal images/foci as negative (P = 0.04). FCH uptake was more intense in adenomas than in hyperplastic parathyroid glands. Thyroid lesions were suspected in 9 patients. They may induce false-positive results as in one case of oncocytic thyroid adenoma, or false-negative results as in one case of intrathyroidal parathyroid adenoma. Thyroid cancer (4 cases) can be visualized with FCH as with (99m)Tc-sestaMIBI, but the intensity of uptake was moderate, similar to that of parathyroid hyperplasia.This pilot study confirmed that

  15. The Relationship Between Technetium-99m-Methoxyisobutyl Isonitrile Parathyroid Scintigraphy and Hormonal and Biochemical Markers in Suspicion of Primary Hyperparathyroidism

    Güler Silov; Ayşegül Özdal; Zeynep Erdoğan; Özgül Turhal; Hatice Karaman

    2013-01-01

    Objective: Technetium-99m-methoxyisobutyl isonitrile (Tc-99m MIBI) has been widely used to evaluate hyperfunctioning autonomous parathyroid glands in patients with elevated intact parathyroid hormone (iPTH) and/or calcium (Ca) level. The aim of this study was to evaluate the relationship between Tc-99m MIBI parathyroid scintigraphy and hormonal and biochemical markers in suspicion of primary hyperparathyroidism (PHPT). Material and Methods: Dual-phase Tc-99m MIBI parathyroid scintigraphy and ...

  16. Contribution of {sup 99m}Tc-sestamibi scintigraphy by double phase in the exploration of hyperparathyroidism. Report of 20 cases; Apport de la scintigraphie parathyroidienne au {sup 99m}Tc-MIBI en double phase dans l'exploration des hyperparathyroidies. A propos de 20 cas

    Ghfir, I.; Ben Rais, N. [Hopital Ibn Sina, CHU de Rabat, Service de Medecine Nucleaire de Rabat (Morocco)

    2008-11-15

    Introduction {sup 99m}Tc-sestamibi parathyroid scintigraphy is a means of functional imaging allowing the exploration of hyperparathyroidism. The aim of our study is to demonstrate the utility of double-phase {sup 99m}Tc-sestamibi scintigraphy in the exploration of the secreting abnormal parathyroid gland. Materials and methods We report, through this work, the observation of 20 patients followed for a biologically ascertained hyperparathyroidism and explored, for the majority of them, by ultrasonography and/or computed tomography. All our patients benefited from a double-phase {sup 99m}Tc-sestamibi scintigraphy. Results On the 20 studied cases, the sex-ratio was equal to 1, two patients exhibited three high uptake foci at the {sup 99m}Tc-sestamibi scintigraphy, six exhibited two foci, twelve exhibited one parathyroid focus. In our series, 80% of patients exhibited secondary hyperparathyroidism and 20% exhibited a primary hyperparathyroidism. The pathologic exam revealed four cases of parathyroid adenoma and 16 parathyroid cases of hyperplasia. Discussion The double-phase {sup 99m}Tc-sestamibi scintigraphy contributes to the orientation and the improvement of the surgical attitude of the hyperparathyroidism, insofar as it could affirm the multiplicity of some adenomas, the diffuse form of some hyperplasia, and especially ectopic localization of the abnormal parathyroid gland.

  17. Development of methods of labeling pentavalent DMSA with {sup 99m}Tc and {sup 188}Re; Desenvolvimento de metodos para marcacao de DMSA pentavalente com {sup 99m}Tc e {sup 188}Re

    Brambilla, Tania de Paula, email: jtoniolo@ipen.br

    2009-07-01

    Technetium-99 m is the most useful radionuclide in diagnostic imaging procedures in Nuclear Medicine, more than 80 percent of radiopharmaceuticals are {sup 99m}Tc-labeled compounds. {sup 99m}Tc-DMSA(V) has been used for imaging of soft tissue, head and neck tumors. It shows a particularly high specificity for medullary thyroid carcinoma and bone metastases in a variety of cancers. Biodistribution studies of {sup 188}Re-DMSA(V) have shown that its general pharmacokinetic properties are similar to that of {sup 99m}Tc-DMSA(V), so this agent could be used for targeted radiotherapy of these tumors. The aim of this work is the development of methods of labeling DMSA(V) with {sup 99m}Tc and {sup 188}Re. {sup 99m}Tc-DMSA(V) can be prepared by two methods. One of them is the indirect one, through the use of a commercial kit of DMSA (III), by adjusting the pH from 2.5 to {approx} 8.5 with NaHCO{sub 3}. This method was evaluated and optimized presenting high labeling yields. The other method is the direct one, through the preparation of a lyophilised kit ready for labeling with {sup 99m}Tc, being the method of interest of this work, due to the easy of its clinical use. The most adequate formulation of the kit was: 1.71 mg of DMSA, 0.53 mg of SnCl{sub 2}.2H{sub 2}O and 0.83 mg of ascorbic acid (pH 9). Labeling yields higher than 95% were achieved labeling this kit with 1 to 2 m L of {sup 99m}Tc with activities up to 4736 MBq (128 mCi). The kit was stable up to 6 months and biodistribution studies confirmed the quality of the DMSA (V) labeled with {sup 99m}Tc using this kit. The reduction potential of Re is lower than the one for Tc, so the labeling conditions of {sup 188}Re-DMSA(V) are different from the ones used for {sup 99m}Tc- DMSA(V). {sup 188}Re-DMSA(V) is prepared in acid solution, that makes it possible to use the DMSA (III) commercial kit developed for labeling with {sup 99m}Tc, prepared in pH 2.5, for labeling with {sup 188}Re. Labeling yields higher than 95% were

  18. Standardization of a method to calculate absolute renal uptake of {sup 99m} Tc-DMSA in children; Padronizacao do metodo para calculo da captacao renal absoluta do {sup 99m}Tc-DMSA em criancas

    Ono, Carla Rachel; Sapienza, Marcelo Tatit; Watanabe, Tomoco; Costa, Paulo Luiz Aguirre; Okamoto, Miriam Roseli Yoshie; Garcez, Alexandre Teles; Buchpiguel, Carlos Alberto [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Servico de Medicina Nuclear]. E-mail: crachelo@usp.br; Machado, Beatriz Marcondes; Machado, Marcia Melo Campos [Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital Universitario; Liberato Junior, Waldyr de Paula

    2006-01-15

    Objective:To standardize a method and determine normal values for absolute renal uptake of 99m Tc-DMSA in children with normal creatinine clearance. Materials and methods: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years) without clinical evidence of renal disease were studied using 99m Tc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99m Tc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance. Absolute renal uptake of 99m Tc-DMSA (DMSA-Abs) was expressed as the fraction of the administered dose retained by each kidney six hours after administration of the radiopharmaceutical. Results: DMSA-Abs was 21.8 +- 3.2% for the right kidney and 23.1 +-3.3% for the left kidney. There was no correlation between renal uptake and the age groups studied, although there was a tendency to an increase in the creatinine clearance with age. Conclusion: Normal values of DMSA-Abs can be used as an additional parameter for the initial diagnostic evaluation and during follow-up of renal diseases, mainly when bilateral impairment of renal function is suspected or in a patient with a single functioning kidney (in which renal differential function is of limited value). (author)

  19. Is Brown Adipose Tissue Visualization Reliable on 99mTc-Methoxyisobutylisonitrile Diagnostic SPECT Scintigraphy?

    Haghighatafshar, Mahdi; Farhoudi, Farinaz

    2016-01-01

    The 99mTc-MIBI has been used with great value as a diagnostic technique in patients with primary hyperparathyroidism. False-positive scans may occur due to misinterpretation of the physiologic distribution of the 99mTc-MIBI. Reviewing consecutive SPECT scans, we evaluated this possibility and assessed how frequently brown adipose tissue (BAT) is seen on 99mTc-MIBI scintigraphy. Here, we retrospectively reviewed scans of consecutive patients who were evaluated for parathyroid adenomas from March 2015 to June 2015, using dual-phase (early and delayed) planar imaging and SPECT. We identified 60 patients (48 female and 12 male; mean age, 52.25 ± 15.20 years; range, 22-86 years).We detected the presence of 99mTc-MIBI uptake in BAT in 20 of 60 patients (33.33%) in the neck. Although the patients with T99mc-MIBI uptake in BAT were younger (mean age, 48.85 ± 15.27 years, range, 26-73 years) than the patients with no 99mTc-MIBI uptake (mean age, 53.95 ± 15.07 years, range, 22-86 years), this difference was not statistically significant (P = 0.224). The percentage of female patients with BAT detection was higher (17/48 patients; 37.5%) than that of the male population (3/12 patients; 25%), this difference was not also statistically significant (P = 0.85).In patient population referred to 99mTc MIBI scintigraphy of the parathyroid glands, uptake of 99mTc-MIBI in BAT should not be misinterpreted with 99mTc-MIBI-avid-tumors. Fused SPECT/CT images (not SPECT-only) are necessary to distinguish BAT from bone, muscle, thyroid, myocardium, parathyroids, and other structures in the neck and chest. PMID:26765463

  20. {sup 99m} Tc-UBI 29-41: radiolabelled antimicrobial peptide for the diagnostic by image of infectious processes; {sup 99m} Tc-UBI 29-41: peptido antimicrobiano radiomarcado para el diagnostico por imagen de procesos infecciosos

    Ferro F, G.; Ramirez C, F.M. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico); Murphy, C.A. de; Pedraza L, M.; Rodriguez C, J. [INCMNSZ, 14000 Mexico D.F. (Mexico); Melendez A, L. [Facultad de Medicina, UAEM, 50000 Toluca, Estado de Mexico (Mexico)

    2005-07-01

    Recently the radiolabelled anti microbic peptides has intended as new radiopharmaceuticals for distinguish a bacterial infection of a sterile inflammatory process through a diagnostic image. The ubiquicidine 29-41 (UBI), it is a fragment of an anti microbic cationic peptide located in the human skin whose sequence of amino acids is Thr-Gly-Arg-Ala-Lys-Arg-Arg-Met-Gln-Tyr-Asn-Arg-Arg. The objective of this study was to develop a derived of the UBI 29-41 radiolabelled with Tc-99m in high radiochemical purity and to evaluate the feasibility of using it in the specific detection of infectious focuses. The molecular structures of the UBI as well as of other 2 cationic peptides used as control (Tat-1-Scr and Tat-2-Scr), they were calculated and optimized in their more stable configuration by molecular mechanics procedures and quantum mechanics. Once established the site for the labelled with {sup 99m} Tc, the three complexes were represented by the general formula [Tc(V)(O)(H{sub 2}O){sub 2} (Lys{sub n=1,2}-Arg{sub n=0.1}-peptide)]{sup 10+,11+}, with potential energy of 104.5 Kcal/mol, 95.6 Kcal/mol and 90.8 Kcal/mol for the {sup 99m}Tc-Tat-1-Scr, {sup 99m} Tc-Tat-2-Scr and {sup 99m}Tc-UBI 29-41 respectively. The three radio complexes got ready experimentally and their stability in vitro saline solution is evaluated, human serum and cysteine solutions. The experimental results correlated appropriately with the calculated data. The specificity in vitro was carried out evaluating the percentage of union of the {sup 99m}Tc-UBI 29-41 as well as of the control peptides at bacteria of S. aureus and two tumoral cellular lines (LS174T and ACHN). The In vivo specificity was determined using Balb-C mice with induction in a paw of an infectious process and in another paw of a sterile inflammatory process. Simultaneously it was administered to the mice with infection and inflammation induced {sup 99m}Tc-UBI 29-41 and {sup 67}Ga-citrate this last an unspecific radiopharmaceutical

  1. Development of lyophilized kit of Tin-Glucoheptonate for in vitro labeling of leucocytes with {sup 99m}Tc; Desenvolvimento de reagente liofilizado de glucoheptonato-estanho para marcacao de leucocitos com Tecnecio-99m in vitro

    Nascimento, Rosemeire Fagundes

    2007-07-01

    The study and localization of inflammatory and infection process in Nuclear Medicine represents a relevant tool in diagnostic procedures. In same cases, the diagnostic is easy and based on anamnesis and clinical observation; in other cases, the patients are asymptomatic or present non specific symptoms that difficult the diagnostic. The early diagnostic of inflammatory or infectious process allow the early introduction of therapy and prevents complications. Farther, the differentiation between inflammation and infection is of extreme importance as well as the localization of the focus. The use of labeled leucocytes, studied and applied in much pathologies, is the method of choice for the visualization of inflammation and infection. The scintigraphy using labeled leucocytes was introduced at 1976 by McAffe and Thakur and since of this is used in the diagnostic of different pathologies related to leucocyte infiltration like intestinal inflammatory disease, bone or prosthetic-vascular infections. The in vitro labeling of leucocytes with {sup 111}In was performed using oxime or tropolone as ligand and with {sup 99m}Tc using hexamethylpropylene amine oxime (HMPAO) as ligand, resulting in a lipophilic complex. The {sup 99m}Tc-HMPAG complex was preferably employed in many indications and countries do to the ideal physical properties of {sup 99m}Tc that results in low dose to the patient. However, the labeling employing the HMPAO complex results in some disadvantages like the low stability of the complex, and some requirements related to the {sup 99m}Tc elution (like the time pos elution), beyond the high cost of the compound that is imported. The aim of this work was the development of a tin-glucoheptonate lyophilized kit for in vitro leucocytes labeling with {sup 99m}Tc using the pre-stannization method. The optimization of the labeling technique was developed using leucocytes isolated from total blood and employing different volumes of the tinglucoheptonate reagent and

  2. Staging and therapy monitoring of multiple Myeloma by 99mTc-Sestamibi Scintigraphy: a five year single center experience

    The aim of the present study was the evaluation of the diagnostic value of 99mTc-sestamibi (MIBI) in the detection of bone marrow involvement in patients suffering from multiple myeloma (MM) and its possible role in the follow-up. Between 1998 and 2003, 68 patients with MM and 42 pts with monoclonal gammopathy of undetermined significance (MGUS) were consecutively enrolled in this study. 51/68 MM patients had active disease (AD), 11/62 were in complete remission (CR) and 6/68 in partial remission (PR) after chemotherapy. 18 patients with MM repeated a 99mTc-MIBI scintigraphic study at least 2 months after high-dose chemotherapy. All the scans were score semi quantitatively according to extension and intensity of tracer uptake. All MGUS pts had a negative 99mTc-MIBI. As far as the MM pts are concerned, 54/68 (49%) pts (48 with AD, 5 with PR and 1 with CR) had a positive 99mTc-MIBI scan, while the 99mTc-MIBI scan was negative in 14/68 pts (10 with CR, 1 with PR and 3 with AD). The overall sensitivity of the 99mTc-MIBI scintigraphy was 92%; specificity was 96%. In the follow up of the pts treated with chemotherapy 99mTc-MIBI closely paralleled the activity of myeloma bone disease. In conclusion, these results indicate that 99mTc-MIBI scintigraphy closely reflects myeloma disease activity in the bone marrow, and that a negative 99mTc-MIBI scan in patients with suspected MM clearly, though not absolutely, indicates absence of disease or clinical remission. The results of this study suggest a clear diagnostic value of 99mTc-MIBI scintigraphy in patients with MM and its potential role during the follow-up for the monitoring of MM bone disease

  3. Development of methodology for evaluation of {sup 99m}Tc and {sup 131}I incorporated activities during lactation; Desenvolvimento de metodologia para avaliacao da atividade de {sup 99m}Tc e {sup 131}I em lactantes

    Santos, L. [Universidade Federal do Rio de Janeiro (IF/UFRJ), RJ (Brazil). Inst. de Fisica; Dantas, A.L.A.; Mesquita, S.A. [Universidade Federal do Rio de Janeiro (IF/UFRJ), RJ (Brazil). Inst. de Fisica; Oliveira, S.M.V., E-mail: adantas@ird.gov.br, E-mail: silvia@ird.gov.br [Universidade Federal do Rio de Janeiro (IF/UFRJ), RJ (Brazil). Inst. de Fisica; Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Dosimetria

    2012-07-01

    Internal contamination of babies may occur for milk ingestion or inhalation of mothers occupationally exposed to ionizing radiation with possible incorporation or mothers submitted to medical exposures during lactation. Radionuclide concentrations in the mother's milk may cause organ absorbed doses in the babies proportionally to the breast volumes. Milk analysis allow to determine activities ingested by the babies by determining the peak of mother's milk considering the decrease of the activity rate and the milk activities drunk at different time intervals. The work had the aim to develop simulators and methodology to evaluate {sup 99m}Tc and {sup 131}I in lactation, in the following steps: to prepare standard solution of contaminated milk separately with {sup 99m}Tc and {sup 131}I; to build four breast simulators (600 g and 800 g) and respective calibration for two geometries (breast and whole-body) in the Whole-Body Counter Unit in Instituto de Radioprotecao e Dosimetria. The results demonstrated the system efficiency to determine {sup 99m}Tc and {sup 131}I activities in breasts during the lactation period. The methodology for positioning in the 'breast geometry' seemed to be more efficient than the 'whole-body geometry' for different breast volumes. The experiment allows achieving better evaluation of internal dosimetry of mothers and their young children. (author)

  4. Development of a formulation lyophilized for the obtention of a antimicrobial peptide Ubiquicidine labelled with {sup 99m} Tc; Desarrollo de una formulacion liofilizada para la obtencion del peptido antimicrobiano Ubiquicidina marcado con Tc-99m

    Palomares R, P.; Hernandez B, C.A.; Contreras N, G.; Garcia P, M.L.; Pantoja H, I.E. [UAEM, Toluca (Mexico); Ferro F, G. [ININ, A.P. 18-1027, 11801 Mexico D.F. (Mexico)]. E-mail: patodish@hotmail.com

    2004-07-01

    The {sup 99m} Tc-UBI 29-41 are a labelled fragment of the antimicrobial human peptide Ubiquicidine proposed as a new radiopharmaceutical able to differentiate an infectious process of an inflammatory one through the gamma graphic image. It has been demonstrated that the {sup 99m} Tc-UBI 29-41 unite to bacteria in vitro and that accumulates in infection sites in human with minimum captivation in inflammation sites. In this work the development of a pharmaceutical lyophilized formulation is presented for the instantaneous marked one of the UBI 29-41 with {sup 99m} Tc. The selection of the components of the formulation settled down by means of the employment of an experimental design of 3 factors with mixed levels, evaluating the effect of the diluent type, concentration of tinny chloride and the reaction volume. The obtained formulations showed to be stable until for 6 months, being obtained complexes of the radiolabelled peptide with radiochemical purity > 95 % in sterile form and apirogen. The developed pharmaceutical form, will facilitate the routinary use of this new radiopharmaceutical in the diverse hospital departments of nuclear medicine. (Author)

  5. Clinical significance of exercise-induced ST segment depression in patients with lateral myocardial infarction involving the left circumflex artery. Evaluation by exercise 99mTc-MIBI myocardial scintigraphy

    The aim of this study is to clarify the causes of exercise-induced ST-segment depression in patients with broad lateral old myocardial infraction involving left circumflex branch (LCX) (LCX-OMI) without ischemia on exercise scintigraphy. Twenty one patients (M/F=11/10, age=62±19 years) with myocardial infraction involving LCX (LCX-MI), but without fill-in on exercise and rest MIBI quantitative gated SPECT (QGS), were selected. They were divided into two groups of Group ST(+) (n=11, with significant ST depression (max-2.8±0.4 mm), Group ST (-) (n=10) without ST depression. On 20 SPECT segments of both exercise and rest SPECT, we scored uptake score as defect score (DS) (0=normal to 3=defect) and wall motion as wall motion score (WMS) (0=normal to -5=dyskinesis) and summed DS (TDS) and WMS (TWMS) in LCX region, furthermore, calculated the difference of TWMS (ΔTWMS {exercise-rest}), end diastolic volume (EDV) and ejection fraction (EF) during exercise were compared between the two groups. Group ST(+) showed significantly (p2-4 without ischemia in LCX-MI was observed in patients with broad LCX-MI, low EF, and was related to impaired wall motion in LCX region. ST depression in V2-4 was considered to appear as miller image of ST elevation at postero-inferior wall due to disturbed wall motion on exercise. (author)

  6. Prediction of sensitivity to anticancer agents for patients with advanced or recurrent breast cancer by Tc-99m sestamibi

    Tc-99m Sestamibi (99mTc-MIBI) is known to be a substrate of P-glycoprotein (P-gp) that effluxes the drugs out of cancer cells. The overexpression of P-gp involved in multidrug resistance phenomenon in patients with advanced or recurrent breast cancers was shown in the plasma membrane of breast cancer cells. In this study, we examined the usefulness of 99mTc-MIBI scintigraphy for the prediction of sensitivity to anticancer agents in 8 cases with advanced or recurrent breast cancer. The retrospective analysis showed that the sensitivity to the chemotherapy could be evaluated in 3 cases by 99mTc-MIBI scintigraphy, but in the other 5 cases 99mTc-MIBI scintigraphy was not eligible for the prediction of sensitivity. Two out of 3 cases showed over 50% in reduction rate of target tumors (PR) with higher accumulation of 99mTc-MIBI, while another case with PD showed lower. These results suggest that the accumulation of 99mTc-MIBI could be associated with the sensitivity to P-gp-related anticancer agents, and that the functional analysis of P-gp by 99mTc-MIBI might be useful for the prediction of responsiveness of chemotherapy in patients with breast cancer. (author)

  7. Scintigraphic findings on 99mTc-MDP, 99mTc-sestamibi and 99mTc-HMPAO images in Gaucher's disease

    We report here on the use of the lipophilic cationic complex technetium-99m sestamibi (99mTc-MIBI), employed as an indicator of increased cellular density and metabolic activity, to evaluate Gaucher cell infiltrates in the bone marrow; 99mTc-hexametazime (99mTc-HMPAO) was also employed, as a pure indicator of lipidic infiltration in the bone marrow. A 67-year-old patient with known type 1 Gaucher's disease presented with a painful left hip and knee and difficulty in gait subsequent to traumatic fracture of the left femoral neck that had required implant of a fixation screw-plaque. Bone scan with 99mTc-methylene diphosphonate revealed reduced uptake at the distal metaphyseal-epiphyseal femoral region. In addition, whole-body maps and spot-view acquisitions of the thighs and legs were recorded at both 30 min and 2.5 h after the injection of 99mTc-MIBI: the scintigraphic pattern clearly showed increased uptake at several sites involved by Gaucher deposits in the bone marrow (both knees, with variable intensity in different areas), matching the bone changes detected by conventional x-ray. The target to non-target ratios slowly decreased with time, from an average value of 2.25 in the early scan to an average value of 2 in the delayed scan. The lipid-soluble agent 99mTc-HMPAO exhibited a superimposable scintigraphic pattern of accumulation at the involved sites, though with lower target to non-target ratios (1.27-1.48). The results obtained in this patient suggest a potential role of 99mTc-MIBI in the scintigraphic evaluation of Gaucher's lipid deposits in the bone marrow. If the results are confirmed in other patients, this radiopharmaceutical would offer clear advantages over 133Xe because of its wider availability and greater practicality (i.v. administration of 99mTc-MIBI versus inhalation of 133Xe, and use of a single gamma camera instead of two as with 133Xe). (orig.). With 3 figs

  8. Radiation exposure of the patient in diagnostic nuclear medicine. Experimental studies of the biokinetics of 111In-DTPA-D-Phe1-octreotide, 99mTc-MIBI, 14C-triolein and 14C-urea, and development of dosimetric models

    Biokinetic and dosimetric models for a number of clinically used radiopharmaceuticals, for which information on the radiation dosimetry is scarce, have been produced. On patients undergoing investigations with 111In-DTPA-D-Phe1-octreotide (for diagnosis of neuroendocrine tumours) and 99mTc-MIBI (for myocardial perfusion imaging), whole body gamma camera scanning was performed several times after administration of the radiopharmaceutical. Total body and organ activity content was determined using the geometric mean of the number of counts in two 180 deg opposed planar images. A thorough investigation of sources influencing the accuracy of the quantification of activity was carried out, showing an overall uncertainty varying from 10% to 30% for organs with a significant uptake and 5% for the whole body. The activity in blood and urine was also measured. 111In-DTPA-D-Phe1-octreotide was predominantly excreted via the kidney-bladder system and a typical investigation with 1200 MBq resulted in an effective dose of 8.4 mSv (0.076 mSv/MBq). 99mTc-MIBI was to a great extent excreted via the gastrointestinal tract and an investigation with 1200 MBq resulted in an effective dose of 13 mSv (0.011 mSv/MBq). Accelerator mass spectrometry (AMS) was used to investigate the possibility to measure ultra-low activity concentrations of 14CO2, in exhaled air from patients undergoing 14C-breath tests, with special application to 14C-triolein (for study of fat malabsorption). AMS was proven to be a useful technique for long-term retention studies of 14C, and was used together with liquid scintillation counting in an investigation of the biokinetics of 14C-urea in adult and paediatric patients (for diagnosis of Helicobacter pylori infection in the upper gastrointestinal tract). The effective dose for 14C-urea was 0.019 mSv/MBq for adults and from 0.041 to 0.019 mSv/MBq for seven- to fourteen -year-old children, resulting in an effective dose of approximately 0.002 mSv per investigation

  9. Radiation exposure of the patient in diagnostic nuclear medicine. Experimental studies of the biokinetics of {sup 111}In-DTPA-D-Phe{sup 1}-octreotide, {sup 99m}Tc-MIBI, {sup 14}C-triolein and {sup 14}C-urea, and development of dosimetric models

    Leide Svegborn, S

    1999-03-01

    Biokinetic and dosimetric models for a number of clinically used radiopharmaceuticals, for which information on the radiation dosimetry is scarce, have been produced. On patients undergoing investigations with {sup 111}In-DTPA-D-Phe{sup 1}-octreotide (for diagnosis of neuroendocrine tumours) and {sup 99m}Tc-MIBI (for myocardial perfusion imaging), whole body gamma camera scanning was performed several times after administration of the radiopharmaceutical. Total body and organ activity content was determined using the geometric mean of the number of counts in two 180 deg opposed planar images. A thorough investigation of sources influencing the accuracy of the quantification of activity was carried out, showing an overall uncertainty varying from 10% to 30% for organs with a significant uptake and 5% for the whole body. The activity in blood and urine was also measured. {sup 111}In-DTPA-D-Phe{sup 1}-octreotide was predominantly excreted via the kidney-bladder system and a typical investigation with 1200 MBq resulted in an effective dose of 8.4 mSv (0.076 mSv/MBq). {sup 99m}Tc-MIBI was to a great extent excreted via the gastrointestinal tract and an investigation with 1200 MBq resulted in an effective dose of 13 mSv (0.011 mSv/MBq). Accelerator mass spectrometry (AMS) was used to investigate the possibility to measure ultra-low activity concentrations of {sup 14}CO{sub 2}, in exhaled air from patients undergoing {sup 14}C-breath tests, with special application to {sup 14}C-triolein (for study of fat malabsorption). AMS was proven to be a useful technique for long-term retention studies of {sup 14}C, and was used together with liquid scintillation counting in an investigation of the biokinetics of {sup 14}C-urea in adult and paediatric patients (for diagnosis of Helicobacter pylori infection in the upper gastrointestinal tract). The effective dose for {sup 14}C-urea was 0.019 mSv/MBq for adults and from 0.041 to 0.019 mSv/MBq for seven- to fourteen -year-old children

  10. Evaluation of aptamers labelled with {sup 99m}Tc for identification of Staphylococcus aureus bacteria; Avaliacao de aptameros marcados com {sup 99m}Tc para identificacao de focos infecciosos de Staphylococcus aureus

    dos Santos, Sara Roberta

    2014-06-01

    Staphylococcus aureus is specie of great medical importance because it is often associated with many infections in humans. This bacterium can cause diseases ranging from simple infections to life-threatening infections such as endocarditis, pneumonia, meningitis, toxic shock syndrome, septicemia, osteomyelitis, among others. S. aureus is the most commonly agent found in infections of the skin and soft tissues, bone infections and bone prostheses. The difficulty in early detection of specific foci caused by bacteria has raised the need to search for new techniques for this purpose. Diagnosis by scintigraphy has advantages over other methods because it is able to identify damage tissues without the need of invasive procedures and is able to perform an early diagnosis even before anatomic changes. Thus, nuclear medicine could contribute to an accurate diagnosis of bacterial infections, since specific radiopharmaceuticals were developed. Aptamers are oligonucleotides that have high affinity and specificity for their molecular targets and are emerging as a new class of molecules for radiopharmaceuticals development. Radiolabeled aptamers specific to the infectious agents, could give a significant contribution to the infection diagnosis by scintigraphy. In this study, aptamers selected to S. aureus were labeled with {sup 99m}Tc and used for the bacteria identification in vitro and in vivo. The aptamers labeled with {sup 32}P and incubated in vitro with S. aureus cells showed high affinity for the bacterial cells when compared with the library of oligonucleotides with random sequences used as control. The aptamers labeled with {sup 99m}Tc also showed affinity for S. aureus cells when compared with the library, but unspecific binding was also verified. The {sup 99m}Tc labelled aptamers were stable in 0.9% saline, plasma of Swiss mice and in excess of cysteine. The in vivo biodistribution studies using Swiss mice with intramuscular infection in the right thigh showed that

  11. Intraoperative injection of technetium-{sup 99m}-dextran 500 for the identification of sentinel lymph node in breast cancer; Injecao intraoperatiria de dextran-500-{sup 99m}-tecnecio para identificacao do linfonodo sentinela em cancer de mama

    Delazeri, Gerson Jacob, E-mail: gersonjacob@gmail.co [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Programa de Pos-Graduacao em Medicina e Ciencias Medicas; Xavier, Nilton Leite [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Fac. de Medicina. Dept. de Ginecologia e Obstetricia; Menke, Carlos Henrique; Bittelbrunn, Ana Cristina [Hospital de Clinicas (HCPA), Porto Alegre, RS (Brazil). Servico de Mastologia; Spiro, Bernardo Leao [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Fac. de Medicina. Dept. de Radiologia; Mosmann, Marcos Pretto [Hospital de Clinicas (HCPA), Porto Alegre, RS (Brazil). Servico de Medicina Nuclear; Graudenz, Marcia Silveira [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Dept. de Patologia

    2010-07-01

    Purpose: to determine the efficacy of intraoperative injection of Dextran-500-{sup 99m}-technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region. Methods: a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500-{sup 99m}-Tc filtered 0.22 {mu}m in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18. Results: we identified the SLN in 100% of cases. The rate of SLN identification with the probe was 98% (73/74 cases). In one case (1.35%) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97{+-}0.22 mCi. The average time to label the SLN was 10.7 minutes ({+-}5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope. Conclusion: the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team. (author)

  12. Development of nano radiopharmaceutical based on Bevacizumab labelled with Technetium-99m for early diagnosis of gastrointestinal stromal tumor; Desenvolvimento de nanorradiofarmaco a base de Bevacizumabe marcado com tecnecio-99m para diagnostico precoce do tumor estromal gastrointestinal

    Braga, Thais Ligiero

    2015-06-01

    The development of new radiopharmaceuticals is an essential activity to improve nuclear medicine, and essential for the early and effective diagnosis of oncological diseases. Among the various possibilities current research in the world, the radiopharmaceuticals to chemotherapeutic base may be the most effective in detecting tumors, particularly Gastrointestinal Stromal Tumor (GIST), the Metastatic Renal Cell Carcinoma and neuroendocrine pancreatic tumors. However, difficulties in directing, as well as adhesion of the radiopharmaceutical in the desired location, are currently the main problems in the early detection and treatment of some of these tumors. Advances in the field of nanotechnology, particularly in recent years, indicate significant contribution to overcoming these obstacles, particularly in the implementation of molecular barriers as well as the functionalization of the nanoparticles, thereby improving targeting by the use of surface nucleotides, and the increased adhesion, which facilitates the release of the drug and therefore increases the chances of early diagnosis and more effective treatment. This study aimed to the production, characterization and evaluation of cytotoxicity, as well as in vivo biodistribution test Bevacizumab nanoparticles labeled with Technetium-99m radionuclide for detection of type GIST tumors. Bevacizumab was encapsulated in the form of nanoparticles by the emulsification method using double poly-acetic acid and polyvinyl alcohol polymers (PLA / PVA) at a concentration of 2% of the monoclonal antibody. The characterization of the nanoparticles was performed by the technique of scanning electron microscopy (SEM). The cytotoxicity assessment was performed by XTT assay with various cell lines of solid tumor cells. The labeling with technetium-99m was done by the direct method, and its yield determined by paper chromatography using paper Whatmam 1 as the stationary phase and acetone as mobile phase. In the biodistribution study

  13. {sup 99m}Tc sestamibi imaging. Can it be a useful substitute for hepatobiliary scintigraphy in infantile jaundice?

    Sadeghi, R.; Kakhki, V.R.D.; Zakavi, R. [Mashhad Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.; Kianifar, H.R. [Mashhad Univ. of Medical Sciences (Iran). Paediatric Dept.; Ansari, K. [Tehran Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.

    2009-07-01

    Hepatobiliary scintigraphy is an integral part in the diagnostic work-up of the neonatal cholestasis syndrome. However, less than optimal specificity is its major disadvantage. Differentiation between biliary atresia and neonatal hepatitis is nearly impossible in some cases with poor hepatocellular function. {sup 99m}Tc sestamibi (MIBI) is a cationic lipophilic agent which is a substrate of P-glycoprotein. This glycoprotein is normally expressed in biliary canalicular surfaces of hepatocytes. This property provides a hepatic excretory mechanism which is different from bilirubin excretion. In this study we evaluated the value of {sup 99m}Tc MIBI in differential diagnosis of neonatal cholestasis. 20 infants with a mean age of 2.41 months (range, 0.1-5 months) were included in the study. Ten infants turned out to have extrahepatic biliary atresia and the other ten had neonatal hepatitis. Hepatobiliary (with {sup 99m}Tc BrIDA) and {sup 99m}Tc MIBI scintigraphy were performed for all the patients. {sup 99m}Tc MIBI scintigraphy has shown bowel activity in all patients, including the patients with biliary atresia. Hepatobiliary scintigraphy revealed bowel activity only in five patients with neonatal hepatitis. Bowel visualization with {sup 99m}Tc MIBI may be seen in patients with biliary atresia and {sup 99m}Tc MIBI has limited value in differential diagnosis of neonatal cholestasis. (orig.)

  14. Synthesis, labeling with {sup 99m}Tc and biokinetics of brains scintigraphy diaminodithiol perfusion radiopharmaceuticals; Sintese, marcacao com {sup 99m}Tc e biocinetica de radiofarmacos perfusorios diaminoditiolicos para cintilografias cerebrais

    Goncalves, Marcos Moises

    1999-07-01

    The recent tomography status using radiopharmaceuticals have been contributing greatly with the 'age of certainty' in the diagnosis examination of syndromes, pathologies and clinical signs, because they can evidence some phenomena occurring in a molecular manner. The purpose of this work have had the development of new diaminodithiol (DADT) perfusion radiopharmaceuticals to be used in brain diagnosis using S.P.E.T. (Single Photon Emission Tomography). Initially, the rational planning had been performed with the new DADT molecular structures as radiopharmaceutical candidates. Using of Q.S.A.R. (Quantitative Structure Activity Relationship) techniques, the molecular descriptors such as partition coefficient and effective polarizability, have been studied in order to increase the blood brain barrier transport and the brain uptake respectively. Applying the Q.S.P.R. (Quantitative Structure Property Relationship) concepts to perform drug latentiation, based on bio-labile functional groups, the congener DADT derivative has been transformed into a pro-drug that works as a DADT moiety carrier, allowing the increasing of brain radiopharmaceutical uptake. Later on, synthetic routes and chemical purifications have been developed allowing the creation of the proposed chemical structure. Each new DADT derivative has been synthesized and analyzed in terms of elemental analysis, infrared and NMR spectra, in order to confirm its proposed chemical structure. Then, the new derivative has been labeled with {sup 99m}Tc, radiochemically purified, intravenously injected in Swiss mice, allowing its biodistribution to evidence its brain transport and uptake. The rational planning studies have been re-evaluated after each biodistribution had been performed, to see what kind of molecular descriptor was responsible for causing a stronger optimization in the brain perfusion characteristics and then, new DADT derivatives have been prepared. Three new DADT derivatives have been

  15. Comparative uptake of Tc-99m sestamibi and Tc-99m tetrofosmin in cancer cells and tissue expressing P-Glycoprotein or multidrug resistance associated protein

    99mTc-sestamibi(MIBI) and 99mTc-tetrofosmin have been used as substrates for P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP), which are closely associated with multidrug resistance of the tumors. To understand different handling of radiotracers in cancer cell lines expressing Pgp and MRP, we compared cellular uptakes of 99mTc-MIBI and 99mTc-tetrofosmin. The effects of cyclosporin A (CsA), well-known multidrug resistant reversing agent, on the uptake of both tracers were also compared. HCT15/CL02 human colorectal cancer cells for Pgp expressing cells, and human non-small cell lung cancer A549 cells for MRP expressing cells, were used for in vitro and in vivo studies. RT-PCR, western blot analysis and immunohistochemistry were used for detection of Pgp and MRP. MDR-reversal effect with CsA was evaluated at different drug concentrations after incubation with MIBI or tetrofosmin. Radioactivities of supernatant and pellet were measured with gamma well counter. Tumoral uptake of the tracers were measured from tumor bearing nude mice treated with or without CsA. RT-PCR, western blot analysis of the cells and immunochemical staining revealed selective expression of Pgp and MRP for HCT15/CL02 and A549 cells, respectively. There were no significant difference in cellular uptakes of both tracers in HCT15/CL02 cells, but MIBI uptake was slightly higher than that of tetrofosmin in A549 cells. Co-incubation with CsA resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Uptake of MIBI or tetrofosmin in HCT15/CL02 cells was increased by 10-and 2.4-fold, and by 7.5 and 6.3-fold in A549 cells, respectively. Percentage increase of MIBI was higher than that of tetrofosmin with CsA for both cells (ρ < 0.05). In vivo biodistribution study showed that MIBI (114% at 10 min, 257% at 60 min, 396% at 24C min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively increased by the time, up to 240 min with CsA. But

  16. Comparative uptake of Tc-99m sestamibi and Tc-99m tetrofosmin in cancer cells and tissue expressing P-Glycoprotein or multidrug resistance associated protein

    Cho, Jung Ah; Lee, Jae Tae; Yoo, Jung Ah [School of Medicine, Kyungpook National University, Daegu (Korea, Republic of)] (and others)

    2005-02-15

    {sup 99m}Tc-sestamibi(MIBI) and {sup 99m}Tc-tetrofosmin have been used as substrates for P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP), which are closely associated with multidrug resistance of the tumors. To understand different handling of radiotracers in cancer cell lines expressing Pgp and MRP, we compared cellular uptakes of {sup 99m}Tc-MIBI and {sup 99m}Tc-tetrofosmin. The effects of cyclosporin A (CsA), well-known multidrug resistant reversing agent, on the uptake of both tracers were also compared. HCT15/CL02 human colorectal cancer cells for Pgp expressing cells, and human non-small cell lung cancer A549 cells for MRP expressing cells, were used for in vitro and in vivo studies. RT-PCR, western blot analysis and immunohistochemistry were used for detection of Pgp and MRP. MDR-reversal effect with CsA was evaluated at different drug concentrations after incubation with MIBI or tetrofosmin. Radioactivities of supernatant and pellet were measured with gamma well counter. Tumoral uptake of the tracers were measured from tumor bearing nude mice treated with or without CsA. RT-PCR, western blot analysis of the cells and immunochemical staining revealed selective expression of Pgp and MRP for HCT15/CL02 and A549 cells, respectively. There were no significant difference in cellular uptakes of both tracers in HCT15/CL02 cells, but MIBI uptake was slightly higher than that of tetrofosmin in A549 cells. Co-incubation with CsA resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Uptake of MIBI or tetrofosmin in HCT15/CL02 cells was increased by 10-and 2.4-fold, and by 7.5 and 6.3-fold in A549 cells, respectively. Percentage increase of MIBI was higher than that of tetrofosmin with CsA for both cells ({rho} < 0.05). In vivo biodistribution study showed that MIBI (114% at 10 min, 257% at 60 min, 396% at 24C min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively increased by the time, up to

  17. Usefulness of {sup 99m}Tc-methoxy-isobutyl-isonitrile scintigraphy for preoperative localization of adenoma in primary hyperparathyroidism

    Yamaguchi, Seiji; Kobayashi, Yoshiyuki; Tsujikawa, Kozo [Ikeda Municipal Hospital, Osaka (Japan)] (and others)

    2001-09-01

    We evaluated the usefulness of {sup 99m}Tc-methoxy-isobutyl-isonitrile (MIBI) dual phase scintigraphy for detecting hyperfunctioning parathyroid adenoma. We retrospectively reviewed 18 hyperparathyroid patients who received MIBI prior to neck exploration and compared the radiological findings of MIBI with ultrasonography (US) and magnetic resonance imaging (MRI). Fifteen patients were studied with MRI, and 17 patients were examined with US. All patients were found to have a solitary parathyroid adenoma histopathologically. MIBI correctly revealed the location of 17 adenomas among 18 confirmed tumors. In our series, there was one false-positive case that was found to have thyroid adenoma. The diagnostic sensitivity of MIBI MRI and US and 94.4%, 80% and 52.5%, respectively. The positive predictive value (PPV) was 94.4% for MIBI, 81.8% for MRI and 92.3% for US. We conclude that MIBI is useful and accurate for the preoperative localization of adenoma in primary hyperparathyroidism. (author)

  18. Usefulness of 99mTc-methoxy-isobutyl-isonitrile scintigraphy for preoperative localization of adenoma in primary hyperparathyroidism

    We evaluated the usefulness of 99mTc-methoxy-isobutyl-isonitrile (MIBI) dual phase scintigraphy for detecting hyperfunctioning parathyroid adenoma. We retrospectively reviewed 18 hyperparathyroid patients who received MIBI prior to neck exploration and compared the radiological findings of MIBI with ultrasonography (US) and magnetic resonance imaging (MRI). Fifteen patients were studied with MRI, and 17 patients were examined with US. All patients were found to have a solitary parathyroid adenoma histopathologically. MIBI correctly revealed the location of 17 adenomas among 18 confirmed tumors. In our series, there was one false-positive case that was found to have thyroid adenoma. The diagnostic sensitivity of MIBI MRI and US and 94.4%, 80% and 52.5%, respectively. The positive predictive value (PPV) was 94.4% for MIBI, 81.8% for MRI and 92.3% for US. We conclude that MIBI is useful and accurate for the preoperative localization of adenoma in primary hyperparathyroidism. (author)

  19. Technetium-99m ceftizoxime kit preparation

    Simone Odília Fernandes Diniz

    2005-10-01

    -99m Ceftizoxima (99mTc-CFT, com estabilidade e atividade biológica preservadas, capaz de identificar um foco séptico (E.coli em um modelo experimental de infecção em ratos. A preparação do kit de CFT baseou-se em uma mistura de soluções contendo o antibiótico ceftizoxima (2,5mg/mL e o agente redutor ditionito de sódio (6,0mg/mL que foram submetidos a um processo de liofilização. Após a liofilização, o kit foi reconstituído with 1,0 mL de solução de pertecnetato de sódio (Na99mTcO4 -, contendo uma atividade de 370 MBq. Em seguida, a solução foi incubada, por 10 min, em banho fervente (1000C e, posteriormente, foi resfriada em água corrente por 5 min. A eficiência de marcação foi da ordem de 92% permanecendo estável por 6 horas e o kit permaneceu estável por 2 meses. A atividade biológica do 99mTc-CFT foi avaliada por difusão em ágar impregnado com E.coli e S. aureus. Foram utilizados 07 ratos Wistar, pesando entre 200 a 250 g, para o desenvolvimento do foco séptico. Após 24 horas da indução do foco infeccioso (E.coli, os animais foram anestesiados e 0,1 mL da 99mTc-CFT (37 MBq foi injetado na veia da cauda dos animais. As imagens de 1, 2 e 6 horas após a injeção foram adquiridas em uma gama câmara e as regiões de interesse (ROIS foram calculadas. Os valores obtidos dos diâmetros dos halos de inibição para 99mTc-CFT foram 27,16±0,23 e 27,17±0,20 para S. aureus e E.coli, respectivamente, sendo que para CFT não marcada foram 30,4±0,33 e 29,43±0,26, respectivamente. Os resultados obtidos da biodistribuição da 99mTc-CFT nos animais com focos infecciosos mostraram uma relação alvo/não alvo de 1,97±0,31, 2,10±0,42 e 2,01±0,42 para os tempos de 1, 2 e 6 horas, respectivamente. As imagens obtidas mostraram nítida captação do antibiótico marcado (99mTc-CFT pelo foco infeccioso ao longo do experimento. Os resultados obtidos neste trabalho atestam a viabilidade de produção de um kit da ceftizoxima marcada com 99m tecn

  20. Postreperfusion myocardial technetium-99m-sestamibi defect corresponds to area at risk

    Poulsen, Runa Hyldgaard, E-mail: runa.poulsen@ki.au.dk [Clinical Institute, Aarhus University, DK-8000 Aarhus C (Denmark); Botker, Hans Erik [Department of Cardiology, Aarhus University Hospital, Skejby (Denmark); Rehling, Michael [Department of Nuclear Medicine, Aarhus University Hospital, Skejby (Denmark)

    2011-08-15

    Introduction: Technetium-99m-sestamibi (MIBI) is the most frequently used myocardial perfusion tracer in patients with ischemic heart disease. In patients with acute ST-elevation myocardial infarction, we previously found that the defect in myocardial MIBI uptake was the same in patients injected with MIBI before primary angioplasty and in patients injected immediately after successful treatment. Thus, reperfusion may not be followed by increased uptake of MIBI. Instead, the MIBI defect after reperfusion may reflect the area at risk (AAR) defined by MIBI injected before treatment. We intended to investigate whether myocardial imaging with MIBI administered after reperfusion reflects myocardial perfusion or rather the ischemic AAR. Methods: In 12 pigs, left anterior descending coronary artery was totally occluded for 45 min with an angioplasty balloon. After a 2-h reperfusion, MIBI was injected intravenously, and {sup 153}Gd-microspheres were injected in left atrium. AAR and infarct size (IS) were determined by histochemical staining. MIBI and microsphere distribution were evaluated by counting the sliced left ventricle on a gamma camera. Defects were defined as uptake less than 45% of maximum uptake. Results: The mean{+-}S.D. defect size as a fraction of left ventricle was for MIBI 21%{+-}5.5%, AAR 25%{+-}6.3%, IS 13%{+-}3.9% and microspheres defect size 7.3%{+-}5.5%. MIBI defect size overestimated IS (P=.0005) and microspheres defect size (P=.0001), but it was not significantly different from AAR (P=.30). Conclusion: In a porcine model of myocardial infarction after 45 min of ischemia, MIBI administered 120 min after reperfusion delineates AAR.

  1. Evaluation of patients with rheumatoid arthritis by Tc-99m MlBl imaging

    We investigated whether Tc-99m MlBl imaging is useful to predict the response of drug treatment in patients with rheumatoid arthritis. 24 patients (15 women and 9 men, age 49±12 year) rheumatoid arthritis and treated with disease modifying antirheumatic drugs (DMARDs) were included in this study. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured, and Tc-99m MIBI scan was obtained before drug treatment. Quantitative analysis of uptake in diseased joints was performed and expressed as joint-to background ratio (J/B) and percent retention (%R) of Tc-99m MIBI. Clinical symptoms were evaluated and graded from 0 (no) to 3 (severe) regarding to presence of tenderness and swelling. J/B of the diseased joints were significantly correlated with ESR and CRP (p<0.05). A highly significant correlation was found between the improvement of clinical symptoms and %R of Tc-99m MIBI (p<0.05). The results demonstrate that Tc-99m MIBI scan may be used to predict the therapeutic response in patients with rheumatoid arthritis

  2. Development of MIBI kit for heart imaging

    99mTc-isonitriles have been shown to be a very promising substitute for Thallium-201 (201TI) for myocardial perfusion imaging. In this study, the lyophilized kit of Methoxyisobutylisonitrile (MIBI) was prepared and labeled with 99mTc. Several factors affecting the labeling yield such as the kit's stannous content, boiling time during labeling, and the volume of 99mTc used during reconstitution were also investigated. The radiochemical purity (RCP) determination of the labeled product was analyzed by HPLC, solvent-extraction, TLC and ITLC-SG chromatographic methods in various systems. Animal biodistribution study performed in rats indicated the 99mTc-MIBI accumulation in the myocardial is up to 3 hours with little or no redistribution. Toxicity studies performed indicate no clinical signs of abnormality in mice at injected dose equivalent in amount of 100 times the human dose in proportion to body weight. Stability studies of the labeled complex performed at room temperature showed no change in radiochemical purity (> 95%) 6 hours post-preparation. Compatibility and comparative studies were done using both MINT and commercially available MIBI kits and 99mTc generator eluates. From the results obtained the MINT produced MIBI kits were found to be comparable in quality to that of commercials. (author)

  3. Comparison of the accumulation and efflux kinetics of technetium-99m sestamibi and technetium-99m tetrofosmin in an MRP-expressing tumour cell line

    The potential clinical use of technetium-99m labeled sestamibi (Tc-MIBI) and tetrofosmin (Tc-Tfos) to image tumours is currently being evaluated. In this study, the accumulation and efflux of Tc-MIBI and Tc-Tfos in the nasopharyngeal carcinoma cell line CNE-1 were examined in the presence or absence of various inhibitors of P-glycoprotein (PGP) and/or multidrug resistance associated protein (MRP) activity [GG918, PSC833, verapamil (Vrp), cyclosporin A (CsA) and buthionine sulfoximine (BSO)]. Reverse-transcriptase polymerase chain reaction analysis and immunodetection of the CNE-1 cells detected expression of MRP, MRP1 and MRP2 but not PGP. Tc-MIBI and Tc-Tfos accumulation was increased (P2 times greater than for Tc-MIBI). However, no qualitative differences in inhibitors were seen between Tc-MIBI and Tc-Tfos. These results suggest that both Tc-MIBI and Tc-Tfos are substrates for the MRP transporter and that PSC833, Vrp, CsA and BSO but not GG918 can inhibit MRP activity. These results indicate that Tc-MIBI and Tc-Tfos may be suitable imaging agents for detecting MRP-mediated drug resistance in human cancers. (orig.)

  4. Estudos in vitro e in vivo de análogo da timidina marcada com complexo organometálico de tecnécio-99m para potencial uso em diagnóstico tumoral Studies in vitro and in vivo of thymidine analog labeled with organometalic complex of technetium-99m for potential use in tumor diagnosis

    Rodrigo Luis Silva Ribeiro Santos

    2008-03-01

    Full Text Available Análogos da timidina têm sido marcados com diferentes radioisótopos devido ao seu potencial em monitorar a proliferação incontrolável de células. Considerando que o radioisótopo tecnécio-99m ainda mantém uma posição privilegiada devido às suas propriedades químicas e nucleares, este trabalho constituiu-se no desenvolvimento da marcação da timidina com o 99mTc, mediante o emprego de compostos organometálicos. Os objetivos principais foram a síntese do precursor carbonil-tecnécio-99m, marcação da timidina com este precursor, estudo da estabilidade, e avaliações radioquímicas e biológicas com animais sadios e portadores de tumor. A síntese do precursor organometálico e a marcação da timidina com este precursor foi realizada com > 97% e > 94% de pureza radioquímica, respectivamente, obtendo-se também uma boa estabilidade em até 6 h em temperatura ambiente. A transquelação frente aos aminoácidos cisteína e histidina apresentou perdas entre 8 e 11% para concentrações de até 300 mM. Os ensaios de biodistribuição em camundongos sadios indicaram que o complexo radiomarcado apresentou um rápido depuramento sangüíneo e baixa captação nos demais órgãos, com predominância de excreção da droga pelo sistema urinário e hepatobiliar. A captação tumoral foi de 0,28 e 0,18 %DI/g para tumor de pulmão e mama, respectivamente. Os resultados obtidos sugerem maiores investigações em outros análogos da timidina.Thymidine analogs have been labeled with different radioisotopes due to their potential in monitoring the uncontrollable cell proliferation. Considering that the radioisotope technetium-99m still keeps a privileged position as a marker due to its chemical and nuclear properties, this work was designed to develop a new technique of labeling of thymidine analog with 99mTc, by means of the organometallic compounds. The aims of this research were: synthesis of the organometallic precursor technetium-99m

  5. Bone marrow uptake of 99mTc-sestamibi in patients with multiple myeloma and related gammopathies

    Aim: The aim of this study was to assess the diagnostic value of 99mTc-sestamibi (MIBI) in the detection on bone marrow involvement in patients suffering from multiple myeloma (MM) or monoclonal gammopathy of undefined significance. 99mTc-Sestamibi is routinely used in the diagnostic approach of several neoplastic diseases and a MIBI scan was recently proposed as a diagnostic tool for staging and monitoring the therapy in multiple myeloma. Materials and methods: 68 pts with MM and 82 pts with monoclonal gammopathy of undetermined significance (MGUS) were enrolled in this study. Forty nine out sixty eight MM pts had active disease (AD), 11/68 were in complete remission (CR) and 8/68 in partial remission (PR) after chemotherapy. Diagnosis of the disease was made according to standard criteria (Greipp, 1992). The clinical status at time of the scan was assessed by complete clinical and biochemical evaluations including full blood counts, renal and liver function tests, protein electrophoresis and evaluation of monoclonal component, serum Ig concentration, CRP, 2-microglobulin, urinary light chain and bone marrow biopsy. In all the pts a whole-body scans were obtained 10 min after the i.v. injection of 740 MBq of 99mTc-MIBI in anterior and posterior view. All the scans were scored semi quantitatively according to extension and intensity of tracer uptake (Pace, 1998). Results: 81 out 82 MGUS pts had a negative 99mTc-MIBI scan. One MGUS patient showed a mild diffuse pathologic uptake in bone marrow of the thighs. As to the MM pts, 54/68 pts (47 with AD, 8 with PR and 1 with CR) had a positive 99mTc-MIBI scan, while the 99mTc-MIBI scan was negative in 14/68 pts (10 with CR, 2 with PR and 2 with AD). The radioactivity ratios of the more evident bone marrow involvement or soft tissue uptake to a contralateral normal tissue (T/N) were calculated in AD patients(T/N=2.06 0.5). The overall sensitivity of the 99m Tc-MIBI scintigraphy was 92% while specificity was 95% in overall

  6. Tc-99m tetrofosmin in breast cancer comparative study with Tc-99m sestamibi: early washout of Tc-99m tetrofosmin for assessment of MDR gene 1 expression

    The usefulness of TF for detection of breast cancer was investigated and compared with Tc-99m Sestamibi(MIBI). We performed scintimammography(SM) in a total of 55 patients with breast tumors, 28 patients underwent MIBI SM other 27 patients underwent TF SM. Sensitivity, specificity, and accuracy values obtained with MIBI and TF SM for breast cancer were 73.7%, 58.9%, 83.9% and 70.6%, 61.1% and 83.3%, respectively. Also we investigated whether early imaging with TF may be used for evaluating Pgp status in breast cancer patients. Fifteen patients with breast cancer were evaluated. Tumor/background ratio(T/Bg) and washout rates(WR) were calculated, which were compared with the amount of Pgp staining in tumour cells. The average WR were 0.35±0.09. The WR demostrated significant correlation with the amount of Pgp expression (rho=0.73, p<0.01). TF was effective in detecting breast cancer. TF washout at 1hr showed good correlation with the amount of Pgp. Thus 1hr delay imaging with TF may suffice for evaluating Pgp status in breast cancer patients

  7. A comparative study of technetium-99m sestamibi and technetium-99m tetrofosmin single-photon tomography in the detection of nasopharyngeal carcinoma

    The intention of this prospective study was to compare the diagnostic potential of technetium-99m sestamibi (MIBI) and a novel radiotracer, 99mTc-Tetrofosmin (Tetro), for the assessment of primary nasopharyngeal carcinoma (NPC) and the differentiation of residual disease from post-therapy changes. A total of 38 patients underwent MIBI and Tetro single-photon emission tomography (SPET) imaging at initial presentation (n=22) or following therapy (n=16). The findings were correlated with computed tomography or magnetic resonance imaging (MRI) on a site-by-site basis. Tumour/background (Tm/Bkg) ratios were obtained on coronal sections. Biopsy (nine patients) and/or 12- to 24-month clinical follow-up data were available in the post-therapy group. All primary disease sites were accurately detected by both imaging studies. Although there was no statistical difference between the two imaging techniques in the detection of primary disease, MIBI was superior to Tetro in the detection of regional lymph node metastases (sensitivity: 95% vs 79%). Tetro and MIBI SPET were true-positive in all patients (n=7) with proven residual/recurrent disease. In nine patients who had no evidence of residual/recurrent tumour, MRI was false-positive in five while Tetro and MIBI SPET were false-positive in two and three patients, respectively. Tm/Bkg ratios were ≤1.7 in all false-positive cases except one. Tetro, MIBI and MRI had specificities of 78%, 67% and 44%, and accuracies of 87.5%, 81% and 69%, respectively. The results of Tetro and of MIBI SPET were not statistically different from one another with regard to the prediction of residual/recurrent or metastatic NPC. (orig.). With 3 figs., 4 tabs

  8. MIBI: preparation and evaluation of lyophilization kits

    The lyophilization kits of MIBI- 99m Tc were obtained by its own synthesis. The quality control showing the high stability of kits was mentioned. the bio-distribution, evaluated in dogs, was identical to that presented by the radiopharmaceutical with the import kit. The obtained results, allowing the prepare of lyophilization kits for medical use were also presented. (C.G.C.)

  9. Profile of MIBI Liquid Phase Radiopharmaceutical for Myocardial Imaging

    I. Daruwati

    2016-04-01

    Full Text Available The 99mTc-MIBI radiopharmaceutical has been used innuclear medicine in Indonesia for myocardial imaging. BATAN researchers have mastered the technology to manufacture MIBI as a liophylized kit. A reformulation of MIBI radiopharmaceutical has been conducted to improve the stability of the kit especially in the liquid-phase kit. Basically, radiopharmaceuticals in liquid form are not different from the dry kit. However in the manufacturing of liquid-phase kit, lyophilization process was not done. To improve the stability of liquid kit, a reformulation of the components was conducted by using two separate vials (Formulation 2 and the characteristics were compared with the one-vial formulation (Formulation 1.The MIBI Formulation 2 consists of two vials, vial A containing 0.06 mg of SnCl2 2H2O and 2.6 mg Sodium Citrate 2H2O and vial B containing 0.5 mg of [Cu(MIBI4]BF4, 1 mg of cysteine hydrochloride, and 20 mg of mannitol.The purposes of this study wereto determine the stability of two different formulations of MIBI as a liquid-phase kit, to compare theirstability in different storage condition such as in refrigerator and freezer, and to compare the ratio of activities attained between target and nontargetorgans after injection to animal model. As a diagnostic agent, MIBI was reconstituted with Technetium-99m as radionuclide tracer to 99mTc-MIBI labeled compound. The radiochemical purity of 99mTc-MIBI was determined by chromatography method using alumina thin-layer chromatography paper as the stationary phase and ethanol 95% as the mobile phase. The results showed MIBI Formulation 2 has a higher stability than Formulation 1. Formulation 2 also maintaineda 96.68%radiochemical purity under 52-day storage and attainedatarget-to-nontarget activity ratio of 8.22.

  10. Tc-99m imaging agents

    A wide range of pharmaceuticals for labeling with Tc-99m, developed by the Soreq Radiopharmaceuticals Department, is described. Details of the production and quality control of 13 kits are given, as well as the range of results required for consistently high quality imaging agents

  11. 99mTc-sestamibi to monitor treatment with antisense oligodeoxynucleotide complementary to MRP mRNA in human breast cancer cells

    Technetium-99m sestamibi (MIBI) has been utilized to evaluate multi-drug resistance (MDR) phenomenon of malignant tumors and to predict chemotherapeutic effects on them. The current investigation examined the possibility of monitoring changes with respect to mRNA expression of multi-drug resistance associated protein (MRP) following antisense oligodeoxynucleotide (AS-ODN) treatment involving 99mTc-MIBI. The human breast cancer MCF-7 cell line and its MDR-induced MCF-7/VP cell line were employed. Cell suspensions of the two cell lines at 1 x 104 cells/ml were inoculated in 24-well plates (0.2 ml/well) and incubated for one day. Antisense (AS) 20-mer phosphorothioate ODN complementary to the coding region of MRP mRNA and its sense (S) ODN were administered at final concentrations up to 25 μM, followed by a 5-day incubation. 99mTc-MIBI solution was added to each well and incubated for 30 min. Cellular 99mTc-MIBI uptake was corrected for protein concentration. MRP mRNA expression levels were analyzed via the reverse transcription polymerase chain reaction (RT-PCR). Cellular uptake of 99mTc-MIBI in MCF-7/VP cells was only 15% of that of MCF-7 cells. Following AS-ODN treatment at 25 μM for five days, 99mTc-MIBI uptake in MCF-7/VP cells increased 2.4-fold in comparison with non-treated control cells. 99mTc-MIBI uptake in MCF-7 cells was unaffected by AS-ODN administration. Sense ODN did not alter uptake in either cell line. RT-PCR confirmed reduction of MRP mRNA in MCF-7/VP cells following AS-ODN treatment. Effects of AS-ODN administration on MRP function can be monitored via assessment of cellular uptake of 99mTc-MIBI. (author)

  12. Washout of [99mTc] sestamibi in predicting response to chemotherapy in patients with multiple myeloma

    Aim. Technetium-99m 2-methoxy-isobutyl-isonitrile ([99mTc] MIBI) has been successfully used to study patients with multiple myeloma (MM). This tracer is also a substrate for P-glycoprotein (Pgp). Since Pgp overexpression is one of the primary mechanisms of multidrug resistance in MM, the aim of this study was to test whether [99mTc] MIBI could be an index of Pgp overexpression and function in MM and therefore predicts response to chemotherapy. Methods. Forty patients with MM (12 in stage 1., 15 in stage 2., and 13 in stage 3.) showing diffuse bone marrow [99mTc] MIBI uptake were included in the study. All patients underwent whole body scintigraphy at 10 and 60 minutes after i.v. injection of 555 MBq of [99mTc] MIBI. [99mTc] MIBI washout was measured, after decay correction, as: (10 minute counts/pixel minus 60 minute counts/ pixel) divided by 10 minute counts/ pixel, computed on a region of interest drawn on the thoracic spine (posterior projection), taking care of avoiding heart and splancnic organs. Disease restaging was performed at a mean time of 32±20 months, and patients were considered to be in remission (complete or partial) or to show disease progression on the basis of a complete clinical and hematological evaluation. Results. Patients showing disease progression at restaging (n=26) had higher washout (19.3:±9.8 % vs 12.8±6.9%, p99mTc] MIBI. No differences in therapeutic regimen and stage of disease at admission were found between the 2 groups. When patients treated with melphalan were excluded tram the analysis, 87.5% of patients in remission had low washout

  13. Technetium-99m methoxyisobutylisonitrile imaging for parathyroid adenoma: relationship to P-glycoprotein or multidrug resistance-related protein expression

    Gland size has been reported to have a major influence on localisation of parathyroid adenomas by technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) imaging. It has also been suggested that P-glycoprotein (Pgp) expression in parathyroid adenomas may influence localisation because false negative studies have been reported with large tumours and true positives with very small tumours. Therefore, the purpose of this study was to retrospectively evaluate the relationship between 99mTc-MIBI parathyroid imaging results and Pgp or multidrug resistance-related protein (MRP) expression in parathyroid adenomas. Before surgery, 47 patients with large parathyroid adenomas (larger than 1.5 g) underwent early and delayed parathyroid imaging, 10 min and 2 h after intravenous injection of 99mTc-MIBI. Immunohistochemical analyses (IHA) were performed, using multiple non-consecutive sections of the operative specimens, to detect Pgp or MRP expression. According to the results of IHA, the 34 parathyroid adenomas were separated into four groups: (1) three adenomas positive for both Pgp and MRP expression, (2) one adenoma positive for Pgp but negative for MRP expression, (3) four adenomas negative for Pgp but positive for MRP expression and (4) 39 adenomas with negative for both Pgp and MRP expression. All 39 adenomas in group 4 could be detected by 99mTc-MIBI parathyroid imaging. None of the eight adenomas in groups 1-3 could be detected by 99mTc-MIBI parathyroid imaging (P99mTc-MIBI imaging in localising parathyroid adenomas preoperatively. (orig.)

  14. Hypoxia-induced alteration of tracer accumulation in cultured cancer cells and xenografts in mice: implications for pre-therapeutic prediction of treatment outcomes with 99mTc-sestamibi, 201Tl chloride and 99mTc-HL91

    Weak visualization of tumours in pre-therapeutic scintigrams with technetium-99m sestamibi (MIBI) is likely a predictive sign of unfavourable tumour response to radiotherapy and chemotherapy. However, factors relating to this scintigraphic finding are not well understood. The presence of hypoxic tumour cells is one of the major reasons for therapeutic failure; consequently, we attempted to determine whether oxygenation status affects 99mTc-MIBI accumulation in tumour cells. LS180 human colon cancer and T24 human bladder cancer cells were incubated in air or N2 gas at 37 C. Cellular uptake of 99mTc-MIBI was subsequently determined at 15, 60 and 120 min. Uptake of thallium-201 chloride was also assessed. Uptake of 99mTc-HL91 was assessed as a hypoxic marker. Accumulation of the tracers in LS180 xenografts was observed in mice treated with 5 mg/kg hydralazine and compared with that in untreated mice. pO2 in the medium and tumours was measured with O2 microelectrodes. N2 gas flow gradually reduced pO2 in the cell suspension to 1-2 mmHg in 60 min. Cellular uptake of 99mTc-MIBI in LS180 cells decreased by approximately 30% in N2 gas in comparison to that in air throughout the study. Hypoxia had a more prominent influence on 201Tl uptake, which displayed a reduction of approximately 60% in N2 gas at 120 min, than on 99mTc-MIBI uptake. On the other hand, N2 gas induced an increase of 170% in 99mTc-HL91 uptake at 120 min, indicating the hypoxic condition of cells. The results of in vitro assays employing the T24 cell line were similar to those obtained with the LS180 cell line. Hydralazine treatment markedly reduced 99mTc-MIBI and 201Tl accumulation in LS180 xenografts; moreover, intratumoural pO2 decreased from 14.5±6.6 mmHg to 7.6±6.2 mmHg. 99mTc-HL91 accumulation in xenografts was markedly increased by hydralazine. In conclusion, hypoxia reduced accumulation of 99mTc-MIBI and 201Tl in tumour cells. Accordingly, hypoxia may be an important factor in terms of the

  15. Comparison of the accumulation and efflux kinetics of technetium-99m sestamibi and technetium-99m tetrofosmin in an MRP-expressing tumour cell line

    Utsunomiya, K.; Su, Z.-F.; Ichise, M. [Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Ont. (Canada); Ballinger, J.R. [Nuclear Medicine, Addenbrooke' s Hospital, Cambridge University, Cambridge (United Kingdom); Piquette-Miller, M.; Tang, W. [Faculty of Pharmacy, University of Toronto, 19 Russell Street, Toronto, ON (Canada); Rauth, A.M. [Division of Experimental Therapeutics, Princess Margaret Hospital, Ontario Cancer Institute, ON (Canada)

    2000-12-01

    The potential clinical use of technetium-99m labeled sestamibi (Tc-MIBI) and tetrofosmin (Tc-Tfos) to image tumours is currently being evaluated. In this study, the accumulation and efflux of Tc-MIBI and Tc-Tfos in the nasopharyngeal carcinoma cell line CNE-1 were examined in the presence or absence of various inhibitors of P-glycoprotein (PGP) and/or multidrug resistance associated protein (MRP) activity [GG918, PSC833, verapamil (Vrp), cyclosporin A (CsA) and buthionine sulfoximine (BSO)]. Reverse-transcriptase polymerase chain reaction analysis and immunodetection of the CNE-1 cells detected expression of MRP, MRP1 and MRP2 but not PGP. Tc-MIBI and Tc-Tfos accumulation was increased (P<0.0001) and efflux decreased (P<0.05) in the presence of BSO, CsA, Vrp and PSC833 but not GG918, which is a specific inhibitor of PGP. The absolute accumulation of Tc-MIBI was approximately twofold higher than that seen with Tc-Tfos, whereas the addition of inhibitors caused a much greater suppression of Tc-Tfos transport (>2 times greater than for Tc-MIBI). However, no qualitative differences in inhibitors were seen between Tc-MIBI and Tc-Tfos. These results suggest that both Tc-MIBI and Tc-Tfos are substrates for the MRP transporter and that PSC833, Vrp, CsA and BSO but not GG918 can inhibit MRP activity. These results indicate that Tc-MIBI and Tc-Tfos may be suitable imaging agents for detecting MRP-mediated drug resistance in human cancers. (orig.)

  16. Technetium-99m methoxyisobutylisonitrile localizes an ectopic ACTH-producing tumour: case report and review of the literature

    Jacobsson, H. (Dept. of Diagnostic Radiology, Karolinska Hospital, Stockholm (Sweden)); Wallin, G. (Dept. of Surgery, Karolinska Hospital, Stockholm (Sweden)); Werner, S. (Dept. of Endocrinology and Diabetology, Karolinska Hospital, Stockholm (Sweden)); Larsson, S.A. (Dept. of Hospital Physics, Karolinska Hospital, Stockholm (Sweden))

    1994-06-01

    Extensive investigation including whole-body examinations with computed tomography and magnetic resonance imaging did not detect the suspected ectopic ACTH-producing tumour in a patient with advanced Cushing's syndrome and hypokalemic alkalosis. Gamma camera examination with technetium-99m methoxyisobutylisonitrile (MIBI) depicted the tumour, which was localized in the anterior neck and mediastinum. This was later verified by surgery. [sup 99m]Tc-MIBI is normally used for myocardial scintigraphy. Its accumulation is unspecific and merely reflects metabolic activity. Despite this, the present case shows that examination with this agent can provide important information with regard to tumour localization in a given situation, thereby serving as a complement to other imaging modalities. The current literature on [sup 99m]Tc-MIBI for tumour diagnosis is reviewed. (orig.)

  17. The role of Tc-99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer

    Multidrug resistance (MDR) is a major problem in lung cancer. Tc-99m methoxyisobutyl isonitrile (MIBI) has been demonstrated to be a non-invasive marker to diagnose MDR1 related P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) expression in various solid tumors. The aim of this study was to evaluate the relationship between the degree of Tc-99m MIBI uptake and its retention on delayed images and the response to chemotherapy in lung cancer. Twenty-three patients (1 woman and 22 men, age range 40-67 years) with lung cancer (9 small cell and 14 non-small cell) were examined with Tc-99m MIBI imaging before chemotherapy. After i.v. administration of 740 MBq Tc-99m MIBI, planar and SPECT imaging at 30 minutes and 2 hours was performed. Tumor to normal lung uptake ratio (T/N) and percent retention were measured. Response to chemotherapy was evaluated according to follow-up CT and grouped as complete responders (CR), partial responders (PR) and non-responders (NR). Clinical follow-up and CT evaluation revealed that 12 patients had partial remission, 4 patients had complete remission and 7 patients had no-remission after chemotherapy. Statistically, there was no significant correlation between early (30 min), delayed (2 hr) T/N ratios and percent retention of Tc-99m MIBI with chemotherapeutic response of the lung cancer among the three groups (p>0.05). Results of the current study imply that Tc-99m MIBI uptake and the retention index may not correlate with chemotherapy response in lung cancer, so that the accuracy of this method needs to be verified in a larger series with additional investigation at the molecular level. (author)

  18. The role of Tc-99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer

    Dirlik, A.; Burak, Z.; Goksel, T.; Erinc, R.; Karakus, H.; Ozcan, Z.; Veral, A.; Ozhan, M. [Ege Universitesi, Izmir (Turkey). Medical Faculty

    2002-04-01

    Multidrug resistance (MDR) is a major problem in lung cancer. Tc-99m methoxyisobutyl isonitrile (MIBI) has been demonstrated to be a non-invasive marker to diagnose MDR1 related P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) expression in various solid tumors. The aim of this study was to evaluate the relationship between the degree of Tc-99m MIBI uptake and its retention on delayed images and the response to chemotherapy in lung cancer. Twenty-three patients (1 woman and 22 men, age range 40-67 years) with lung cancer (9 small cell and 14 non-small cell) were examined with Tc-99m MIBI imaging before chemotherapy. After i.v. administration of 740 MBq Tc-99m MIBI, planar and SPECT imaging at 30 minutes and 2 hours was performed. Tumor to normal lung uptake ratio (T/N) and percent retention were measured. Response to chemotherapy was evaluated according to follow-up CT and grouped as complete responders (CR), partial responders (PR) and non-responders (NR). Clinical follow-up and CT evaluation revealed that 12 patients had partial remission, 4 patients had complete remission and 7 patients had no-remission after chemotherapy. Statistically, there was no significant correlation between early (30 min), delayed (2 hr) T/N ratios and percent retention of Tc-99m MIBI with chemotherapeutic response of the lung cancer among the three groups (p>0.05). Results of the current study imply that Tc-99m MIBI uptake and the retention index may not correlate with chemotherapy response in lung cancer, so that the accuracy of this method needs to be verified in a larger series with additional investigation at the molecular level. (author)

  19. Comparison of the uptakes of {sup 99m}Tc-sestamibi and {sup 99m}Tc-tetrofosmin in cancer cell lines expressing multidrug resistance

    Yoo, Jeong Ah; Chung, Shin Young; Seo, Myeng Rang; Kwak, Dong Suk; Ahm, Byeong Cheol; Lee, Kyu Bo; Lee, Jae Tae [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

    2003-06-01

    Cellular uptakes of {sup 99m}Tc-sestamibi(MIBI) and {sup 99m}Tc-tetrofosmin into cancer cell lines expressing multidrug resistance(MDR) were investigated and compared. The effects of verapamil and cyclosporin A, well-known multidrug resistant reversing agents, on cellular uptakes of both tracers were also compared. Doxorubicin-resistant HCT15/CL02 human colorectal cell and doxorubicin-resistant K562(Adr) and vincristin-resistant K562(Vcr) human leukemic cells were studied. RT-PCR analysis was used for the detection of mdr1 mRNA expression. MDR-reversal effects with verapamil and cyclosporine A were evaluated at different drug concentrations after incubation with MIBI and tetrofosimin for 1, 15, 30, 45 and 60 min, using single-cell suspensions at 1x10{sup 6} cells/ml incubated at 37 .deg. C. Radioactivity in supernatants and pellets were measured with gamma well counter. The cellular uptakes of MIBI and tetrofosmin in K562(Adr) and K562(Vcr) were lower than those of parental K562 cell. In HCT15/CL02 cells ad K562(Adr) cells, there were no significant difference in cellular uptakes of both tracers, but cellular uptake of MIBI was higher than that of tetrofosmin in K562(Vcr) cells. Coincubation with verapamil resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Verapamil increased cellular uptakes of MIBI and tetrofosmin by HCT15/LC02 cell by 11.9- and 6.8-fold, by K562(Adr) cell by 14.3- and 8-fold and by K562(Vcr) cell by 7- and 5.7-fold in maximum, respectively. Cyclosporin A increased cellular uptakes of MIBI and tetrofosmin by HCT15/CL02 cell by 10- and 2.4-fold, by K562(Adr) cell by 44- and 13-fold and by K562(Vcr) cell by 18.8- and 11.8-fold in maximum, respectively. Taking together, MIBI and tetrofosmin are considered as suitable radiopharmaceuticals for detecting multidrug resistance. However, MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators. Since cellular uptakes of both tracers might

  20. The Relationship Between Technetium-99m-Methoxyisobutyl Isonitrile Parathyroid Scintigraphy and Hormonal and Biochemical Markers in Suspicion of Primary Hyperparathyroidism

    Güler Silov

    2013-04-01

    Full Text Available Objective: Technetium-99m-methoxyisobutyl isonitrile (Tc-99m MIBI has been widely used to evaluate hyperfunctioning autonomous parathyroid glands in patients with elevated intact parathyroid hormone (iPTH and/or calcium (Ca level. The aim of this study was to evaluate the relationship between Tc-99m MIBI parathyroid scintigraphy and hormonal and biochemical markers in suspicion of primary hyperparathyroidism (PHPT. Material and Methods: Dual-phase Tc-99m MIBI parathyroid scintigraphy and total serum iPTH, Ca, phosphorus (P and albumin measurements were performed in 60 patients (52 females, 8 males; mean age, 59.38±12.51 years; range, 34 to 86 years with suspicion of PHPT. Results: The iPTH median level was 160.3 pg/mL (47.8 to 782.6. Thirty-five of the patients had surgical resection of hyperfunctioning parathyroid glands. Of the 35 patients, parathyroid gland pathology was detected in 30 patients using scintigraphic examination. Tc-99m MIBI parathyroid scintigraphy was negative in 30 patients. The iPTH, Ca and P levels were significantly different between in the Tc-99m MIBI positive group and the negative group, respectively: For iPTH, 202.1 (47.8-782.6 pg/mL versus 111.6 (80.1-373 pg/mL; p0.05. Tc-99m MIBI parathyroid scintigraphy showed good correlation with iPTH level and histopathological diagnosis. Sensitivity and specificity was found 83.3% and 76.7%, respectively at the level of iPTH>147.7pg/mL. Conclusion: Tc-99m MIBI parathyroid scintigraphy is most likely to produce identification and localization of a parathyroid adenoma when both iPTH and Ca are elevated as well as decreased P levels.

  1. MIBI-SPECT in hypofunctioning thyroid nodules for detection of thyroid carcinoma; MIBI-SPECT bei kalten Knoten zur Schilddruesenkarzinomdetektion

    Schmidt, M.; Schicha, H. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    The clinical usefulness of Tc-99m-MIBI in hypofunctioning thyroid nodules for detection of thyroid carcinoma is presented. Tc-99m-MIBI is a lipophilic cation and a non-specific radiopharmaceutical for tumour imaging. It has become an important imaging technique for the assessment of hypofunctioning thyroid nodules because of its high negative predictive value excluding malignant thyroid tumours. After injection of Tc-99m-MIBI either a single-phase protocol with late planar and SPECT images about 1-2 h post injection or a double-phase protocol with early (about 15-30 min p.i.) and late images (about 2 h p.i.) were reported. Findings include a reduced, an isointense or an increased Tc-99m-MIBI accumulation in the thyroid nodule in comparison to the paranodular thyroid tissue and in comparison to pertechnetate thyroid scintigraphy. A 'Match' between pertechnetate and Tc-99m-MIBI scintigraphy is a concordantly decreased uptake in the thyroid nodule in comparison to the normal thyroid gland. This finding has a negative predictive value of >97% to exclude differentiated thyroid cancer. A definite 'Mismatch' means a cold thyroid nodule on pertechnetate scintigraphy and an increased uptake of Tc-99m-MIBI in comparison to the MIBI-uptake of the paranodular thyroid tissue. The positive predictive value of this finding for malignancy varies between studies and is in the range of <10-65% (Cologne data: 19%) depending on the prevalence of malignant thyroid tumours in the patient population studied. An isointense uptake was not associated with thyroid malignancy according to 'Cologne' data. Further studies are desirable for better characterization of the method. (orig.)

  2. Biodistribution dosimetric study of radiopharmaceutical {sup 99mT}c Ixolaris in mice for melanoma diagnosis by molecular image and translational model for human beings; Estudo dosimetrico da biodistribuicao do radiofarmaco Ixolaris-{sup 99m}Tc em camundongos para diagnostico de melanoma atraves de imagem molecular e modelo translacional para humanos

    Soriano, Sarah Canuto Silva

    2015-07-01

    The labeling of Ixolaris with {sup 99m}Tc was developed by Barboza et.al. (2013) aiming its use primarily in glioblastoma and after in melanoma diagnosis, a less common but very aggressive cancer and with high mortality rate. Preliminary tests on animals have proven its effectiveness of labeling but a dosimetric study to human clinical trials should be performed. This study aimed to: (1) determine the biokinetic model for the radiotracer {sup 99m}Tc-Ixolaris in mice by imaging dosimetry method; and (2) estimate the absorbed and effective dose resulting from the use of a new radiopharmaceutical for melanoma and metastases diagnosis in human beings, since a dosimetric study of new radiopharmaceuticals in animals is necessary to test them subsequently in humans and apply for registration in ANVISA. According to SPECT images, was found a latency period of 15 to 21 days for the development of lung metastasis in mice. Three C57BL6 mice, one control animal, and two animals with induced cell line B16-F10 murine melanoma were tested. The {sup 99m}Tc-Ixolaris radiopharmaceutical was administered intravenously in a caudal vein, and SPECT images were acquired 0.5 h, 1.5 h, 2.5 h, 3.5 h and 24 h post-administration for analysis and biodistribution quantification. The biokinetic model was determined and thus, obtained cumulative activity in order to estimate the absorbed dose in each organ. The mass and metabolic differences between mice and humans were considered and used to extrapolate the data acquired at different scales. Based on dose factors provided by the software MIRDOSE and Olinda (S factor), absorbed doses in irradiated target organs were calculated for the source organs, and finally the effective dose was estimated. The results indicate that for diagnostic exams conducted in human melanoma patients by administering approximately 25.7 MBq the estimated effective dose was 4.3 mSv. Comparing with effective doses obtained in other diagnostic techniques with {sup 99m

  3. Technetium-99m-hexakis-2-methoxyisobutylisonitrile scintigraphy and multidrug resistance-related protein expression in human primary lung cancer

    The occurrence of multidrug resistance (MDR) is a major cause of resistance to chemotherapeutic agents in patients with lung cancer, in part owing to the overexpression of MDR-related proteins. Technetium-99m-hexakis-2-methoxyisobutylisonitrile (99mTc-MIBI) has been shown to be a substrate for some MDR-related proteins. The aim of this study is to evaluate the role of 99mTc-MIBI scintigraphy for functional imaging of MDR-related protein phenotypes. To determine the correlation between 99mTc-MIBI scintigraphy and the expression level of P-glycoprotein (Pgp), multidrug-resistance protein (MRP), and glutathione-S-transferase Pi (GSTπ), 26 patients (17 men and 9 women, median age 57.5 years) with primary lung cancer were investigated. Following intravenous administration of 925 MBq 99mTc-MIBI, single-photon emission computed tomography (SPECT) and computed tomography (CT) were performed at 15 min and 2 h. On the basis of the fused images, tumor to background (T/B) ratio of both early and delayed images, and washout rate (WR%) of 99mTc-MIBI were calculated. The immunohistochemical staining of Pgp, MRP, and GSTπ was performed, and the expression level was semiquantitated using a pathoimage analysis system. The imaging results were compared with the status of Pgp, MRP, and GSTπ expression. The WR% of 99mTc-MIBI showed a significant positive correlation with Pgp expression (r=0.560, P=0.003), as no correlation was observed between WR% and MRP or GSTπ (r=0.354, P=0.076; r=0.324, P=0.106). Neither early T/B nor delayed T/B correlated with the expression level of Pgp, MRP, and GSTπ. WR%, Pgp, and GSTπ expression showed significant differences between squamous cell carcinoma (group A) and adenocarcinoma (group B). There was no significant difference among Pgp, MRP, and GSTπ expression levels in any cases (P>0.05). Our data confirmed that 99mTc-MIBI scintigraphy is useful for determining the MDR caused by Pgp in patients with primary lung cancer. (author)

  4. Synthesis of the d,I-HM-PAO and formulation of nucleo-equipment for the obtention of {sup 99m} Tc-(d,I)-HM-PAO; Sintesis del d,I-HM-PAO y formulacion de nucleo-equipos para la obtencion de {sup 99m} Tc-(d,I)-HM-PAO

    Lezama C, J.; Ferro F, G.; Alcazar A, P

    1991-09-15

    Most brain imaging radiopharmaceuticals are conventional hydrophilic compounds that are excluded from entering the normal brain by an intact blood-brain barrier (BBB). Under pathologic conditions, the barrier is disrupted and radiotracer concentrates in the leisure for positive identification. {sup 99m} Tc- hexa methyl propylene amine oxime ({sup 99} {sup m} Tc-HM-PAO) is a newer-type lipophilic agent that enter the normal brain through an intact BBB. Studies with this agent offer the promise of measuring cerebral perfusion in the normal and diseased brain. In this paper we present the synthesis and Tc-99m labelling of d,I-HM-PAO. The synthesis of the ligand was carried out by condensation of two molecular equivalents of butanedione monoxime with one molecular equivalent of 1,3 propanediamine provided a bis imine intermediate, which was reduced with sodium borohydride to get the meso and d,I diastereoisomers of HM-PAO. Separation of these was achieved by fractional crystallization. {sup 99m} Tc-(d,I)HM-PAO was obtained by stannous ion reduction of Mo-99/Tc-99m generator eluate in the presence of the ligand. Complex radiochemical purity was determined by instant thin layer chromatography and paper chromatography. Finally, we obtained {sup 99m} Tc-(d,I)HM-PAO with a high radiochemical yield, in excess of 90%. However, for subsequent clinical studies the preparation has to be done a few minutes before application because our product has a low stability. (Author)

  5. Dosimetric contribution of organs of biokinetics of {sup 99m}Tc and {sup 123}I to estimate radiation doses in thyroids of children of 1 and 5 years; Contribucion dosimetrica de organos de la biocinetica del {sup 99m}Tc y {sup 123}I para estimar dosis en tiroides de ninos de 1 y 5 anos

    Vasquez, M.V.; Castillo, C.E.; Abanto, D.M.; Rocha, D.; Garcia, W.H.; Marin, K., E-mail: marvva@hotmail.com [Universidad Nacional de Trujillo (UNT), Trujillo (Peru); Quispe, R. [Centro de Ciencias Aplicadas y Desarrollo Tecnologico, UNAM, Mexico (Mexico)

    2015-07-01

    The absorbed doses by thyroids during uptake studies through biokinetics of radiopharmaceuticals containing {sup 123}I (iodine) or {sup 99m}Tc (pertechnetate) are estimated. Using the MIRD scheme and the representation of Cristy-Eckerman for thyroids in children of 1 and 5 years, the objective of the study was to determine whether the dosimetric biokinetic contributions of the organs of {sup 123}I (iodide) and {sup 99m}Tc (pertechnetate) biokinetic are significant in the estimated of the absorbed dose for thyroid uptake studies.

  6. Lyophilized kits of diamino dithiol compounds for labelling with {sup 99m}-technetium. Pharmacokinetics studies and distribution compartmental models of the related complexes; Conjuntos de reativos liofilizados de compostos diaminoditiolicos para marcacao com tecnecio-99m. Estudo farmacocinetico e elaboracao de modelos compartimentalizados dos respectivos complexos

    Araujo, Elaine Bortoleti de

    1995-07-01

    The present work reflects the clinical interest for labelling diamino dithiol compounds with technetium-99m. Both chosen compounds, L,L-Ethylene dicysteine (L,L-EC) and L,L-Ethylene dicysteine diethyl esther (L,L-ECD) were obtained with relative good yield and characterized by IR and NMR. The study of labelling conditions with technetium-99m showed the influence of the type and mass of reducing agent as well as the pH on the formation of complexes with desired biological characteristics. Radiochemical purity was determined by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). Lyophilised kits of L,L-EC and L,L-ECD for labelling with {sup 99m}Tc were obtained, with stability superior to 120 days, when stored under refrigeration, enabling the kits marketing. The ideal formulation of the kits as well as the use of liquid nitrogen in the freezing process, determined the lyophilization success. Distribution biological studies of the {sup 99m}Tc complexes were performed on mice by invasive method and on bigger animals by scintigraphic evaluation. Biological distribution studies of the complex {sup 99m}Tc-L,L-EC showed fast blood clearance, with the elimination of about 90% of the administered dose after 60 minutes, almost exclusively by the urinary system. The biological distribution results were adjusted to a three compartmental distribution model, as expected for a radiopharmaceutical designed to renal dynamic studies, with tubular elimination. The complex interaction with renal tubular receptors is related with structural characteristics of the compound, more specifically with the presence and location of polar groups. In comparison with {sup 99m}Tc-L,L-EC, biological studies of the complex {sup 99m}Tc -L,L-ECD showed different distribution aspects, despite some structural similarities. The presence of ethyl groups confers to the complex neutrality and lipophilicity. It cross the intact blood brain barrier and is retained in the brain

  7. Preparation and bulk production of 99mTc-sestamibi with new formulation

    Full text: Technetium 99m-hexakis-2-methoxy-isobutyl-isonitril (Sestamibi or MIBI) was developed as a myocardial perfusion imaging agent. It was subsequently used as a tumour imaging agent for lung, mammary, thyroid, parathyroid and brain tumours and lymphoma because it accumulates in tumour cells. 99mTc-sestamibi is a number of a chemical family referred to as isonitril. This radiopharmaceutical is a monovalent cation in which 99mTc is surrounded by six isonitril ligands. Regarding to climate in our country, sometimes we had some problems with current sestamibi kit formulation in nuclear medicine centers as low radiolabeling efficiency, so we try to introduce new formulation for this kit respect to our climate. In this new formulation, we changed some materials and decrease the amount of MIBI to half. After preparation of this formulation kit, as lyophilized, following quality control has been done: radiochemical purity, stability at room temperature, biodistribution in mice, determination of shelf life and sterility, pyrogenicity tests. Also, this kit has been sent to hospitals for clinical applications. Radiolabeling efficiency was more than 95 percent with up to 200 mCi of 99mTcO4-. This complex was stable at 6 hrs at room temperature. Biodistribution data in mice showed that 1.36 ± 0.11 percent of injected dose accumulated in heart after 30 min. The shelf life of lyophilized cold kit was more than one year. Clinical application had reasonable scan and during this period, there isn't any unfavorable reports. Our results showed that this kit is a suitable radiopharmaceutical for heart perfusion imaging. The study demonstrated that our formulation with half amount of MIBI regarding to current MIBI kit, has capacity for complexation of 200 mCi of pertechnetate, even one year after production of kit. (author)

  8. Background {sup 99m}Tc-methoxyisobutylisonitrile uptake of breast-specific gamma imaging in relation to background parenchymal enhancement in magnetic resonance imaging

    Yoon, Hai-Jeon; Kim, Bom Sahn [Ewha Womans University, Department of Nuclear Medicine, Yangchun-Ku, Seoul (Korea, Republic of); Kim, Yemi [Ewha Womans University, Clinical Research Institute and Department of Conservative Dentistry, Seoul (Korea, Republic of); Lee, Jee Eun [Ewha Womans University, Department of Radiology, Seoul (Korea, Republic of)

    2015-01-15

    This study investigated factors that could affect background uptake of {sup 99m}Tc- methoxyisobutylisonitrile (MIBI) on normal breast by breast-specific gamma imaging (BSGI). In addition, the impact of background {sup 99m}Tc-MIBI uptake on the diagnostic performance of BSGI was further investigated. One hundred forty-five women with unilateral breast cancer who underwent BSGI, MRI, and mammography were retrospectively enrolled. Background uptake on BSGI was evaluated qualitatively and quantitatively. Patients were classified into non-dense and dense breast groups according to mammographic breast density. Background parenchymal enhancement (BPE) was rated according to BI-RADS classification. The relationship of age, menopausal status, mammographic breast density, and BPE with background {sup 99m}Tc-MIBI uptake was analyzed. Heterogeneous texture and high background uptake ratio on BSGI were significantly correlated with younger age (p < 0.001, respectively), premenopausal status (p < 0.001 and p = 0.003), dense breast (p < 0.001, respectively), and marked BPE (p < 0.001, respectively). On multivariate analysis, only BPE remained a significant factor for background MIBI uptake (p < 0.001).There was a significant reduction in positive predictive value (p = 0.024 and p = 0.002) as background MIBI uptake and BPE grade increased. BPE on MRI was the most important factor for background MIBI uptake on BSGI. High background MIBI uptake or marked BPE can diminish the diagnostic performance of BSGI. (orig.)

  9. Ressonância magnética vs cintilografia com pirofosfato marcado com tecnécio-99m para a detecção de necrose miocárdica perioperatória Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis

    Guilherme Urpia Monte

    2008-08-01

    Full Text Available FUNDAMENTO: O infarto do miocárdio perioperatório (IMPO é uma complicação da cirurgia de revascularização miocárdica (CRM com potencial impacto prognóstico. A cintilografia miocárdica (CM com pirofosfato marcado com tecnécio-99m é utilizada no diagnóstico de IMPO, mas demonstra limitada sensibilidade para lesões subendocárdicas. A ressonância magnética cardiovascular (RMC, por sua vez, detém alta acurácia para a detecção de necrose miocárdica. OBJETIVO: Comparar a RMC e a CM para a detecção de IMPO após CRM. MÉTODOS: Foram estudados 24 pacientes portadores de doença arterial coronária crônica, com a técnica de realce tardio pela RMC e com a CM, antes e depois da CRM, analisando-se o surgimento de áreas de necrose miocárdica perioperatória (IMPO. Mensuraram-se também marcadores bioquímicos de lesão miocárdica (CKMB e troponina I, antes e depois da cirurgia. RESULTADOS: Dezenove pacientes completaram o estudo. Desses, 6 (32% apresentaram IMPO à RMC, e 4 (21% à CM (p = NS. Dos 323 segmentos do ventrículo esquerdo avaliados, 17 (5,3% exibiram necrose perioperatória à RMC, e 7 (2,2% à CM (p = 0,013. Observou-se moderada concordância entre os métodos (kappa = 0,46, havendo divergência, quanto ao diagnóstico de IMPO, em 4 (21% casos, a maioria com pequenas áreas de necrose perioperatória à RMC, não visualizadas à CM. Em todos os casos com IMPO à RMC, houve elevação significativa de CKMB e troponina I. CONCLUSÃO: Houve moderada concordância diagnóstica entre os métodos para a detecção de IMPO, mas a RMC permitiu a visualização de pequenas áreas de necrose miocárdica perioperatória, não identificadas pela CM e associadas à elevação de marcadores bioquímicos de lesão miocárdica.BACKGROUND: Perioperative myocardial infarction (POMI is a complication of coronary artery bypass grafting (CABG with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS is

  10. Technetium-99m nitrido radiopharmaceuticals with unprecedented biological properties

    Adriano Duatti

    2002-09-01

    Full Text Available The chemical methods for the production of technetium-99m radiopharmaceuticals containing a terminal TcºN triple bond have been established more than a decade ago. From that time, the chemistry of nitrido Tc-99m complexes has provided a highly efficient tool for the design and preparation of novel classes of diagnostic agents, and a number of potentially useful radiopharmaceuticals have been discovered. In particular, nitrido technetium-99m tracers have been developed for heart perfusion imaging. In this short review, the chemical and biological properties of the neutral myocardial perfusion tracer bis(N-ethoxy, N-ethyl-dithiocarbamato nitrido Tc-99m (TcN-NOEt will be summarized along with the preparation and preliminary biological evaluation of the first class of monocationic nitrido technetium-99m radiopharmaceuticals exhibiting improved biodistribution properties closer to those expected for an ideal perfusion imaging agent.Os métodos químicos para produção de radiofármacos marcados com tecnécio-99m contendo a ligação tripla terminal TcºN foram estabelecidos há mais de uma década. Desde esta época, a química dos complexos nitridos marcados com 99mTc tem sido uma ferramenta altamente eficiente para o desenho e preparo de novas classes de agentes para diagnóstico e, foi descoberto um número de radiofarmacos potencialmente úteis. Nesta pequena revisão, as propriedades biológicas e químicas do traçador para perfusão miocárdica neutra, o bis(N-etoxi, N-etil-ditiocarbamato nitrido 99mTc (TcN-NOEt, serão resumidas junto com o preparo e avaliação biológica preliminar da primeira classe de radiofármacos nitrido monocatiônico marcado com tecnécio-99m que exibe melhores propriedades em relação à biodistribuição, mais próximas daquelas esperadas para um agente perfusor ideal para imagens.

  11. Reduction of 99mTc-sestamibi and 99mTc-tetrofosmin uptake in MRP-expressing breast cancer cells under hypoxic conditions is independent of MRP function

    Hypoxia reduces the uptake of technetium-99m sestamibi (MIBI) in human cancer cell lines. In the current investigation, we attempted to identify the relationship between hypoxia-induced alteration of 99mTc-MIBI accumulation and expression of multi-drug resistance-associated protein (MRP) in the MCF7/WT breast cancer cell line and its subclonal cell line, MCF7/VP, which expresses high levels of MRP1. A second cationic compound, 99mTc-tetrofosmin (TF), was also examined. Cellular uptake of 99mTc-MIBI and 99mTc-TF was significantly higher in parental MCF7/WT cells than in MCF7/VP cells. Hypoxic conditions generated with a mixture of 95% N2 and 5% CO2 reduced cellular uptake of the two tracers in both parental MCF7/WT cells and MRP1-expressing MCF7/VP cells. Cell binding assay with iodine-125-labelled anti-MRP1 antibody demonstrated its specific binding to MCF7/VP cells. Hypoxia did not affect the amount of antibody bound to MCF7/VP cells. These results indicate that hypoxia-induced reduction of tracer uptake in tumour cells is a phenomenon independent of MRP function. (orig.)

  12. Optimization of the production process of a lyophilized formulation for radiopharmaceutical obtaining {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2}; Optimizacion del proceso de fabricacion de una formulacion liofilizada para la obtencion del radiofarmaco {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2}

    Sanchez R, S.

    2013-07-01

    In this work was optimized the production process of a lyophilized pharmaceutical formulation for the preparation of radiopharmaceutical {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2}, the union specifies to the integrin s α{sub v}β{sub 3} was demonstrated to be used in the nuclear medicine cabinets in the obtaining of scan images for the opportune detection of breast cancer. The good lyophilized pharmaceutical formulation for the preparation of radiopharmaceutical {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2} was established like: HYNIC-E-[c(RGDfK)]{sub 2} - 25 μg; Stannous chloride (SnCl{sub 2}) 20 μg; Ethylenediamine diacetic acid (EDDA) 10 mg; N-tris(hydroxymethyl)methyl glycin (Tricine) 20 mg; Mannitol 50 mg. The results of radiochemical purity of the sterile formulation and free of bacterial endotoxins for the three validation lots prepared under protocols of good manufacturing practices were 97.62 ± 1.48%, 96.54 ± 1.89%, and 97.66 ± 0.57%, for what the production procedure complies the predefined specifications. The radiopharmaceutical {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]2 prepared from the lyophilized pharmaceutical formulation showed to be stable during a period 24 hours, for what can be used in the centers of molecular nuclear medicine. Images in vivo were obtained of the integrin s over-expression α{sub v}β{sub 3} from the radiopharmaceutical {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]2 obtained of the lyophilized and optimized pharmaceutical formulation. The lyophilized pharmaceutical formulation (HYNIC-RGD-Sn) showed stability during 12 months, due to this factor, is requested before the COFEPRIS the radiopharmaceutical expiration for this same period (accession number 123300401A0155). (Author)

  13. Preparation of the radiopharmaceutical {sup 99m} Tc-HYNIC-cyclo-Lys-D-Phe-RGD for In vivo image of integrines; Preparacion del radiofarmaco {sup 99m} Tc-HYNIC-ciclo-Lys-D-Phe-RGD para imagen In vivo de integrinas

    Hernandez H, E. [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)

    2007-07-01

    The diagnostic of some pathological processes by means of images constitutes one of the used methods in the determination of the origin, condition and/or evolution of one illness. The use of contrast agents in conjunction with other techniques help to the obtaining and visualization of complex systems, among these we can find to those radiopharmaceuticals used in nuclear medicine to visualize diverse organs and corporal systems. At the moment it is sought to develop a radiopharmaceutical of third generation that can be used for image In vivo of integrines with the purpose of detecting angio genesis processes, that which would allow to diagnose in way it specifies a wide range of primary tumors and their metastasis. Presently work it developed the radiopharmaceutical {sup 99m}Tc-HYNIC-cycle-Lys-D-Phe-RGD, likewise the good conditions were determined for the formation of this complex. The HYNIC was employee as chelating agent, using as co ligands EDDA and Tricine for to complete the sphere of coordination of the {sup 99m}Tc. The conjugated HYNIC-RGD was synthesized, purified, characterized and radiolabelled In situ with {sup 99m}Tc using High pressure liquid chromatography as analysis method in Reverse Phase (RP-HPLC). By this way it was developed the lyophilized formulation for its instantaneous labelled to which were carried out quality control tests. The one conjugated was obtained free of impurities, showing stability at same as their complex formed with {sup 99m}Tc. The analysis method was validated turning out to be necessary, exact, lineal and specific for the quantification of the analyte of interest. The lyophilized formulation showed a radiochemical purity bigger than 95%, besides being sterile and free of pyrogens. The biodistribution tests in athymic mice with induced tumors showed that the radiopharmaceutical was united mainly to the tumor and that this it was excreted mainly for renal via. (Author)

  14. Optimization of preparation, labelling and quality control procedures of {sup 99m}Tc-glucarate for the diagnosis of acute myocardial infarction; Otimizacao dos procedimentos de preparacao, marcacao e controle de qualidade do glucarato-{sup 99m}Tc para diagnostico do infarto agudo do miocardio

    Camargo, Ana Claudia

    2007-07-01

    Cardiovascular diseases account for the main causes of morbidity and mortality among the adult population. Despite the advances of preventive medicine, acute myocardial infarction continues to be frequent and the difficulty of the differential diagnosis is an additional cause of fatal events. Its diagnosis is based on the triad: typical chest pain, alterations in the electrocardiogram and elevation of serum cardiac enzymes. However, many patients evolve without the complete syndrome. Therefore the development of non-invasive assays for the early detection of damaged myocardium is of extreme importance. {sup 99m}Tc-glucarate is a radiopharmaceutical of great interest for application in Nuclear Medicine, because it is referred as a potential marker of necrotic tissues in the early phase of an acute coronary event. This presentation describes the optimization of preparation, lyophilization and labelling as well as quality control procedures of {sup 99m}Tc-glucarate, based on former studies published in the literature. Radiochemical purity was evaluated by the ascending paper chromatography technique. Labelling efficiency as a function respectively of time of reaction, volume and activity of {sup 99m}TcO4- was consistently higher than 97%. The lyophilized kit was stable during 12 months of storage. Biodistribution in healthy Swiss mice showed rapid blood clearance, renal excretion and low uptake by organs adjacent to the heart. Scintigraphic studies of injected Wistar rats confirmed the results of the biodistribution obtained by direct organ counting. Scintigraphies of infarcted female rats proved the sensitivity of the method. (author)

  15. Study of the viability of technetium-{sup 99m} labeling of whole antimyosin antibody and its fragment: development of radiopharmaceutical for cardiac survey; Estudo da viabilidade da marcacao com tecnecio-99m do anticorpo antimiosina integro e seu fragmento: desenvolvimento de radiofarmaco para avaliacao cardiaca

    Carvalho, Guilherme Luiz de Castro

    2007-07-01

    In the acute myocardium infarction, the myocytes cell membrane loses its integrity, allowing the influx of extracellular macromolecules such as circulating antibody into the damaged cell. The use of the specific antibodies against cardiac myosin labeled with {sup 99m}Tc allows to determine the localization and extension of myocardial infarction. The purpose of this work was to study the viability of labeling of the antimyosin monoclonal antibody and its fragment F(ab')2 with {sup 99m}Tc. Because of the high cost of antimyosin antibody, others antibodies were used to optimize the methodology and the best condition was used for antimyosin antibody. The intact antibody was cleaved by pepsin to produce F(ab'){sub 2} fragment. The F(ab'){sub 2} and the intact antibody were reduced by treatment with Dithiothreitol (DTT) and 2-Mercaptoethanol (2-ME) and labeled with {sup 99m}Tc by direct method. Different concentrations of reductant, mixing conditions and incubation times were studied. In the standard condition, incubation at molar ratio 1:1000 (antibody:reducing agent) at room temperature for 30 minutes with continuous rotation (850 rpm), 13.28 - SH groups were formed per molecule. It was studied the influence of p H, of the concentration of stannous chloride (Sn{sup 2+}) and incubation time in the labeling condition. The better radiochemical yield (90.06 +- 1.53%) was obtained using 2.5 {mu}g of Sn{sup 2+} in p H 4.5 for 60 minutes. The labeling of the fragment F(ab'){sub 2} did not present satisfactory results because of the low yield of the digestion. After purification by PD-10, the biodistribution study was performed and showed that the intact antimyosin antibody labeled with {sup 99m}Tc presented fast kinetic compatible with the biodistribution of an intact antibody labeled with {sup 99m}Tc. Scintigraphy image of the animal with myocardial infarction was obtained and compared with the image of a normal animal. The studies allow to conclude that

  16. The effect of Tc99m Sestamibi scans during acute chest pain on clinical management

    Full text: The aim of this study is to assess whether the increased sensitivity and specificity of Tc99m sestamibi scans, during acute chest pain, will lead to alteration in clinical management and potential cost saving in an Australian population. Consecutive patients who presented with acute chest pain were injected 800 MBq of Tc99m sestamibi during pain (Hot MlBI) and SPECT imaging performed 1-6 hours later. The population was those only with a 'intermediate risk' of myocardial ischaemia The patients included in patients, those in the Emergency Department, and those with a previous history of cardiac disease. 25% of patients required a second, pain free study the following day to differentiate acute ischaemia from prior infarction. A question sheet was filled out by the requesting physician prior to the study indicating the likelihood of cardiac disease and the proposed management if no 'Hot MIBI' scan was available. The treatment that the patient subsequently received was ascertained from the patient's medical record. Of the 28 patients, a prediction whether to or not to proceed to coronary angiography was made in 13 patients prior to the MIBI study being performed. Of the 13, 5 would have had coronary angiography performed. and in all 5, the decision to proceed to coronary angiography was averted by the 'Hot MIBI'. Of note, 3 patients were admitted purely because of an abnormal 'Hot MIBI'. The 'Hot MIBI' was able to reduce coronary care admissions by 83% reduce all admissions by 17%, and avert coronary angiography in 38% of patients. In this intermediate risk category patient, this translates to not only admissions saved but potential cost saving

  17. Dimer of the peptide cycle (Ar-Gly-Asp-D-Phe-Lys) radiolabeled with {sup 99m}Tc for the integrin s over-expression image: formulation, biokinetics and dosimetry; Dimero del peptido ciclo(Arg-Gly-Asp-D-Phe-Lys) radiomarcado con {sup 99m}Tc para la imagen de sobre-expresion de integrinas: formulacion, biocinetica y dosimetria

    Ortiz A, Z.

    2013-07-01

    In breast cancer, α(v)β(3) and/or α(v)β(5) integrin s are over-expressed in both endothelial and tumour cells. Radiolabeled peptides based on the RGD (Arg-Gly-Asp) sequence are radiopharmaceuticals with high affinity and selectivity for those integrin s. The RGD-dimer peptide (E-[c(RGDfK)]{sub 2}) radiolabeled with {sup 99m}Tc has been reported as a radiopharmaceutical with 10-fold higher affinity for the α(v)β(3) integrin as compared to the RGD-monomer. EDDA (Ethylenediamine-N,N-diacetic acid) is a hydrophilic molecule that may favours renal excretion when used as coligand in the {sup 99m}Tc labelling of HYNIC-peptides and can easily be formulated in a lyophilized kit. Aim: Establish a biokinetic model for {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2} prepared from lyophilized kits and evaluate the dosimetry as breast cancer imaging agent. Methods: {sup 99m}Tc labelling was performed by addition of sodium pertechnetate solution and 0.2 M phosphate buffer ph 7.0 to a lyophilized formulation containing E-[c(RGDfK)]{sub 2}, EDDA, tricine, mannitol and stannous chloride. Radiochemical purity was evaluated by reversed phase HPLC and ITLC-SG analyses. Stability studies in human serum were carried out by size-exclusion HPLC. In-vitro cell uptake was tested using breast cancer cells (MCF7, T47D and MDA-MB-231) with blocked and non-blocked receptors. Biodistribution and tumour uptake were determined in MCF7 tumour-bearing nude mice with blocked and non-blocked receptors, and images were obtained using a micro-SPECT/CT. Whole-body images from seven healthy women were acquired at 1, 3, 6 and 24 h after {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2} administration obtained with radiochemical purities of >94 %. Regions of interest (ROIs) were drawn around source organs on each time frame. Each ROI was converted to activity using the conjugate view counting method. The image sequence was used to extrapolate {sup 99m}Tc-EDDA/HYNIC-E-[c(RGDfK)]{sub 2} time-activity curves in each

  18. Technetium-99m sestamibi uptake in human breast carcinoma cell lines displaying glutathione-associated drug-resistance

    Kabasakal, L. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Oezker, K. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Hayward, M. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Akansel, G. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Griffith, O. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Isitman, A.T. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Hellman, R. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States); Collier, D. [Dept. of Nuclear Medicine and Biochemistry, Medical College of Wisconsin, Milwaukee, WI (United States)

    1996-05-01

    An in vitro study was designed to evaluate the uptake of sestamibi (MIBI) in P-glycoprotein (Pgp) and glutathione-associated (GSH) multidrug-resistant (MDR) cell lines. MIBI uptake was studied in various human breast carcinoma cell lines, i.e. in wild-type (MCF7/wt) cells, in adriamycin-resistant (MCF7/adr) cells which express Pgp and in melphalan-resistant (MCF7/mph) cells with increased levels of GSH. The effects of buthiomine sulphoximine (BSO) and verapamil on MIBI uptake were also studied in the MCF7/mph and MCF7/adr cells respectively. The cells were incubated for 1 h with a dose of 0.1 MBq thallium-201 and technetium-99m MIBI. Both BIBI and {sup 201}Tl uptakes were higher for MCF7/mph cells than for the other cells studied. The mean MIBI uptake in MCF7/adr cells was significantly lower than that in MCF7/wt cells (1.9%{+-}0.5% vs 3.1%.0.6%; P<0.01). Verapamil treatment increased the MIBI uptake in MCF7/adr cells (to 2.6%.0.3%; P<0.05). Treatment of MCF7/mph cells with BSO resulted in a significant reduction in GSH content (from 243.2{+-}81.1 nmol/mg protein to 17.6{+-}4.4 nmol/mg protein; P<0.001). However, MIBI uptake in BSO-treated and untreated MCF7/mph cells was similar (4.43%{+-}0.5% and 5.93%{+-}1.7%, respectively; P>0.1). This study suggests that the uptake of MIBI is not diminished by glutathione-associated drug resistance and that MIBI uptake in a tumour sample does not necessarly indicate that a cancer is sensitive to drugs. (orig.)

  19. Cyclotron Production of Technetium-99m

    Gagnon, Katherine M.

    Technetium-99m (99mTc) has emerged as the most widely used radionuclide in medicine and is currently obtained from a 99Mo/ 99mTc generator system. At present, there are only a handful of ageing reactors worldwide capable of producing large quantities of the parent isotope, 99Mo, and owing to the ever growing shutdown periods for maintenance and repair of these ageing reactors, the reliable supply 99mTc has been compromised in recent years. With an interest in alternative strategies for producing this key medical isotope, this thesis focuses on several technical challenges related to the direct cyclotron production of 99mTc via the 100Mo(p,2n)99mTc reaction. In addition to evaluating the 100Mo(p,2n)99mTc and 100Mo(p,x)99Mo reactions, this work presented the first experimental evaluation of the 100Mo(p,2n) 99gTc excitation function in the range of 8-18 MeV. Thick target calculations suggested that large quantities of cyclotron-produced 99mTc may be possible. For example, a 6 hr irradiation at 500 μA with an energy window of 18→10 MeV is expected to yield 1.15 TBq of 99mTc. The level of coproduced 99gTc contaminant was found to be on par with the current 99Mo/99mTc generator standard eluted with a 24 hr frequency. Highly enriched 100Mo was required as the target material for 99mTc production and a process for recycling of this expensive material is presented. An 87% recovery yield is reported, including metallic target preparation, irradiation, 99mTc extraction, molybdate isolation, and finally hydrogen reduction to the metal. Further improvements are expected with additional optimization experiments. A method for forming structurally stable metallic molybdenum targets has also been developed. These targets are capable of withstanding more than a kilowatt of beam power and the reliable production and extraction of Curie quantities of 99mTc has been demonstrated. With the end-goal of using the cyclotron-produced 99mTc clinically, the quality of the cyclotron

  20. Relationship of cell proliferation (Ki-67) to 99mTc-(V)DMSA uptake in breast cancer

    The aim of the present study was to identify the relationships between the uptake of radiotracers – namely pentavalent dimercaptosuccinic acid [(V)DMSA] and sestamibi (MIBI) – and the following parameters in primary breast cancer: steroid receptor concentrations (i.e. estrogen receptor [ER] and progesterone receptor [PR]), Ki-67 expression, tumor size, tumor grade, age, and levels of expression of p53 and c-erbB-2. In addition, by multivariate regression analysis, we further isolated those factors with independent associations with (V)DMSA and/or MIBI uptake in primary breast cancer. Thirty-four patients with histologically confirmed breast carcinoma underwent preoperative scintimammography with technetium-99m (99mTc)-(V)DMSA and/or 99mTc-MIBI in consecutive sessions 10 and 60 min after administration of 925–1110 MBq of each radiotracer. The tumor-to-background ratio was calculated and correlated with the presence of ER, PR, Ki-67, tumor size, tumor grade, p53, and c-erbB-2. ER, PR, p53, and c-erbB-2 were determined immunohistochemically. The analysis included tumor-to-background ratio of (V)DMSA and MIBI uptake as dependent and all of the other parameters as independent variables. Correlation was positive between Ki-67 and (V)DMSA (r = 0.37 at 10 min, P = 0.038; r = 0.42 at 60 min, P = 0.018) and inverse between PR and (V)DMSA uptake (r = -0.46 at 10 min, P = 0.010; r = -0.51 at 60 min, P = 0.003). Multivariate regression analysis demonstrated a positive correlation between Ki-67 and (V)DMSA at 60 min (P = 0.045). Ki-67 was not significantly correlated with MIBI uptake, whereas tumor size was positively correlated with MIBI uptake at 60 min both in univariate (r = 0.45, P = 0.027) and multivariate analysis (P = 0.024). Negative correlations were observed between (V)DMSA uptake and ER, as well as between ER/PR and MIBI uptake, but these were not significant. Ki-67 appears to represent the major independent factor affecting (V)DMSA uptake in breast cancer

  1. 99mTechnetium labelled Escherichia coli

    Samples of a culture of unlabeled Escherichia coli were incubated with different concentrations of stannous chloride for various time periods. 99mTc (26.0 MBq) was added to each preparation and the results showed a labelling yield of 98% for E. coli. Since the bacterial viability of 99mTc-E. coli and E. coli did not show any statistical differences, these results demonstrate that labelling of E. coli with 99mTc does not modify the bacterial viability, and the radiolabelled bacteria may be a good model to study bacterial translocation

  2. Tl-201 and Tc-99m-Sestamibi SPECT for brain tumor detection: Comparison using MRI coregistration

    Darcourt, J.; Itti, L.; Chang, L. [UCLA Medical Center, Torrance, CA (United States)] [and others

    1994-05-01

    Tl-201 (Tl) brain SPECT has been validated for the differential diagnosis of high versus low grade gliomas and recurrence versus radiation necrosis. We compared this technique to Tc-99m-Sestamibi (MIBI) SPECT in 9 patients (pts) with brain tumors using MRI coregistration. Pts were injected with 4 mCi of Tl and brain SPECT was performed using a dedicated brain system. This was immediately following by an injection of 20 mCi of MIBI and a brain SPECT using the same camera and with the pt in the same position. Four pts were studied for the diagnosis of radiation necrosis vs. tumor recurrence (2 had biopsy proven recurrence); 5 pts were studied for primary tumor evaluation: 2 meningiomas, 1 oligodendroglioma, 1 low-grade astrocytoma, 1 cysticercosis. Coregistration was performed for every pt by 3D surface fitting of the inner skull MIBI contour to the MRI brain surface extracted automatically. ROIs were drawn on the MRI and applied to the coregistered MIBI and Tl images for tumor to non-tumor ratios T/NT calculations. There was a tight correlation between MIBI and Tl T/NT (r-0.96) and a 1.5 threshold separated radiation necrosis from recurrence and low from high grade primary tumors. Therefore, the data already available on Tl brain tumor imaging can be used with MIBI SPECT with the advantage of a better image quality (2.5 to 4 times more counts).

  3. Dosimetric evaluation in organs of the Tc{sup 99m}, I{sup 123} bio-kinetics to estimate dose in thyroid children 1 and 5 years; Evaluacion dosimetrica en organos de la biocinetica del Tc{sup 99m}, I{sup 123} para estimar dosis en tiroides ninos 1 y 5 anos

    Vasquez, A. M.; Quispe, R.; Vasquez, D. J.; Rocha, M. D.; Morales, N. R.; Marin, R. K. [Universidad Nacional de Trujillo, Av. Juan Pablo II s/n, Ciudad Universitaria, Trujillo (Peru); Zelada, A. L., E-mail: marvva@hotmail.com [Universidad Cesar Vallejo, Grupo de Fisica Medica, Av. Larco s/n, Trujillo (Peru)

    2012-10-15

    Using the formalism MIRD and the representation of Cristy-Eckerman for the thyroid in children of 1 and 5 years, is demonstrated that the dosimetric contribution of the organs of I{sup 123} (iodure) bio-kinetics is not significant in the dose estimate. The total dose absorbed by the gland is its auto dose. The dosimetric contribution of the organs source of the Tc{sup 99m} (pertechnetate) bio-kinetics in the gland is significant in the dose estimate like to be ignored. The reported results for the iodure are not significantly different to the found for the Marinelli scheme (auto-dose) for thyroid represented by a sphere of 1,78 and 3,45 grams. (Author)

  4. Value of the scintigammagraphy with 99mTc-Glucoheptonate in the diagnosis of the breast cancer

    Aim: To evaluate the use of the scintigammagraphy with 99mTc-Glucoheptonate in the diagnosis of the patients with breast tumours, by means of a comparison with the scintigammagraphy with 99mTc-MIBI, the mammography, the ultrasound and the histology. Materials and Methods: Twenty-two patients from the oncology clinic were included. They had the palpable tumour and were candidates for surgical biopsy. It was carrying out two scintigammagraphy studies (the first with 740-1110 MBq of 99mTc-MIBI and the second, 3 day after the first, with 740-1110 MBq of 99mTc-Glucoheptonato) to each patient. The images were acquired with 256x256 matrix format to the 15 minutes and 1 hour after the radiopharmaceutical administration and were recording three views (lateral right, lateral left and previous) of 10 minutes each one by studies. It was also carried out the ultrasound, mammography and histopathology study to each patient. The histopathological results were considered as gold standard. Results: The histology reported 15 patients with carcinomas, one patient with phylode tumour and six patients were negative of 22 studied patients. The scintigammagraphy with 99mTc-MIBI detected 14 true positive (TP), 5 true negatives (TN), 2 false positive (FP) and 1 false negative (FN) patients with breast cancer. The sensibility, specificity and accuracy were 93.3%, 71.4% and 86.4%, respectively, the positive predictive value (PPV) was of 87.5% and the negative predictive value (NPV) was of 83.3%. The scintigammagraphy with 99mTc-Glucoheptonate detected 15 TP, 5 TN, 2 FP and 0 FN. The sensibility, specificity and accuracy were 100%, 71.4% and 90.9%, respectively, the positive predictive values (PPV) were of 88.2% and the negative predictive value (NPV) was of 100%. The mammography studies obtained a sensibility of 66.7%, specificity of 28.6% and an accuracy of 54.5%, while the ultrasound obtained 86.7% of sensibility, 28.6% of specificity and an accuracy of 68.2%. Conclusions: The specificity

  5. Technetium-99m-human fibrinogen

    Exogenous fibrinogen has been successfully labeled with /sup 99m/Tc using a modified electrolytic method. The exact labeling mechanism has not been determined. Experimental data suggest that the labeling process of /99m/Tc-fibrinogen is quite similar to that of /sup 99m/Tc-human serum albumin as reported earlier by Benjamin. Technetium-99m-fibrinogen is stable in human plasma or in 1 percent buffered human serum albumin. A binding efficiency of 76 percent has been achieved with approximately 25 percent clottable protein. The entire labeling procedure requires less than 1 hr of preparation time. This short labeling time in a closed system may allow development of a practical method for labeling autologous fibrinogen, thus eliminating the risk of hepatitis transmission. (U.S.)

  6. Predictive value of technetium-99m sestamibi in patients with multiple myeloma and potential role in the follow-up

    Pace, L.; Del Vecchio, S.; Salvatore, M. [Cattedra di Medicina Nucleare, Dipt. di Scienze Biomorfologiche e Funzionali, Univ. Federico II, Napoli (Italy); Centro C.N.R. per la Medicina Nucleare, Napoli (Italy); Catalano, L.; De Renzo, A.; Califano, C.; Rotoli, B. [Cattedra di Ematologia, Dipt. di Medicina Clinica e Sperimentale, Univ. Federico II, Napoli (Italy); Di Gennaro, F.; Sica, G.; Tedesco, N.; Borrelli, G. [Cattedra di Medicina Nucleare, Dipt. di Scienze Biomorfologiche e Funzionali, Univ. Federico II, Napoli (Italy)

    2001-03-01

    Technetium-99m 2-methoxyisobutylisonitrile ({sup 99m}Tc-MIBI or setamibi) has recently been proposed for use in the evaluation of multiple myeloma (MM). The aims of this study were to investigate its potential predictive value in patients with MM and its possible role in the follow-up. Thirty patients with MM who had undergone two {sup 99m}Tc-MIBI scintigraphic studies at least 2 months apart constituted the study group; 22 of them received chemotherapy in the interval between the two scans. The scans were classified as showing pattern N when only physiological uptake was present, pattern D when diffuse bone marrow uptake was observed, pattern F when areas of focal uptake of the tracer were evident, and pattern F+D when both D and F patterns were observed. Comparative {sup 99m}Tc-MIBI scintigraphy was considered indicative of disease progression when there was a worsening of the pattern (i.e. from N to D, or from N or D to F or to F+D) or an increase in the pattern D semiquantitative score. It was considered indicative of disease improvement when the opposite trend was observed; otherwise, it was considered to document a stable condition. A significant association was observed between the baseline scintigraphic pattern and clinical status at follow-up in the group of patients evaluated after chemotherapy ({chi}{sup 2}=16.7, P<0.05). A negative baseline {sup 99m}Tc-MIBI scintigram showed a high predictive accuracy (100%) for remission, while the presence of pattern F or F+D was often associated with a less favourable outcome. A multivariate analysis showed that {sup 99m}Tc-MIBI uptake pattern has an added value in relation to known prognostic variables such as C-reactive protein. {sup 99m}Tc-MIBI scintigraphy patterns at follow-up were significantly associated with the clinical status evaluated after chemotherapy ({chi}{sup 2}=32.6, P<0.0001). Considering pattern N as indicating remission, pattern D stable condition, and pattern F or F+D progressive disease, a high

  7. Usefulness of 99mTc-Sestamibi whole body scan in the follow-up of differentiated thyroid cancer

    Although radioiodine is and had been the more common used radioisotope in the follow-up of differentiated thyroid cancer (DTC), other radioisotopes, such as 99mTc sestamibi (MIBI), had been incorporated as auxiliary methods. Our objective was to assess the diagnostic usefulness of MIBI in the long term follow-up of DTC. Thirty-two patients (26 (81%) female), mean age 45 ± 12.6 years, 2 with follicular carcinoma, and 30 with papillary carcinoma, were prospectively studied with MIBI. Mean time of follow-up from thyroidectomy to MIBI was 4.6 ± 4.9 years. (range, 7 months to 22 years). Sensitivity (Sens), specificity (Spec), positive predictive value (PPV), negative predictive value (NPV), and accuracy (A) was evaluated. We assessed agreement for MIBI and 131I, by means of percent agreement and Cohen's kappa (k) statistic. The gold standard method to indicate persistent disease was serum thyroglobulin (Tg) measurement by ICMA, with cut-off level of = 2 ng/ml 'off T4', and > 0.2 ng/ml 'on T4'. In 3 patients with positive anti-Tg antibodies, 131I scan and other auxiliary methods (Ultrasound, CT scan) were considered as gold standard. For MIBI the values of Sens, Spec, PPV, NPP, and A were 29% (26-32), 93% (89-96), 83% (74-91), 53% (51-55), and 59% (57-61), respectively. For 131I were 31% (27-34), 100% (96-100), 100% (90-100), 56% (53-58), and 63% (61-65), respectively. The percent agreement between both radiopharmaceuticals was 76.6%, and k was 0.2 (-0.19 -0.63). Similar statistical indicators for MIBI and 131I warrant the use of the former as alternative method. At the same time, a fair agreement between both radiopharmaceuticals demonstrates the additive information offered by MIBI in the follow-up of DTC. (author)

  8. Technetium-99m ceftizoxime kit preparation

    The aim of this work was to prepare a kit of 99m Tc-ceftizoxime (99m Tc-CFT), with stability and biological activity preserved, able to identify a septic focus (E. coli) in the experimental infection model in rats. The preparation of the CFT kit involved the use of lyophilized solutions containing the antibiotic ceftizoxime and the sodium dithionite reducing agent (6.0 mg/m L). After lyophilization, the kit was reconstituted with 1.0 mL of sodium 99m Tc pertechnetate solution (Na 99m Tc O4-) with an activity of 370 MBq. The solution was boiled for 10 min and filtered through a cellulose ester filter. The labeling efficiency was on the order of 92%, remaining stable for six hours and the kit remained stable for two months. The biological activity of the 99m Tc-CFT was evaluated by diffusion in agar impregnated with E.coli and S. aureus. Seven Wistar rats, weighing from 200 to 250 g, were used for the development of the septic focus. After 24 hours from the induction of the infectious site (E.coli), the animals were anesthetized and 0.1 mL of 99m Tc-CFT (37 MBq) was injected into the tail veins of the animals. The images were obtained with a gamma camera one, two and six hours after injection and the regions of interest (ROIs) were calculated. The diameters of the inhibition halos for 99m Tc-CFT were 27.16 ± 0.23 and 27.17 ± 0.20 for S.aureus and E.coli, respectively, while those for the unlabeled CFT were 30.4 ± 0.33 and 29.43 ± 0.26, respectively. The results for the biodistribution of 99m Tc-CFT in infected animals furnished a ratio of 1.97 ± 0.31, 2.10 ± 0.42 and 2.01 ± 0.42 for cpm-target/cpm-no target for the one, two and six-hour periods, respectively. The images showed a clear uptake of labeled antibiotic (99m Tc-CFT) by the infectious site during the experiment. The results attest to the viability of producing a kit with 99m technetium-labeled ceftizoxime for the investigation of infectious processes. (author)

  9. Preparation and biodistribution of 99mTc-lomefloxacin and 99mTc-ofloxacin complexes

    This paper addresses the development of two new radiopharmaceuticals for imaging sites of infection. The optimization of the labeling yield of ciprofloxacin analogous, lomefloxacin and ofloxacin, with 99mTc was described. At ph 3.5 - 5 99mTc-lomefloxacin was obtained with a high radiochemical yield of 93.6 % by adding 99mTc to 2.5 mg lomefloxacin in the presence of 50 μ SnCl2 while 99mTc ofloxacin was obtained (96.6%) by adding 99mTc to 2 mg ofloxacin in tbe presence of 50μ g SnCl2. Biodistribution studies in rats were carried out in experimentally induced infection in the left thigh using Staphylococcus aureus. Both thighs of the rats were dissected and counted' and the ratio. of bacterial infected thigh/contralateral thigh was then evaluated. 99mTc-lomefloxacin showed higher uptake (T/NT = 6.5 ± 0.5) in the infectious lesion than 99mTc-ofloxacin (T/NT = 4.3 ± 0.6) and abscess-to-muscle ratios for both preparations were higher than that of 99mTc-ciprofloxacin (T/NT = 3.8 ± 0.8), indicating that 99mTc-lomefloxacin could be used instead of 99mTc-ciprofloxacin for imaging sites of infection

  10. Transplant renography: 99m-Tc-DTPA versus 99m-Tc-MAG3

    99mTc-MAG3 (mercaptoacetyltriglycine) has been proposed as a replacement for both 131I-hippuran and 99mTc-DTPA on clinical grounds. We undertook a prospective preliminary study to ascertain whether 99mTc-MAG3 works better than 99mTc-DTPA in the follow up of renal transplant recipients. Seventeen patients (21 renograms each MAG3 and DTPA) were studied, together, with a reference group of 10 patients in whom MAG3 and Hippuran clearance rates were determined simultaneously. As expected, 99mTc-MAG3 analog images were excellent and 99mTcMAG3 clearance correlated very well with 131I-hippuran clearance (r=0.978). MAG3 values were 60% of hippuran values. However, when the corresponding renographic and perfusion findings were faced with different diagnostic challenges, such as post transplant renal failure and rejection, 99mTc MAG3 did not differ from 99mTc-DTPA in a significant way. 99mTc-DTPA was superior to 99mTc-MAG3 in one case of rejection. (orig.)

  11. Feasibility of fractionating MIBI cold kits for cost reduction

    Full text: Recently 99mTc-MIBI become the first 99mTc-labelled myocardial perfusion imaging agent commercially available in Australia. After labelling each vial is sufficient for three to four patient doses. However, it becomes very expensive when only a single patient dose is required (up to $350 per dose). Our goal in this study was to subdivide the MIBI kit into fractions to establish the stability of these split kits. If successful, this would reduce the expense and make the product more cost-effective. After dissolving the Iyophilised ingredients of a MIBI vial with 5 mL of N2-purged normal saline, 1 mL aliquots of the resultant solution were dispensed into N2-filled vials under aseptic conditions. The vials were then stored frozen at -70 deg C. 99mTc-MIBI was prepared by the addition of 2 GBq of 99mTc-pertechnetate in I mL of normal saline to the fractionated kit, followed by heating at 100 deg C for 10 minutes at 0, 2, 4 and 8 weeks post-fractionation. The product was allowed to cool before testing for radiochemical purity (RCP) for up to six hours post-labelling. The RCP of each vial was determined using aluminium oxide coated aluminium TLC strips (Merck) run in 100% ethanol. Over the eight-week evaluation period RCP was maintained at 94.2 + 1.3% over six hours (n = 16), which is greater than the minimum recommended RCP (90%) for patient use. These results show that fractionation of MIBI cold kits and sub-frozen storage under an N2 atmosphere provides a stable and economical multidose product. Using this method the cost of a single patient dose can be reduced considerably from $350, even allowing for the labour involved in the fractionation

  12. 99mTc-EDTA and 99mTc-DTPA complexes as hydrological tracers

    The [99mTc-DTPA]2- and [99mTc-EDTA]1- were evaluated as radiotracers for short time hydrological studies. Their complex stability after labelling with 9.25 GBq of 99mTc, the behaviour against pH variations, from 5 to 9, in simulated solutions and in natural river waters and the sorption of these compounds on the river sediments, were tested in laboratory experiments. Finally field double tracing experiments were carried out for each of labelling complexes and Rhodamine WT. From recovery calculations not losses of the 99mTc activity were observed. The shape of the RTD curves of the [99mTc-DTPA]2- and [99mTc-EDTA]1were quite similar to the Rhodamine Wt ones. May be concluded that both complexes behaved conservatively on the studied environmental conditions. (author)

  13. Under used technetium-99m generators

    Health care reform truly has become a global issue and it will undoubtedly have a dramatic impact on the future of nuclear medicine business in particular. A bigger concern within the nuclear medicine community is its competitiveness with other modalities and cost effectiveness.Technetium-99m and its generators are playing key role for the majority of diagnostic scans performed in the world today. Availability of ''9''9''mTc can be increased if it is separated from ''9''9Mo after much shorter growth times. After proper planning with the extra ''9''9''mTc, a significant number of scans can be performed or we would be able to order approximately 30% low activity ''9''9Tc generators to fulfill our requirements

  14. P-gp and MRP1 Expression in Parathyroid Tumors Related to Histology, Weight and Tc-99m-Sestamibi Imaging Results

    Jorna, F. H.; Hollema, H.; Hendrikse, H. N.; Bart, J.; Brouwers, A. H.; Plukker, J. T. M.

    2009-01-01

    Objective: P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP) are membrane efflux pumps that may have a role in the kinetics of Tc-99m-sestamibi (MIBI) in parathyroid tumors. P-gp and MRP1 expression in parathyroid tumors was studied and related to histology, weight and pre- and

  15. Can tumor uptake Tc-99m MDP

    Aim: To study a distribution of Tc-99m MDP in mice bearing tumor cell lines. Methods: The uptake of Tc-99m MDP was analyzed in seven human tumor cell lines (SPC-A1 adenocarcinoma of lung cancer, P37 Breast cancer, T24 Bladder cancer, SKOV2 Ovary carcinoma, Hela-229 Cervical carcinoma, Osteosarcoma, A375 Melanoma) and one mouse lung cancer cell line (Lewis). They were transplanted into 13, 4, 5, 5, 4, 5 athymic mice, 6 SCID nude mice and 4 C57 black mice, respectively. Approximately 10(7) cells of each cell line were injected subcutaneously into a right chest of mouse. After 5∼6 weeks, the Tc-99m MDP scintigraphy were determined 5-6 hours after i.v. injection of 74MBq in 0.05ml every mouse. Result: Biodistribution and tumor uptake MDP was different in the various cell types investigated. Region of interests (RIOs) placed on a small part of the tumor and horizontal copied to left chest or spine of mice in Tc-99m MDP imaging and the average count ratio (tumor to background ratio: T/B, tumor to spine ratio: T/NT) in each ROI was calculated. 13 nude mice bearing the adenocarcinoma (SPC-A1) were sacrificed and biodistribution was determined after Tc-99m MDP scintigraphy. Results were expressed as % injected dose/gram (%ID/g), mean±SD. T-ulcer=ulcer of tumor, T-round=surrounding of tumor, T-center=the center of tumor, Thor-sp=thoracic spine, Lum-ver=lumbar vertebra, LN=lymph node. Conclusions: Tumor can uptake Tc-99m MDP including adenocarcinoma. Higher uptake rate in the center tissue of tumor is than other part of tumor. It maybe connected with necrosis or fibrosis of tumor

  16. Alternative generators of 99mTc

    Full text: At the last years special attention is paid on reception and use of radiopharmaceutical preparation on the basis of 99mTc radioisotope. 99mTc is the most widely used radioisotope in nuclear medicine for today. Usually 99mTc radioisotope is received from its generator, in which as a parent radioisotope serves 99Mo. In the system, 99mTc and 99Mo radioisotopes are found in genetic balance and certain time interval, 99mTc radioisotope is separated from the system by chemical way. There are many ways of manufacturing and variants of the 99mTc generators. Nevertheless, investigators do not stop to search new methods of generator system. One of such methods can appear tube generators based on solid insoluble salts of Molybdenum with radioactive 99Mo. Such salts in our experiments were used molybdates Barium, Calcium and phosphorus molybdate Cesium. Here we present the solubility product of the specified salts: BaMoO4 - 4.10-8, Ca MoO4 - 4,7.10-9, Cs3 [P (Mo3O10)4] - 1,7.10-11. Salts of Barium and Calcium have been received by inclusion of 99Mo radioisotope into the chemical structure of salts at a stage of their synthesis by mixing solutions containing Ba+2, Ca+2 and 99MoO4-2 ions. Phosphorus molybdate Cesium has been received by mixing solutions containing Cs- and phosphorus molybdate (99Mo) - ions. The basic parameter of radioisotope generators is yield of daughter radioisotope from system. This parameter appeared to be equal to 77,6% in case of Phosphorus molybdate Cesium, 75,2% in case of molybdate Calcium and 70,8% in case of molybdate Barium. Preliminary results show that researches in this field can be continued

  17. Practical aspects of the preparation of 99mTc-labeled radiopharmaceuticals using cold kit

    This paper describes notes for preparation of radiopharmaceuticals (RP) based on the legal standard, package inserts and academic papers. The nuclide 99mTc is the most popular one among RP and labels compounds by ligand-replacement or complex-formation. Radiochemical purity of RP, particularly important for the diagnostic specificity, is practically examined by chromatography (paper, thin-layer, high-performance liquid, electrophoresis, etc). The chromatographic radioactivity is detected by autoradiography, NaI(Tl) scanner or cut-and-count procedure. The sterility and milking interval are important for preparation. Finally, 15 RP specifications are summarized: 99mTc-labeled ECD, HMPAO, MIBI, tetrofosmin, HSA, pyrophosphate, MDP, HMDP, MAA, Sn colloid, phytate, MAG3, DTPA and DMSA (2 preparations). (N.I.)

  18. 24 Hour thallium is superior to nitrate augmented rest MIBI in demonstrating the true extent of myocardial ischemia

    Full text: The aims of this study was to compare 24 hour delayed rest Tl-201 SPECT (24hr Tl) and nitrate-augmented rest Tc-99m MIBI SPECT (GTN-MIBI) in detecting viable ischemic myocardium, and to document the significance of 24hr Tl demonstrated viable myocardium where GTN-MIBI and a stress MIBI pair shows a concordant fixed perfusion defect (FD). Retrospective review of 95 consecutive patients with a FD on a rest GTN-MIBI/stress MIBI SPECT pair who then underwent 24hr Tl. The gold standard was the composite clinical endpoint (CCE) of unstable angina/myocardial infarction/cardiac death in the 6 months following the imaging study, and also the rate of coronary revascularisation. Patients who demonstrated large or moderate extent of 24hr Tl uptake in the FD were considered to have GTN-MIBI underestimated ischemia (n=65); patients who demonstrated small amount or no 24hr Tl uptake in the FD were considered to have no GTN-MIBI underestimated ischemia (n=30). GTN-MIBI underestimates the true amount of myocardial ischemia when compared to 24hr Tl. In patients with a FD on a GTN-MIBI - stress MIBI pair consideration should be given to performing a 24hr Tl in order to unmask underestimated ischemic myocardium. Where such ischemia is unmasked, it is highly clinically important and carries a statistically significant adverse cardiac prognosis. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  19. An introduction to technetium-99m generators

    The role played by technetium-99m generators in diagnostic medicine, their physical and chemical fundamentals and their main technical characteristics are discussed. This report is intended as a general introduction to a group of reports which summarize the work done on the development and production of the generators, and research on the chemical and physical aspects of the generator systems

  20. Gentc99m, computational system for the technetium-99m generator

    The technetium-99m generator is one of the main products of the PPR, as the continuity of the technetium-99m generator production is important for supporting the development of nuclear medicine. GENTC99M has been made for computational for the technetium-99m generator and includes data processing, documentation and information GENTC99M is also very useful in quality control application especially for the determinations of yield and radionuclidic impurities which consume much time. microsoft visual basic for MS-DOS and visual basic for windows have been used for making GENTC99M. Microsoft visual basic has several features that make it an ideal development language for both MS-DOS and Microsoft Windows. These features not only increase productivity, they also provide all the tools and hooks needed to develop some very sophisticated applications. for a production centre like PPR, GENTC99M is very useful to support the data processing, documentation and information system of the technetium-99m generator and it can also be modified for other products

  1. Quantitative renal function study using TC-99mDTPA and TC-99mDMSA

    In quantitative renal function studies using Tc-99m DTPA and Tc-99m DMSA, the kidney depth is an important factor to control the gamma rays' absorption by the soft tissue. However, to date, this renal depth has been estimated from the patient's height and weight according to the formula of Toennesen. In the present study, we measured the kidney depth by ultrasonography and so determined the renal uptake of Tc-99m DTPA and Tc-99m DMSA. Using the kidney depth as measured by ultrasonography, the correlation coefficient between renal uptake of Tc-99m DTPA and GFR (determined by the clearance method) was 0.878 and that between renal uptake of Tc-99m DMSA and ERPF (determined from paraaminohippuran clearance) was 0.945. On the other hand, using the kidney depth as calculated by Toenneren's formula, the correlation coefficient between Tc-99m DTPA uptake and GFR was 0.849 and that between Tc-99m DMSA uptake and ERPF was 0.891. Thus, the renal depth measured by ultrasonography provided a closer correlation than that calculated according to Toenesen's formula. (author)

  2. Imaging prostatitis with Tc-99m ciprofloxacin

    Aim: Tc-99m ciprofloxacin (Infecton) imaging was developed to discriminate infection from inflammation. It claims to show an area of viable, proliferating bacterial population that is actively using DNA gyrase, which the ciprofloxacin inhibits. The application of this imaging has been reported in patients with infected arthroplasty, soft tissue infection, pelvic inflammatory diseases, etc. Clinical evaluation with conventional urological laboratory tests often provides insufficient data in differentiating chronic bacterial prostatitis (CBP) from pelvic pain syndrome, which causes inappropriate or inadequate antibiotic therapy without definite evidence of presence or absence of bacterial infection. Therefore, we investigated the diagnostic value of the Tc-99m ciprofloxacin imaging for CBP by comparing the results of the imaging with those from the conventional tests. Materials and Methods: We custom-formulated a Tc-99m ciprofloxacin kit. We used stannous tartrate for a reducing agent in making the kit. SPECT images of the region of interest were obtained at 3 hours after injection of the radiopharmaceutical. For positive control, we imaged 2 patients: acute prostatitis and urethritis. Then the actual study included 20 subjects. We excluded from the study the patients who had received antibiotic therapy within 6 weeks. The conventional tests included CBC, urinalysis, 4-glass tests, microscopic examination of expressed prostatic secretion, bacterial culture, or PCR for chlamydia trachomatis. Kappa statistics were obtained for comparison of the two tests. Results: By conventional tests, there were 10 subjects with CBP and 10 normal subjects. The typical pattern in the Tc-99m ciprofloxacin imaging indicating CBP was the increased uptake around the prostatic urethra. Five of the 10 subjects with CBP diagnosed by conventional tests showed the increased uptake to be positive cases in the Tc-99m ciprofloxacin imaging. Of the 10 subjects diagnosed as normal by the

  3. Technetium-99m sestamibi single photon emission computed tomography findings correlated with p-glycoprotein expression, encoded by the multidrug resistance gene-1 messenger ribonucleic acid, in intracranial meningiomas

    The present study evaluated whether technetium-99m sestamibi (99mTc-MIBI) single photon emission computed tomography (SPECT) characteristics of intracranial meningioma are correlated with the histological malignancy, proliferative potential, and P-glycoprotein (Pgp) expression, encoded by the multidrug resistance gene-1 (MDR-1) messenger ribonucleic acid (mRNA). Twenty-one patients with intracranial meningiomas, including 17 benign and four nonbenign meningiomas, underwent 99mTc-MIBI SPECT imaging at 15 minutes (early) and 3 hours (delayed) after injection. The tumor-to-normal pituitary gland ratio was calculated on both early (ER) and delayed (DR) images. Retention index (RI) was calculated using the following formula: (DR-ER)/ER x 100%. Meningioma specimens were examined by immunohistochemistry using anti-Pgp and MIB-1 monoclonal antibody. MDR-1 mRNA expression was also investigated using reverse transcription-polymerase chain reaction assay. 99mTc-MIBI was highly accumulated and retained in the tumors. 99mTc-MIBI SPECT findings were not related to MIB-1 labeling index. 99mTc-MIBI SPECT RI of the Pgp-positive group (-9.12±22.27%) was significantly lower than that of the Pgp-negative group (28.79±22.80%) (p=0.0016). No significant difference was seen in ER and DR between the positive and negative groups. These results show that 99mTc-MIBI may not be useful for determining proliferative potential and histological malignancy, but could predict anticancer drug resistance related to the expression of MDR-1 mRNA and its gene product Pgp in patients with intracranial meningiomas. (author)

  4. Can tumor uptake Tc-99m MDP?

    Objective: To study the distribution of 99mTc-MDP in mice bearing tumor cell lines. Methods: The uptake of 99mTc-MDP was analyzed in seven human tumor cell lines (SPC-Al adenocarcinoma of lung cancer, Bcap-37 breast cancer, T-24 bladder cancer, SKOV3 ovary carcinoma, Hela-229 cervical carcinoma, SCI-OS osteosarcoma, SCI-375 melanoma) and one mouse lung cancer cell line (Lewis). They were transplanted into athymic mice, SCID and C57 mice, respectively. Approximately 10(6) cells of each cell line were injected subcutaneously into a right chest of mouse. After 5-6 weeks, Tc-99m MDP scintigraphy were performed 5-6 hours later after i.v. injection of 74 MBq in 0.05 ml in every mouse. Results:Biodistribution and tumor uptake of MDP was different in the various cell types investigated. Region of interests (ROIs) were placed on a small part of the tumor and a horizontal copied to left chest or spine of mice in Tc-99m MDP imaging. The average count ratio (tumor to contralateral tissue ratio: T/L, tumor to spin ratio: T/N) was calculated. Conclusions: Tumor can uptake Tc-99m MDP including adenocarcinoma. Uptake rate in the central tissue of tumor is higher than other parts of tumor. It may be connected with necrosis calcification of tumor. Tumor or acute myocardial infarction uptake of bone scanning agent may follow the sequence: anoxia-necrosis- calcium and phosphorus ions deposition

  5. Imaging recognition of inhibition of multidrug resistance in human breast cancer xenografts using 99mTc-labeled sestamibi and tetrofosmin

    Background: 99mTc-sestamibi (MIBI) and 99mTc-tetrofosmin (TF) are avid transport substrates recognized by the multidrug resistance (MDR) P-glycoprotein (Pgp). This study was designed to compare the properties of MIBI and TF in assessing the inhibition of Pgp by PSC833 in severe combined immunodeficient mice bearing MCF7 human breast tumors using SPECT imaging. Methods: Animals with drug-sensitive (MCF/WT) and drug-resistant (MCF7/AdrR) tumors were treated by PSC833 and by carrier vehicle 1 h before imaging, respectively. Dynamic images were acquired for 30 min after intravenous injection of MIBI/TF using a SPECT system, FastSPECT. The biodistribution of MIBI and TF was determined at the end of the imaging session. Results: MCF7/WT in the absence and presence of PSC833 could be visualized by MIBI and TF imaging within 5 min and remained detectable for 30 min postinjection. MCF7/AdrR could be visualized only 2-5 min without PSC833 treatment but could be detected for 30 min with PSC833, very similar to MCF7/WT. MCF7/AdrR without PSC833 showed significantly greater radioactive washout than MCF7/WT and MCF7/AdrR with PSC833 treatment. PSC833 increased the accumulation (%ID/g) in MCF7/AdrR 3.0-fold (1.62±0.15 vs. 0.55±0.05, P<.05) for TF and 1.9-fold (1.21±0.04 vs. 0.64±0.05, P<.05) for MIBI but did not affect MCF7/WT. Conclusions: The feasibility of MIBI and TF for assessment of MDR expression and inhibition was demonstrated in mice through FastSPECT imaging. The results indicate that TF may be at least comparable with MIBI in recognizing Pgp expression and modulation

  6. Imaging recognition of inhibition of multidrug resistance in human breast cancer xenografts using {sup 99m}Tc-labeled sestamibi and tetrofosmin

    Liu Zhonglin [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States)]. E-mail: zliu@radiology.arizona.edu; Stevenson, Gail D. [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States); Barrett, Harrison H. [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States); Furenlid, Lars R. [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States); Wilson, Donald W. [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States); Kastis, George A. [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States); Bettan, Michael [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States); Woolfenden, James M. [Department of Radiology University of Arizona, Tucson, AZ 85724-5067 (United States)

    2005-08-01

    Background: {sup 99m}Tc-sestamibi (MIBI) and {sup 99m}Tc-tetrofosmin (TF) are avid transport substrates recognized by the multidrug resistance (MDR) P-glycoprotein (Pgp). This study was designed to compare the properties of MIBI and TF in assessing the inhibition of Pgp by PSC833 in severe combined immunodeficient mice bearing MCF7 human breast tumors using SPECT imaging. Methods: Animals with drug-sensitive (MCF/WT) and drug-resistant (MCF7/AdrR) tumors were treated by PSC833 and by carrier vehicle 1 h before imaging, respectively. Dynamic images were acquired for 30 min after intravenous injection of MIBI/TF using a SPECT system, FastSPECT. The biodistribution of MIBI and TF was determined at the end of the imaging session. Results: MCF7/WT in the absence and presence of PSC833 could be visualized by MIBI and TF imaging within 5 min and remained detectable for 30 min postinjection. MCF7/AdrR could be visualized only 2-5 min without PSC833 treatment but could be detected for 30 min with PSC833, very similar to MCF7/WT. MCF7/AdrR without PSC833 showed significantly greater radioactive washout than MCF7/WT and MCF7/AdrR with PSC833 treatment. PSC833 increased the accumulation (%ID/g) in MCF7/AdrR 3.0-fold (1.62{+-}0.15 vs. 0.55{+-}0.05, P<.05) for TF and 1.9-fold (1.21{+-}0.04 vs. 0.64{+-}0.05, P<.05) for MIBI but did not affect MCF7/WT. Conclusions: The feasibility of MIBI and TF for assessment of MDR expression and inhibition was demonstrated in mice through FastSPECT imaging. The results indicate that TF may be at least comparable with MIBI in recognizing Pgp expression and modulation.

  7. Prediction of chemotherapy response in untreated malignant lymphomas using technetium-99m methoxyisobutylisonitrile scan. Comparison with P-glycoprotein expression and other prognostic factors. A preliminary report

    The purpose of this study was to predict chemotherapy response in untreated malignant lymphomas using technetium-99m methoxyisobutylisonitrile (Tc-MIBI) scan. Twenty-five patients with malignant lymphoma were studied before receiving chemotherapy. Early Tc-MIBI scan was performed 10 min after intravenous injection of Tc-MIBI. Immunohistochemical analyses were performed on multiple non-consecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the first 1-2 years after completion of treatment by clinical and radiological methods. The mean tumor-to-background ratio of the 15 patients with good response (3.3±0.6) was significantly higher than that of the 10 patients with poor response (1.2±0.1). Among the 15 patients with good response to chemotherapy, all had positive Tc-MIBI scan results but negative Pgp expression. Among the 10 patients who had poor response to chemotherapy, all 10 had negative Tc-MIBI scan, but six patients had positive Pgp expression and four had negative Pgp expression. Significant differences were found in the incidences of good and poor responses determined by Tc-MIBI scan and Pgp expression. However, there were no significant differences in the incidences of good and poor responses for other prognostic factors. Compared with other prognostic factors, early Tc-MIBI scan more accurately predicts chemotherapy response in patients with malignant lymphoma. (author)

  8. Comparison of SPECT/CT and planar MIBI in terms of operating time and cost in the surgical management of primary hyperparathyroidism.

    Setabutr, Dhave; Vakharia, Kavita; Nogan, Stephen J; Kamel, George N; Allen, Thomas; Saunders, Brian D; Goldenberg, David

    2015-01-01

    We conducted a retrospective study to compare operating times and costs in patients who underwent guided parathyroidectomies with either (1) technetium-99m ((99m)Tc) multiplex ion-beam imaging (MIBI) parathyroid scintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT) fusion images or (2) sestamibi dual-phase (99m)Tc MIBI planar parathyroid scintigraphy alone preoperatively. Our study population was made up of the first 24 patients at our facility who had undergone SPECT/CT parathyroid imaging with technetium-99m ((99m)Tc) MIBI and a group of 24 patients who had undergone MIBI planar imaging alone. Patient demographics, preoperative laboratory test results, operating times, and hospital charges were analyzed. We found that less operating time was required for the planar MIBI group than in the SPECT/CT group (mean: 135 vs. 158 min), although the difference was not statistically significant. Likewise, the total cost of treatment was lower in the planar MIBI group (mean: $10,035 vs. $11,592); the difference was statistically significant by one measure (p × 0.02, Wilcoxon rank sum test) but not by another (p × 0.06, Student t test). Although SPECT/CT is efficient for patients with small and difficult-to-localize adenomas, it has yet to demonstrate greater efficacy or cost-effectiveness than planar MIBI for routine parathyroidectomy in patients with primary hyperparathyroidism when an easily identifiable parathyroid adenoma is localized. PMID:26535821

  9. Biodistribution studies of 99mTc-labeled myoblasts in a murine model of muscular dystrophy

    The purpose of this study was twofold: first, to evaluate the myoblast labeling of various 99mTc complexes and to select the complex that best accomplishes this labeling, and second to evaluate the biodistribution of myoblasts labeled with this complex using mice with MDX muscular dystrophy (the murine homologue of Duchenne's muscular dystrophy). The following ligands were used to prepare the corresponding 99mTc complexes: hexakis-methoxy-isobutyl-isonitrile (MIBI), bis(2-ethoxyethyl)diphosphinoethane (Tf), (RR,SS)-4,8-diaza-3,6,6,9-tetramethyl-undecane-2,10-dione-bisoxime (HM-PAO), bis(N-ethyl)dithiocarbamate (NEt), and bis(N-ethoxy, N-ethyl)dithiocarbamate (NOEt). One million murine myoblasts were incubated for 30-60 minutes with 5 mCi of each of the 99mTc complexes prepared from the above ligands. Viability was assessed by microscopic counting after trypan blue staining, and the radioactivity absorbed in the cells was measured after centrifugation. The compound with the highest uptake in cellular pellets was [99mTc]N-NOEt. The biodistribution of myoblasts labeled with this complex was evaluated after intraaortic injection in dystrophic mice. Such an approach has the potential of effecting widespread gene transfer through the bloodstream to muscles lacking dystrophin

  10. 99mTechnetium labelled vasoactive intestinal peptide analogue for rapid localization of tumours in humans

    In recent years, imaging tumours with receptor specific biomolecules has been the focus of increasing interest. VIP has a high affinity for specific receptors that are expressed in high density on a large number of malignant tumours. VIP was modified (TP 3654) without compromising its biological activity, and labelled with 99mTc. Pharmacokinetics and feasibility studies were performed in three normal volunteers and 11 patients with a history of cancer. Imaging was performed for up to two h post-injection. Within 24 h after injection of 99mTc-TP 3654 (10-15 mCi/5 μg), approximately 70% of the tracer cleared through the kidneys, and 20% through the liver. Blood clearance was rapid. No adverse reaction was noted in any subjects. All known tumours were clearly delineated within 20 min. Findings were compared with the results of 99mTc-MIBI, CT, MRI, or histology. There was concordance in nine patients. In the other two, only the VIP scan was positive for tumours known to express VIP receptors. The early results of imaging tumours with 99mTc-VIP are promising and warrant further studies. (author)

  11. Technetium-99m myocardial imaging agents

    A major focus of cardiovascular radiopharmaceutical research over the past decade has been the search for a Tc-99m agent that could replace Tl-201, the current agent of choice for myocardial perfusion imaging. Recent advances in the inorganic chemistry of technetium, and in the translation of this chemistry to radiopharmaceutical development, make it very likely that this search will soon be successfully completed

  12. Can tumor uptake Tc-99m MDP ?

    To explore the mechanism of technetium-99m-methylene diphosphonate (MDP) uptake within tumor through analyze a distribution of Tc-99m MDP in mice bearing tumor cell lines. Methods: The uptake of Tc-99m MDP was analyzed in seven human tumor cell lines ( SPC-A1 adenocarcinoma of lung cancer, Bcap-37 Breast cancer, T-24 Bladder cancer, SKOV3 Ovary carcinoma, Hela-229 Cervical carcinoma, SCI-OS Osteosarcoma, SCI-375 Melanoma) and mouse Lewis lung cancer cell line. They were transplanted into athymic mice, SCID nude mice and C57BL/6 mice, respectively. Approximately 10(6) cells of each cell line were injected subcutaneously into a right chest of mouse. After 4 and 5 weeks, the Tc-99m MDP scintigraphy were determined 6 hours after tail vein injection of 74MBq in 0.05ml every mouse. Result: Biodistribution and tumor uptake MDP was different in the various cell types investigated. According to the Region Ratio program of Siemens Power Macintosh 9500 Computer System, region of interests (RIOs) placed on a small part of the tumor and horizontal copied to left background (T/B) and thoracic spine (T/N) of mice in Tc-99m MDP imaging. The average cpm/pixel ratios were calculated by standardized uptake measure (SUM) and determined the tumor-positive value (T/B) greater than or equal to 1.2. T/B of cell lines were sorted from higher to lower as follows: SCI-OS, Lewis, SKOV3, SCI-375, T-24, SPC-A1, Bcap-37, Hela-229. T/N: SCI-OS, SKOV3, T-24, SCI-375, Lewis, SPC-A1, Bcap-37, Hela-229. The biodistribution data of 99Tcm-MDP in SPC-A1 tumor-bearing BALB/c nude mice were given as ID/g and represent the means D (n=13) in 30 hours after injection of Tc-99m MDP. ID/g of major tissue were sorted from higher to lower as follows: thoracic spine, lumbar, ribs, kidneys, the center of tumor, the ulcer of tumor, the surrounding of tumor, lymph node, blood, lungs, heart, liver. Conclusions: Most of tumor can uptake Tc-99m MDP including human adenocarcinoma. The uptake rate in the center tissue of

  13. SPECT/CT with 99mTc MIBI in patients with secondary hyperparathyreoidismus and chroniodyalisis

    Full text: Introduction: Secondary hyperparathyroidism( SHPT ) is a complication of impaired calcium and phosphorus metabolism, which develops in the course of chronic kidney disease (CKD ) and subsequent chronic renal failure (CRF). What you will learn: The aim of the study is to locate pathologically changed parathyroid glands (hyperplasia, adenoma) in patients with chronic renal failure undergoing chroniohemodialisis treatment. Discussion: Twelve patients undergoing HDL lapse of 36 to 82 months were observed. The conservative treatment of calcium and phosphorus metabolism and the use of calcimimetics did not lead to control of developing secondary hyperparathyroidism. In these patients biochemical studies were performed and the levels of parathyroid hormone ( PTH at all over 1000 pg / ml) have been detected and the degree of vascular calcification was determined using classical roentgenography. For the visualization of the parathyroid classic echography and single-photon emission computed tomography with computed tomography were used. The latter is carried out with the new hybrid device 670 Discovery NM / CT, with coupled two-head SPECT gamma camera and CT diagnostic MSCT/16-sliced. Conclusion: In all patients the SHPT progression and the severity of vascular calcification correspond to the severity of sonographic and SPECT/CT findings. The conducting of surgical treatment is discussed

  14. Detection of axillary lymph node involvement of breast cancer by Tc-99m MIBI scintimammography

    Breast cancer is the most common malignancy among women, leading to hundreds of thousands of deaths annually around the world. Lymph node status is the most important prognostic indicator in newly diagnosed breast cancer. The presence of axillary lymph node metastases has major prognostic implications in breast cancer patients, and it is an important criterion in determining the need for adjuvant chemotherapy. There is not an accurate anatomical test for detecting axillary lymph node metastasis and clinical examination has inappropriate diagnostic values. Routine lymph node dissection is the only accepted method for therapeutic decisions but it is invasive and produces significant morbidity such as lymphedema and infections. On the other hand, an important proportion of breast cancer patients are nodenegative. Ultrasonography has also been reported to be helpful, especially in conjunction with fine needle aspiration biopsy

  15. Automatic detection of breast lesions with MIBI-Tc99m scintimammography using a novelty filter

    An automatic method for detecting breast lesion in scintimammography is described. It is reported that the proposed method not only detects lesions but also classifies them as benign or malignant. The detection method makes use of Kohonen's novelty filter and the classification method is obtained by the analysis of an identified lesion mean profile. The method was able to detect all lesions presented in the scintimammogram and to correctly classify 16 out of 17 malignant lesions and 15 out of 17 benign lesions. The sensitivity of the method was 94,12% and specificity was 88,24%

  16. Tc-99m MIBI Gated SPECT in detection of left ventricular stunning vs. Coronary angiography

    Assessment of myocardial perfusion and myocardial contractility is of diagnostic and prognostic factor in patient with severe coronary heart diseases. It is associated with transient cardioplegic of variable duration (post-ischemic LV dysfunction or LV stunning). After recovery of perfusion defect there is abnormal wall motion, and decrease in EF by 5 units. Gated SPECT image enables analysis of wall motion, wall thickening, and ejection fraction measurement with a combined assessment of myocardial perfusion and ventricular function during single injection of radiopharmaceutical. It aims to:- 1-Estimate the prevalence of stunning in different patients with CAD. 2-Evaluate the best time of post stress acquisition of gated SPECT for detection of stunning. Patients and methods: The study includes 173 patients, which was categorized according to severity of the disease into 4 groups. Group I: control, 4 of them has hypertension .Group II: myocardial ischemia alone. Group IIa: mild and moderate myocardial ischemia. Group IIb: sever myocardial ischemia. Group III: myocardial infarction. Group IV: myocardial infarction and myocardial ischemia. The results revealed that: 1- Early imaging (10 min.) post stress gated SPECT is highly recommended to detect stunning especially in high risk patient. 2- Gated SPECT setting at stress and rest is very necessary for detection of stunning and in prognostic stratification. 3- Wall motion assessment is more important than EF assessment to detect stunning

  17. Diagnostic Performances of 99mTc-Methoxy Isobutyl Isonitrile Scan in Predicting the Malignancy of Lung Lesions

    Zhang, Shuxin; Liu, Yang

    2016-01-01

    Abstract We performed a meta-analysis to evaluate the value of technetium-99m methoxy isobutyl isonitrile (99mTc-MIBI) single photon emission computed tomography (SPECT) in differentiating malignant from benign lung lesions. The PubMed and Embase databases were comprehensively searched for relevant articles that evaluated lung lesions suspicious for malignancy. Two reviewers independently extracted the data on study characteristics and examination results, and assessed the quality of each selected study. The data extracted from the eligible studies were assessed by heterogeneity and threshold effect tests. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and areas under the summary receiver-operating characteristic curves (SROC) were also calculated. Fourteen studies were included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratio, and DOR of 99mTc-MIBI scan in detecting malignant lung lesions were 0.84 (95% confidence interval [CI]: 0.81, 0.87), 0.83 (95% CI: 0.77, 0.88), 4.22 (95% CI: 2.53, 7.04), 0.20 (95% CI: 0.12, 0.31), and 25.71 (95% CI: 10.67, 61.96), respectively. The area under the SROC was 0.9062. Meta-regression analysis showed that the accuracy estimates were significantly influenced by ethnic groups (P the overall analysis did not raise suspicion of publication bias (P = 0.50). Our results indicated that 99mTc-MIBI scan is a promising diagnostic modality in predicting the malignancy of lung lesions. PMID:27149482

  18. Technetium-99m pyridoxylideneglutamate (P. G. ) cholescintigraphy

    Stadalnik, R.C.; Matolo, N.M.; Jansholt, A.L.; Krohn, K.A.; DeNardo, G.L.; Wolfman, E.F Jr.

    1976-12-01

    Technetium-99m P.G. cholescintigraphy was performed in 27 human volunteers and 81 patients referred for hepatobiliary tract disease. The gallbladder, biliary system, and gastrointestinal tract were well visualized in the normal patients and volunteers. The gallbladder was not visualized in 22 patients with histologically proved cholecystitis with cystic duct obstruction. Nine patients with complete extrahepatic obstruction of the common bile duct were correctly diagnosed. Hepatocellular disease and incomplete obstruction, with and without jaundice, were diagnosed with this technique. Oral cholecystography is superior to this method for the detection of cholelithiasis in nonjaundiced patients.

  19. Comparison study among methodologies of planar chromatography for radiochemical control of technetium-99m

    Radiopharmaceuticals are substances that have radioisotopes in their composition. About 95% of the procedures performed in nuclear medicine use radiopharmaceuticals with diagnostic purposes, and the Lyophilized Reagents (LR) labeled with Technetium-99m (99mTc), obtained from 99Mo/99mTc generator, are the most one used. Quality Control represents the set of assays to be performed to assure that the product is adequate to its purpose. An important feature to be evaluated in 99mTc radiopharmaceuticals is the radiochemical purity (% RqP) to quantify free pertechnetate (99mTcO4-) and technetium colloidal (99mTcO2) mainly by paper chromatography (PC), thin layer (TLC) and High Performance Liquid Chromatography (HPLC). The objective of this work was to perform the comparison among the radiochemical control methodologies of LR labeled with 99mTc, described in the United States Pharmacopoeia (USP) and European Pharmacopoeia (EP) and those used by IPEN. 99mTcO4- eluate and DISIDA, DMSA, DTPA, EC, ECD, GHA, MIBI, MDP, PIRO, SAH and Sn Coloidal LR were provided by IPEN-CNEN/SP. TLC-cellulose, TLC-SG.TLC-SG reverse phase, HPTLC-cellulose, HPTLC-SG (Merck) and ITLC-SG (Pall Corporation), W1MM, W3MM, W17M e W31ET (Whatman) chromatographic plates were used. The measurement of the radioactivity was done in a Perkin Elmer Cobra D-5002 gamma counter. LR were labeled to obtain 55,0 MBq mL1 (1,5 mCi mL1) of final radioactive concentration. The %99mTcO4-, %99mTcO2 and % RqP were determined up to 4 hour labeling. From 11 LR, only EC and GHA have no radiochemical control methods in USP and EP. In USP and/or EP, DTPA, MDP, PIRO, SAH and Sn Coloidal methods use ITLC-SG; IPEN uses this chromatography plate in DISIDA, EC, ECD, GHA, PIRO, MIBI and SAH. As ITLC-SG had been out of production (recommended in 40, 70 and 41% of the USP, EP and IPEN methodologies, respectively), it was necessary to search alternatives to replace ITLC-SG plate in the radiochemical control, comparing with HPTLC

  20. Evaluation of the effect of trimetazidine on Tc-99m methoxyisobutyl isonitrile gated scintigraphy in patients with coronary artery ectasia

    Coronary artery ectasia (CAE) is the abnormal dilatation of a segment of the coronary artery to a diameter of at least 1.5 times that of normal adjacent segments. Symptoms are variable, and its prognosis and treatment modalities are unclear. The aim of this study is to evaluate the effect of trimetazidine (TMZ) on ischemic left ventricular function by rest-stress Tc-99m methoxyisobutyl isonitrile (Tc-99m MIBI) myocardial scintigraphy in symptomatic patients with CAE. We included patients with ectasia admitted to our Cardiology Department, Turkey, between 2003 and 2004 in this study. All patients underwent coronary angiography and diagnosed with CAE, before and 4 weeks after TMZ administration. Seventeen patients (9 men, 8 women) underwent gated single-proton emission tomographic (SPECT) using Tc-99m MIBI. We performed quantitative global and regional ventricular functional analysis using quantitative gated SPECT software. The global ejection fraction increased from 59.9%+/-8.9% to 62.6%+/-8.3% after therapy (p=0.033). In addition, the end systolic volume and the end diastolic volume decreased after therapy (101.7+/-23.5 ml to 95.1+/-22.9 ml, p=0.002; from 41.1+/-14.3 to 36.4+/-13.6, p=002). In all segments, we observed significant post-therapy increases in relative tracer uptake. Percentage of MIBI uptake was 71.2+/-15.3 at baseline stress and 73.2+/-15 post-TMZ (p=0.001). As global function parameters, the total wall motion normal areas changed significantly (67-74% p=0.01) after therapy, but the total wall thickness did not changed significantly(49-45%, p=0.21). The results of this study demonstrate that TMZ improves myocardial function by rest-stress Tc-99m MIBI gated SPECT during stress-induced ischemia in patients with CAE. Also, the outcomes revealed improvement in functional parameters, and percentage of MIBI uptake post TMZ administration. We can use this procedure to monitor the effect of TMZ in CAE patients. (author)

  1. Use of {sup 99m}Tc 2-methoxyisobutyl isonitrile in minimally invasive radioguided surgery in patients with primary hyperparathyroidism: A narrative review of the current literature

    Denmeade, Kristie A [Nuclear Medicine and Ultrasound Department, Bankstown-Lidcombe Hospital, Bankstown, New South Wales (Australia); Constable, Chris [Brain and Mind Research Institute, University of Sydney, New South Wales (Australia); Reed, Warren M [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, New South Wales (Australia); Nuclear Medicine and Ultrasound Department, Bankstown-Lidcombe Hospital, Bankstown, New South Wales (Australia)

    2013-06-15

    The use of technetium-99m 2-methoxyisobutyl isonitrile ({sup 99m}Tc MIBI) for assistance in minimally invasive radioguided surgery (MIRS) is growing in popularity as a safe, effective, and proficient technique used for parathyroidectomy in primary hyperparathyroidism (PHPT) treatment. Previously, the preferred treatment for PHPT was bilateral neck exploration (BNE), a very invasive, costly, and lengthy procedure. However, as a large majority (80–85% of cases of PHPT) are attributed to a single parathyroid adenoma (PA), a simpler more direct technique such as MIRS is a far better option. The following article is an exploration of the current literature concerning varied protocols utilizing {sup 99m}Tc MIBI for assistance in MIRS for patients undergoing treatment of PHPT. This technique boasts many advantageous outcomes for patients suffering from PHPT. These include a reduction in cost, operating time, and patient recovery; less evidence of post-surgical hypocalcaemia, less pain, and complications; superior cosmetic results; same-day discharge; and the possibility of local anaesthesia which is particularly beneficial in elderly patients. Better outcomes for patients with deep or ectopic PAs, reduced intra-operative complications, and improved cosmetic outcomes for patients who have previously undergone thyroid and/or parathyroid surgery are also advantageous. Of the literature reviewed it was also found that no patients suffered any major surgical complications such as laryngeal nerve palsy or permanent hypoparathyroidism using {sup 99m}Tc MIBI for assistance in MIRS.

  2. Use of 99mTc 2-methoxyisobutyl isonitrile in minimally invasive radioguided surgery in patients with primary hyperparathyroidism: A narrative review of the current literature

    The use of technetium-99m 2-methoxyisobutyl isonitrile (99mTc MIBI) for assistance in minimally invasive radioguided surgery (MIRS) is growing in popularity as a safe, effective, and proficient technique used for parathyroidectomy in primary hyperparathyroidism (PHPT) treatment. Previously, the preferred treatment for PHPT was bilateral neck exploration (BNE), a very invasive, costly, and lengthy procedure. However, as a large majority (80–85% of cases of PHPT) are attributed to a single parathyroid adenoma (PA), a simpler more direct technique such as MIRS is a far better option. The following article is an exploration of the current literature concerning varied protocols utilizing 99mTc MIBI for assistance in MIRS for patients undergoing treatment of PHPT. This technique boasts many advantageous outcomes for patients suffering from PHPT. These include a reduction in cost, operating time, and patient recovery; less evidence of post-surgical hypocalcaemia, less pain, and complications; superior cosmetic results; same-day discharge; and the possibility of local anaesthesia which is particularly beneficial in elderly patients. Better outcomes for patients with deep or ectopic PAs, reduced intra-operative complications, and improved cosmetic outcomes for patients who have previously undergone thyroid and/or parathyroid surgery are also advantageous. Of the literature reviewed it was also found that no patients suffered any major surgical complications such as laryngeal nerve palsy or permanent hypoparathyroidism using 99mTc MIBI for assistance in MIRS

  3. Development and validation of methodology for technetium-99m radiopharmaceuticals using high performance liquid chromatography (HPLC)

    Radiopharmaceuticals are compounds, with no pharmacological action, which have a radioisotope in their composition and are used in Nuclear Medicine for diagnosis and therapy of several diseases. In this work, the development and validation of an analytical method for 99mTc-HSA, 99mTc-EC, 99mTc-ECD and 99mTc-Sestamibi radiopharmaceuticals and for some raw materials were carried out by high performance liquid chromatography (HPLC). The analyses were performed in a Shimadzu HPLC equipment, LC-20AT Prominence model. Some impurities were identified by the addition of a reference standard substance. Validation of the method was carried out according to the criteria defined in RE n. 899/2003 of the National Sanitary Agency (ANVISA). The results for robustness of the method showed that it is necessary to control flow rate conditions, sample volume, pH of the mobile phase and temperature of the oven. The analytical curves were linear in the concentration ranges, with linear correlation coefficients (r2) above 0.9995. The results for precision, accuracy and recovery showed values in the range of 0.07-4.78%, 95.38-106.50% and 94.40-100.95%, respectively. The detection limits and quantification limits varied from 0.27 to 5.77 μg mL-1 and 0.90 to 19.23 μg mL-1, respectively. The values for HAS, EC, ECD and MIBI in the lyophilized reagents were 8.95; 0.485; 0.986 and 0.974 mg L-1, respectively. The mean radiochemical purity for 99mTc-HSA, 99mTc-EC, 99mTc-ECD and 99mTc-Sestamibi was (97.28 ± 0.09)%, (98.96 ± 0.03)%, (98.96 ± 0.03)% and (98.07 ± 0.01)%, respectively. All the parameters recommended by ANVISA were evaluated and the results are below the established limits. (author)

  4. Possible role of 99mTc-Dextran (99mTc-Dx) in detection of occult small intestinal lesions

    Two cases are presented wherein 99mTc-dextran (99mTc-Dx) imaging localised focal pathology in the small intestine and contributed in reaching a preoperative diagnosis. In the first case, 99mTc-pertechnetate and 99mTc-Dx accumulated in a suspected Meckel's diverticulum equally well. 99mTc-Dx additionally identified exudative discharge from the lesion. In the second case, 99mTc-Dx identified a distal ileal lesion later proved to be a non-specific ulcer on surgery. 99mTc-Dx scanning may have a role in imaging of occult intestinal lesions. (author)

  5. The role of scintimammography with 99MTC-MIBI in evaluation of the breast lesions

    Introduction: The aim of this study was to determine diagnostic value of prone lateral 99mTc-MIBI scintigraphy in detection of primary breast cancer in patients with breast lesions. Materials and methods: We evaluated 142 patients with breast lesions and/or suspicious mammographic findings. In all patients, the diagnosis was established by pathology. Pattern of abnormal MIBI uptake ( focal or diffuse ) and quantitative measurement of the Ratio of Lesion to normal tissue uptake( T/N Ratio) was recorded. All lesions with abnormal focal uptake with T/N Ratio of more than 1.30 were considered as malignant lesion. Cases with normal homogeneous or abnormal diffusely increased uptake in the breast tissue were interpreted as negative for malignant lesion. Results: Of 142 patients, histopathologic study of 36 cases showed Malignancy which 34 cases of them had Positive MIBI scan. Of 106 cases of negative pathology ,cases had Negative MIBI scintimammography. Analysis of the findings showed high sensitivity, Specificity, accuray and Negative predictive value for 99m-MIBI scintimammography in detection of malignant breast lesion. Conclusion: We concluded that MIBI Scan can be used as complementary or even competitory imaging to the mammography in the evaluation of the breast lesions. (authors)

  6. Bioavailability of {sup 99m}Tc-paclitaxel-glucuronide ({sup 99m}Tc-PAC-G)

    Biber Muftuler, F.Z.; Demir, I.; Uenack, P.; Ichedef, C.; Yurt Kilcar, A. [Ege Univ., Izmir (Turkey). Dept. of Nuclear Applications

    2011-07-01

    An antitumor agent paclitaxel (PAC) has been proved to be efficient in the treatment of breast and ovarian cancer. Glucuronic acid-derived paclitaxel compound (paclitaxel-glucuronide (PAC-G)) was enzymatically synthesized using microsome preparate separated from rat livers. The biodistribution mechanism of PAC-G in healthy female Albino Wistar rats has been investigated. The expected structure is confirmed according to LC/MS results, and the possible attachment is to C2-hydroxyl group. PAC-G was labeled with {sup 99m}Tc and the radiochemical yield of radiolabeled compound ({sup 99m}Tc-PAC-G) was 98.0 {+-} 02.74% (n=9). The range of the breast/blood and breast/muscle ratios is approximately between 3 and 35 in 240 min. All these experimental studies indicate that {sup 99m}Tc-PAC-G may potentially be used in breast tissue as an imaging agent. (orig.)

  7. Tc- 99 m gel generator; an alternative source of Tc-99 m for medical uses

    Tc-99 m is widespread radioisotope in nuclear medicine and it can be produced by two different methods. The first method is performed by chromatographic genera tory by using Mo-99 prepared by fission of U-235, and another method is activation of Mo-99 can be complexed by ZrOCl2 and produce a gel. Mo-99 remains in this gel and Tc-99 m elute with normal saline solution. Many factors such as P H, concentration of Mo in the gel structure, and drying conditions of gel affect on the efficiency of the generator. In this research the gel generator production and some factors which are effecting on the 99 m Tc production are presented

  8. Evaluation of Pakgen {sup 99m}Tc generators loaded with indigenous fission {sup 99}Mo

    Mushtaq, A.; Pervez, S.; Hussain, S.; Mirza, J.A.; Asif, M.; Siddique, M.U.; Khalid, U.; Khan, B.; Khalid, M. [Pakistan Institute of Nuclear Science and Technology, Islamabad (Pakistan). Isotope Production Div.; Khan, M.M.

    2012-07-01

    Fission produced {sup 99}Mo/{sup 99m}Tc generators, called Pakgen, have been manufactured at the PINSTECH generator production facility since 2000 for nuclear medicine applications in Pakistan. These generators were loaded with fission {sup 99}Mo imported from NTP South Africa. Recently production of fission {sup 99}Mo has begun in the Molybdenum-99 Production Facility at PINSTECH. Prior to use in the clinic, eight sets of generators were produced, 23 GBq and 74 GBq at time of calibration, and they were subjected to various quality control procedures recommended in the pharmacopoeia to assess their performance. The elution profile, volume, activity, pH, radionuclidic, chemical, radiochemical and biological purity, and expiry time of the eluates were examined. Labeling efficiency tests were also carried out with a number of the more widely used in vivo radiopharmaceutical kits like DTPA, MDP and MIBI. Performance of {sup 99m}Tc generators loaded with locally produced and imported fission {sup 99}Mo was comparable, and the users of Pakgen generators were fully satisfied. The effect of a wet vs. a dry column on {sup 99m}Tc yields of generators loaded with low and high activity was also studied for the first time. (orig.)

  9. Diagnosis of parathyroid adenoma - the role of two phase mibi scintigraphy (abstract)

    Dual radionuclide imaging using a combination of /sup 201/Ti with/sup 99m/Tc pertechnetate is a useful procedure in the localization of parathyroid adenomas. Recently /sup 99m/Tc Sesta - Methoxy Isobutyle Isonitrile (MIBI) has been used for detection and localization of parathyroid adenoma in patients with hyperparathyroidism as a single radionuclide imaging procedure (Double phase study). In our study 4 female patients with picture of metabolic bone disease on bone scintigraphy and raised serum parathyroid hormone levels and raised levels of serum calcium, were subjected to two phase parathyroid MIBI scintigraphy. Cervicothoracic planar images (Anterior view) were acquired at 15-20 minutes and 2-4 hours after an intravenous injection of 15-20 mCi /sup 99m/Tc MIBI. A positive scan was defined as an area of increased focal uptake in normal tissue, which progressively decreased over time. All the 4 patients had a positive scan for parathyroid adenoma which was confirmed by histopathological examination of the excised tumor. It was concluded that the two phase 99mTc-MIBI parathyroid scintigraphy is a specific and sensitive modality for detection, localization and even diagnosis of parathyroid adenoma. (author)

  10. Failed Switching off in the MIBI-Parathyroid Scintigraphy in a Dialyzed Patient with Secondary Hyperparathyroidism Responsive to Cinacalcet Therapy

    Piergiorgio Bolasco; Alessandra Serra; Maurizio Loi; Andrea Galfré; Mario Piga

    2010-01-01

    The aims of your case report is to show the predictivity of Tc99m-sestamibi (MIBI) scintigraphy and doppler ultrasound imaging on secondary hyperparathyroidism (SHPT) in a patient responsive to calcimimetic treatment. Moreover, it has been reported that calcimimetic has great potential in reducing the volume of the parathyroid gland. On the other hand, the MIBI scintigraphy is considered a crucial diagnostic procedure to monitor the response to therapy in terms of turnover and cellular metabo...

  11. Tagging fatty acids with 99m tecnetium

    In a search for a fatty acid analogue suitable for labelling with sup(99m)Tc for myocardial imaging, analogues of the general formula X-Y-COOH where the ligand groups X, Y were NH2, SH or COOH, capable of forming complexes with metal ions, were synthesized. Among many such, one compound (CH2(SH).CH2(SH).(CH2)8.COOH) was selected for further study. Injected intravenously together with a reducing agent into mice, rats and one dog, the compound proved unsatisfactory for the purpose because of its toxicity and its failure to localize in the myocardium. The search for alternative analogues and alternative labelling procedures must continue

  12. Preparation and assessment of [99mTc]technetium aquacarbonyl complexes with 1,2-diaminoethane-N-substituted ligands for tumor detection

    Over least 15 years the complex [[99mTc](H20)3(CO)3]+ has been used as an intermediary to obtain technetium radiopharmaceuticals for applications in cardiology, neurology and oncology. Two important characteristics of this molecule are: the facility for obtaining that compound from aqueous solutions and the easiness of substituting H2O molecules by atoms of other ligand molecules. In this project we prepared new complexes [[99mTc](CMNS001-3)(H2O)(CO)3]+, where (CMNS001) = N-[(4-methoxy) benzyl]-1,2-diaminoethane, (CMNS003) = N,N'-bis-[(4-methoxy)benzyl]-1,2-diaminoethane, and assessed the uptake of these complexes in murine melanoma cancer cell B16F10 and breast cells MCF-7 and MDA-MD-231, and compared with [[99m](MIBI)6]+ uptake. In vitro uptake for both new technetium complex reached values close to 5%, for all cell lines, whereas the [[99mTc](MIBI)6]+ uptake was close to 1 %. The assessment of subcellular distribution showed high accumulation of the new complex in the membrane fraction, for MDAMB-231, while for B16F10 accumulation occurred both in membrane and cytoplasm; the concentration of [[99mTc](MIBI)6]+ was mainly in the cytoplasm portion. Biodistribution study in mice allowed to observe the capture of up to 1.6% of the administered dose per gram of tumor tissue for the complex [[99mTc](CMNS001)(H2O)(CO)3]+, whereas other organs such as heart, lung and muscle, showed uptake of about 5.6%, 6.4% and 2%, respectively. The complexes in this work showed a high rate of uptake in vitro, but was not reproduced in vivo model, which can be related to low concentration of the complexes inside the cells and reduced vascularity of tumor tissue, with lower intake of complex through the blood system. (author)

  13. Process modifications of obtaining Tc-99m by solvent extraction

    This paper describes a modification in the process to obtaining Tc-99m by the extraction method of solvent from Mo-99 produced by irradiation. Tc-99m is considered an ideal radionuclide for medical and biological applications

  14. Myocardial 99mTc-sestamibi extraction and washout in hypertensive heart failure using an isolated rat heart

    Purpose: Myocardial mitochondria are the primary part of energy production for healthy cardiac contraction. And mitochondrial dysfunction would play an important role in progressive heart failure. In the recent years, myocardial washout of 99mTc-sestamibi [(99mTc-hexakis-2-methoxy-2-methylpropyl isonitrile (MIBI)] has been introduced to be a potential marker in patients with heart failure. The objective of this study was to clarify MIBI extraction and washout kinetics using isolated perfusion system in hypertension induced model of myocardial dysfunction. Methods: Six-week-old Dahl-salt sensitive rats, allotted to 4 groups; a 5-week high-salt group (5wk-HS), 12-week high-salt group (12wk-HS) and two age-matched, low-salt diet control groups (5wk-LS and 12wk-LS). The rats in 5wk-HS and 12wk-HS groups were fed a high-salt diet (containing 8% NaCl). Cardiac function was examined by echocardiography before removing heart. Hearts were perfused according to the Langendorff method at a constant flow rate, in which 20-min MIBI washin was conducted followed by 25-min MIBI washout. Whole heart radioactivity was collected every sec by an external gamma detector. The myocardial extraction, K1 (ml/min) and washout rate, k2 (min-1) were generated. Results: High-salt diet groups showed significant high-blood pressure. Echocardiography revealed thickened LV walls in 5wk-HS, and reduced cardiac function in 12wk-HS, compared to each age-matched control group. K1 showed no significant difference among all groups (5wk-HS: 2.36±1.07, 5wk-control: 2.59±0.28, 12wk-HS: 1.91±0.90, and 12wk-control: 2.84±0.57). k2 in 5wk-HS was comparable to that in the age matched control group (0.00030±0.00039 vs -0.000010±0.00044), but it was increased remarkably in 18wk-HS compared to the age matched control group (0.0025±0.0011 vs 0.000025±0.000041, P<.01), and 5wk-HS (P<.01). Conclusion: In the course of hypertensive heart disease, MIBI washout was increased in the transitional state from

  15. Myocardial {sup 99m}Tc-sestamibi extraction and washout in hypertensive heart failure using an isolated rat heart

    Fukushima, Kenji [Department of Cardiology, Tokyo Women' s Medical University, Tokyo 162-8666 (Japan); Department of Radiology, Johns Hopkins University, Baltimore, MD (United States); Momose, Mitsuru, E-mail: mmomose@rad.twmu.ac.j [Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women' s Medical University, Tokyo 162-8666 (Japan); Kondo, Chisato [Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women' s Medical University, Tokyo 162-8666 (Japan); Higuchi, Takahiro [Department of Radiology, Johns Hopkins University, Baltimore, MD (United States); Kusakabe, Kiyoko [Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women' s Medical University, Tokyo 162-8666 (Japan); Hagiwara, Nobuhisa [Department of Cardiology, Tokyo Women' s Medical University, Tokyo 162-8666 (Japan)

    2010-11-15

    Purpose: Myocardial mitochondria are the primary part of energy production for healthy cardiac contraction. And mitochondrial dysfunction would play an important role in progressive heart failure. In the recent years, myocardial washout of {sup 99m}Tc-sestamibi [({sup 99m}Tc-hexakis-2-methoxy-2-methylpropyl isonitrile (MIBI)] has been introduced to be a potential marker in patients with heart failure. The objective of this study was to clarify MIBI extraction and washout kinetics using isolated perfusion system in hypertension induced model of myocardial dysfunction. Methods: Six-week-old Dahl-salt sensitive rats, allotted to 4 groups; a 5-week high-salt group (5wk-HS), 12-week high-salt group (12wk-HS) and two age-matched, low-salt diet control groups (5wk-LS and 12wk-LS). The rats in 5wk-HS and 12wk-HS groups were fed a high-salt diet (containing 8% NaCl). Cardiac function was examined by echocardiography before removing heart. Hearts were perfused according to the Langendorff method at a constant flow rate, in which 20-min MIBI washin was conducted followed by 25-min MIBI washout. Whole heart radioactivity was collected every sec by an external gamma detector. The myocardial extraction, K{sub 1} (ml/min) and washout rate, k{sub 2} (min{sup -1}) were generated. Results: High-salt diet groups showed significant high-blood pressure. Echocardiography revealed thickened LV walls in 5wk-HS, and reduced cardiac function in 12wk-HS, compared to each age-matched control group. K{sub 1} showed no significant difference among all groups (5wk-HS: 2.36{+-}1.07, 5wk-control: 2.59{+-}0.28, 12wk-HS: 1.91{+-}0.90, and 12wk-control: 2.84{+-}0.57). k{sub 2} in 5wk-HS was comparable to that in the age matched control group (0.00030{+-}0.00039 vs -0.000010{+-}0.00044), but it was increased remarkably in 18wk-HS compared to the age matched control group (0.0025{+-}0.0011 vs 0.000025{+-}0.000041, P<.01), and 5wk-HS (P<.01). Conclusion: In the course of hypertensive heart disease, MIBI

  16. Evaluation of the absorbed dose to the kidneys due to Tc99m (DTPA) / Tc99m (Mag3) and Tc99m (Dmsa)

    The absorbed dose in the kidneys of adult patients has been assessed using the biokinetics of radiopharmaceuticals containing Tc99m (DTPA) / Tc99m (Mag3) or Tc99m (Dmsa).The absorbed dose was calculated using the formalism MIRD and the Cristy-Eckerman representation for the kidneys. The absorbed dose to the kidneys due to Tc99m (DTPA) / Tc99m (Mag3), are given by 0.00466 mGy.MBq-1 / 0.00339 mGy.MBq-1. Approximately 21.2% of the absorbed dose is due to the bladder (content) and the remaining tissue, included in biokinetics of Tc99m (DTPA) / Tc99m (Mag3). The absorbed dose to the kidneys due to Tc99m (Dmsa) is 0.17881 mGy.MBq-1. Here, 1.7% of the absorbed dose is due to the bladder, spleen, liver and the remaining tissue, included in biokinetics of Tc99m (Dmsa). (Author)

  17. Comparative biological parameters for the evaluation of common renal pharmaceutical preparations. 99mTc-DTPA, 99mTc-GH, and 99mTc-DMSA

    This work is concerned on establishing the necessary comparative quality control biological parameters for the evaluation of locally produced renal pharmaceutical preparations viz. tin complexes of 99mTc-DTPA, 99mTc-GH, and 99mTc-DMSA using gel chromatography column scanning techniques. Radiochemical purity, labeling yields, organ distribution, blood clearance and plasma protein binding were used as a selected indicator for quality control. The higher renal accumulation and tissue distribution were apparent with 99mTc-DTPA in mice, while blood retention was considerably low. The blood clearance of 99mTc-DMSA was relatively slow, while that of 99mTc-GH was rapid. The binding of 99mTc- DTPA, 99mTc-GH and 99mTc-DMSA with plasma protein were found to be 5, 65, and 95 % at 1.0 h, respectively. The stability of these cold kits was not affected on storing at 37 deg C for 30 days. (author)

  18. 99mTc-sestamibi scintimammographic evaluation of the mammae for carcinoma

    Full text: Introduction: The value of 99m Tc-sestamibi (MIBI) in the detection of breast carcinoma has been reported extensively, but the extent to which it might complement conventional mammography demands more studies. Although an excellent diagnostic intervention, the sensitivity of mammography decreases to less than 70% in women with radiologically dense breast tissue. The sensitivity of scintimammography, unlike standard screening modalities, is not compromised by inherent breast density. The incidence of breast cancer varies significantly among racial/ethnic groups and apparently Negroid women have higher blood estrogen levels than their Caucasian counterparts. Considering the racial, cultural and socio-economic differences of the South African population, as well as the relative simple technology and cost effectiveness of MIBI scintimammography, the question is: should scintimammography not play a more prominent role as rule-out diagnostic protocol in the evaluation of the breasts for carcinoma? Materials and methodology: Fifty-three consecutive patients presenting to the surgical out-patient department with or without breast nodules but high risk category for breast carcinoma have been recruited. After taking a history and performing a physical examination patients were referred for scintimammography and some of the patients were also referred for radiological mammography. Fine needle aspiration (FNA) was performed on all the lesions. Results: Clinical evaluation: sensitivity: 88,89%; specificity: 88.64%; false +ve: 4; false -ve :1. Sonographic evaluation: sensitivity: 100%; specificity: 33.35%; false +ve: 4; false -ve :0. MIBI scintimammography evaluation: sensitivity: 90.91%; specificity: 90,48%; false +ve: 4; false -ve: 1. Mammographic evaluation: sensitivity: 100%; specificity: 45,5%; false +ve: 6; false -ve: O. Fine needle aspiration cytology: sensitivity: 100%; specificity: 95,35%; false +ve: 2; false -ve: 1. Conclusion: Interesting as the results may

  19. Mismatched uptake of Tc-99m-ECD and Tc-99m-HMPAO in subacute cerebral infarction: Tc-99m-ECD for viability and Tc-99m-HMPAO for flow restoration

    Lee, D. S.; Hyun, I. Y.; Kim, S. K. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)] [and others

    1997-07-01

    Tc-99m-HMPAO reflects tissue perfusion but Tc-99m-ECD uptake is affected by tissue viability in addition to tissue perfusion which the varied state of cellular retention of Tc-99m-ECD reflects. Luxuriously perfused area on Tc-99m-HMPAO SPECT implies that this cortex was already reperfused either spontaneously or after thrombolysis and that accompanied paralysis of vascular reactivity in those zones warms progressive deterioration. We tried to find out if we can use sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT to reveal cortical perfusion and severity and range of risky areas of cerbral cortex despite reperfusion in sub-acute infarction. In 13 patients (M ; F =7 : 6, mean age 57 (range: 26-84)) with cortical (n=12) and basal ganglia infarction (1), we performed sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT at the same position. At first, 555 MBq of Tc-99m-ECD was injected and imaged and then 1110 MBq of Tc-99m-HMPAO was injected again and imaged with the patients in situ, and the first image (Tc-99m-ECD) and the subtracted image (2nd- 1st : Tc-99m-HMPAO) were compared slice by slice. Study was done from 3 days to 31 days (16{+-}9) after ictus. Tc-99m-ECD uptake was always less than or equal to Tc-99m-HMPAO uptake at the lesion in all cases. Luxury perfusion was prominent in four patients. Mismatched uptake was found in 10 patients. Severity of mismatch showed diverse spectrum and was ranged from total middle cerebral artery territory (1 case) to peripheral thin zones around infarction (2 cases). The other 7 showed intermediate amount of tissues with mismatch , i.e., Tc-99m-ECD defects where Tc-99m-HMPAO uptake is in part increased, normal or decreased. Upon discharge, patients having more uptake with Tc-99m-ECD predicted improvement. Patients having mismatched uptake went dichotomous way. In conclusion, Tc-99m-ECD/Tc-99m-HMPAO sequential SPECT is feasible and reveal both tissue perfusion (Tc-99m-HMPAO ) and discrepant Tc-99m-ECD uptake probably reflecting viability in acute

  20. Mismatched uptake of Tc-99m-ECD and Tc-99m-HMPAO in subacute cerebral infarction: Tc-99m-ECD for viability and Tc-99m-HMPAO for flow restoration

    Tc-99m-HMPAO reflects tissue perfusion but Tc-99m-ECD uptake is affected by tissue viability in addition to tissue perfusion which the varied state of cellular retention of Tc-99m-ECD reflects. Luxuriously perfused area on Tc-99m-HMPAO SPECT implies that this cortex was already reperfused either spontaneously or after thrombolysis and that accompanied paralysis of vascular reactivity in those zones warms progressive deterioration. We tried to find out if we can use sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT to reveal cortical perfusion and severity and range of risky areas of cerbral cortex despite reperfusion in sub-acute infarction. In 13 patients (M ; F =7 : 6, mean age 57 (range: 26-84)) with cortical (n=12) and basal ganglia infarction (1), we performed sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT at the same position. At first, 555 MBq of Tc-99m-ECD was injected and imaged and then 1110 MBq of Tc-99m-HMPAO was injected again and imaged with the patients in situ, and the first image (Tc-99m-ECD) and the subtracted image (2nd- 1st : Tc-99m-HMPAO) were compared slice by slice. Study was done from 3 days to 31 days (16±9) after ictus. Tc-99m-ECD uptake was always less than or equal to Tc-99m-HMPAO uptake at the lesion in all cases. Luxury perfusion was prominent in four patients. Mismatched uptake was found in 10 patients. Severity of mismatch showed diverse spectrum and was ranged from total middle cerebral artery territory (1 case) to peripheral thin zones around infarction (2 cases). The other 7 showed intermediate amount of tissues with mismatch , i.e., Tc-99m-ECD defects where Tc-99m-HMPAO uptake is in part increased, normal or decreased. Upon discharge, patients having more uptake with Tc-99m-ECD predicted improvement. Patients having mismatched uptake went dichotomous way. In conclusion, Tc-99m-ECD/Tc-99m-HMPAO sequential SPECT is feasible and reveal both tissue perfusion (Tc-99m-HMPAO ) and discrepant Tc-99m-ECD uptake probably reflecting viability in acute or

  1. The behavior of 99mTc-hexamethylpropyleneamineoxime (99mTc-HMPAO) in blood and brain

    99mTc-hexamethylpropyleneamineoxime (99mTc-HMPAO) is a reagent for scanning cerebral blood flow. We investigated how 99mTc-HMPAO changed in the blood and brain. The 99mTc-HMPAO, which was prepared by adding of 99mTcO4- to HMPAO and Sn(II), consisted of primary and secondary complexes, reduced hydrolyzed 99mTc, and 99mTc-pertechnetate. The percentage of the primary complex in 99mTc-HMPAO decreased with time after preparation. The primary complex converted to the secondary one very rapidly in the presence of plasma. When 99mTc-HMPAO was injected into patients, 99mTc activity was immediately partitioned in the plasma fraction, with approximately 60% in whole blood. In plasma, 99mTc was found to be associated with proteins such as albumin and globulin. 99mTc trapped in red cells was not washed out with either plasma or saline. Biodistribution studies showed that the less lipophilic compounds of 99mTc-HMPAO could not pass through the blood brain barrier (BBB), and therefore did not accumulate in the brain. The results of gel chromatography and equilibrium dialysis indicated that no specific 99mTc binding protein was present in the brain. Considering the instability of 99mTc-HMPAO in vivo, we proposed that the speed at which the primary complex converted to the less lipophilic compounds was important in allowing 99mTc-HMPAO to pass through the BBB and to be fixed in the brain. (orig.)

  2. Technetium-99m-dimethylglyoxime ([sup 99m]Tc-DMG) as renal imaging agent

    Adonaylo, V.N. (Buenos Aires Univ. (Argentina). Facultad de Ciencias Exactas y Naturales Buenos Aires Univ. (Argentina). Dept. de Ciencias Biologicas); Stahl, Adriana; Pomilio, A.B.; Vitale, A.A. (Buenos Aires Univ. (Argentina). Facultad de Ciencias Exactas y Naturales); Canellas, C.O. (Buenos Aires Univ. (Argentina). Facultad de Ciencias Exactas y Naturales Comision Nacional de Energia Atomica, Buenos Aires (Argentina))

    1993-06-01

    Dimethylglyoxime (DMG) labelled with [sup 99m]Tc is presented as a renal imaging agent. The behaviour of this complex was analysed at different pH by means of UV spectral data and using DMG-calcium chloride as a reference complex. Biokinetic data were evaluated in two biological models, Sprague-Dawley rats and Didelphis albiventris argentine opossum. Biodistribution in rats demonstrated fast and specific renal excretion. Time-activity values over both kidneys could be quantified for this complex. Renographic studies led to mean time-to maximum values on twelve assays of 2.0 [+-] 0.1 min and a mean relative function of 53.0 [+-] 2.3 and 47.0 [+-] 3.2 for right and left kidneys, respectively. [sup 99m]Tc-DMG showed specificity for the renal excretion pathway and therefore seems to be a very useful radiopharmaceutical for renal function studies. (Author).

  3. Technetium-99m-dimethylglyoxime (99mTc-DMG) as renal imaging agent

    Dimethylglyoxime (DMG) labelled with 99mTc is presented as a renal imaging agent. The behaviour of this complex was analysed at different pH by means of UV spectral data and using DMG-calcium chloride as a reference complex. Biokinetic data were evaluated in two biological models, Sprague-Dawley rats and Didelphis albiventris argentine opossum. Biodistribution in rats demonstrated fast and specific renal excretion. Time-activity values over both kidneys could be quantified for this complex. Renographic studies led to mean time-to maximum values on twelve assays of 2.0 ± 0.1 min and a mean relative function of 53.0 ± 2.3 and 47.0 ± 3.2 for right and left kidneys, respectively. 99mTc-DMG showed specificity for the renal excretion pathway and therefore seems to be a very useful radiopharmaceutical for renal function studies. (Author)

  4. Kinetic investigations of sup(99m)Tc-labelled radiopharmaceuticals

    Several radiopharmaceuticals (sup(99m)Tc-Fe-ascorbates, sup(99m)Tc-Sn-DTPA, sup(99m)Tc-Sn-ACD-citrate-complex and sup(99m)Tc-Sn-tetracyclin-HAsc-ACD-complex) for renal and tumour scintigraphy were tested in animal experiments. Also tested was sup(99m)Tc-penicillamine for scintigraphic investigations of the gallbladder and the liver. The findings suggest that the different radiopharmaceuticals have different degrees of reliability and exactness, and that some of them should be combined to achieve better diagnostic values. (GSE/AK)

  5. Tc 99m-infecton and Tc99m-HiG in evaluation of patients with pulmonary tuberculosis

    The m of the present study is to clarify the role of Tc99m-HIG and Tc99m-infecton in assessment of patients with pulmonary TB. Thirty-four patients with pulmonary tuberculosis proved by X-ray, bronchial lavage, sputum analysis and culture were included in the study. Tc99m-infecton and Tc99m-HIG were given intravenous in a dose of 740 MBq (20 md) with imaging after 1 and 4 hours. Images were correlated with clinical, radiological and laboratory data. Tc99m-infecton and Tc99m-HIG showed true positive results in 30 and 24 patients and false negative study in 4 and 10 patients, respectively. The sensitivity of Tc99m-infecton was 88% whereas that of Tc99m-HIG was 70%. When eighteen patients were followed up for 8 months after therapy with anti-tuberculous therapy, sixteen of them showed conversion of mycobacterium culture to negative. Tc99m-infecton images were true negative in 12 of them (specificity 75%) while only 8 of them were true negative on Tc99m-HIG study (specificity 50%) and only 6 were true negative on chest X-ray (specificity 37.5%). It can be concluded that Tc99m-infecton is more sensitive than Tc99m-HIG in diagnosis and monitoring response to treatment of pulmonary tuberculosis

  6. Evaluation of coronary artery disease by exercise Tc-99m sestamibi myocardial SPECT

    Aim: The role and utility of exercise Tc-99m sestamibi myocardial SPECT in the detection and assessment of coronary artery disease. Material and Methods: 29 patients (24 males and 5 females, with a mean age of 54 years) with suspected coronary artery disease were studied. All patients had a coronary angiography prior to the radionuclide study. Eighteen patients had previous history of myocardial infarction. All underwent exercise Tc-99m sestamibi myocardial SPECT by same day stress and rest Tc-99m sestamibi protocol. Eight mCi of Tc99m MIBI was injected intravenously at peak exercise and 25mCi for rest. Imaging in all patients was done using Dual Headed SPECT Gamma Camera (Millennium VG), 64 x 64 matrix, 3o/view, and 20s/frame, 180 deg. rotation RAO to LPO. Segmental myocardial uptake defects were compared with diseased vessels as shown in angiography. Results: The overall sensitivities of exercise Tc-99m sestamibi myocardial SPECT for the detection of 50-70% and > 70% stenoses were 88% and 91,3% respectively. The specificity for lesion between 50-70% was 100%, and it was 83.3% for lesion with >70% stenosis. The sensitivity rates for the diagnosis of stenosis in left anterior descending coronary artery, left circumflex, and right coronary artery based on defect in at least one of the segments corresponding to one of the diseased vessels were 75.3%; 80% and 76.5% for lesion showing 50-70% stenoses, and 80%, 85.7% and 86.7% for lesions with >70% stenoses respectively. The corresponding specificity rates for detection of 50-70% stenoses were 60%, 71.4% and 91.7% respectively, and for detection of >70% stenoses were 55.6%; 73.3% and 92.9% respectively. Conclusion: Exercise Tc-99m estamibi myocardial SPECT is useful in the evaluation of significant coronary artery disease, in predicting prognosis and in the evaluation of patients with suspected coronary artery disease. (This study was conducted as a part of International Atomic Energy Agency's fellowship program in

  7. MIBI scintigraphy in hypofunctioning thyroid nodules. Can it predict the dignity of the lesion?

    Theissen, P.; Schmidt, M.; Ivanova, T.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2009-07-01

    Aim: Several authors have investigated the value of technetium-MIBI scanning to predict the dignity of hypofunctioning, cold thyroid nodules (HTN) in regions with differing levels of iodine supply. They concluded that an MIBI scan can exclude thyroid malignancy, although comparisons between the studies are of limited value owing to differences in methodology and wide variations in patient selection criteria. The present study investigates whether the above claim is also valid in Germany, a country with a long-standing and persistent, mild iodine deficiency and a high incidence of nodules in large goiters with a low prevalence of malignancy. Patients, methods: The study compares the results of {sup 99m}Tc-MIBI scintigraphy (incl. SPECT and planar images) in HTN (MIBI) with those of fine-needle aspiration biopsy (FNAB) and histology. Of 154 consecutive patients (121 women, 33 men; mean age 56 {+-} 12 years), 73 underwent thyroid surgery from which the results of FNAB and MIBI were assessed. Selection criteria were risk estimation or conditions limiting the feasibility of FNAB. The mean thyroid volume was 42 {+-} 25 ml, with 2.1 {+-} 1.4 nodules per patient. Results: Histology revealed thyroid malignancies in 8 out of 73 patients (11.0%). The negative predictive value for MIBI was 97%, which is comparable to FNAB (94%). However, in 19.5% of patients FNAB was indeterminate. Lower specificity (54%) and low positive predictive value (19%) showed that MIBI accumulation cannot differentiate between malignant and benign thyroid nodules. However, comparison with cytological and/or histological findings indicated that it could distinguish between lesions with differing rates of mitochondrial metabolism. Conclusion: Even in areas of former or mild iodine deficiency MIBI forms a basis for choosing between wait-and-see and surgical strategies if FNAB is unfeasible or not representative. However, even for pathological MIBI results, the prevalence of malignancy is not very high

  8. Retention of 99mTc-DMSA(III) and 99mTc-nanocolloid in different syringes affects imaging quality.

    Bauwens, Matthias; Pooters, Ivo; van der Pol, Jochen; Mottaghy, Felix M; van Kroonenburgh, Marinus

    2014-04-01

    (99m)Tc-dimercaptosuccinic acid [DMSA(III)] and colloidal human serum albumin ((99m)Tc-nanocolloid) are widely used radiopharmaceuticals. Recently, in our institution we encountered image quality problems in DMSA scans after changing the brand of syringes we were using, which triggered us to look into the adsorption properties of syringes from different brands for (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid. We also describe a clinical case in which adsorption of (99m)Tc-DMSA(III) caused inferior imaging quality. DMSA and nanocolloid were labeled with (99m)Tc following manufacturer guidelines. After synthesis, syringes with (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid were stored for 15, 30, 60, and 120 min. We evaluated Luer Lock syringes manufactured by different brands such as Artsana, Henke-Sass-Wolf, B. Braun Medical N.V., CODAN Medizinische Geräte GmbH & Co KG, Becton Dickinson and Company, and Terumo Europe. Adsorption of (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid was acceptably low for all syringes (brands with (99m)Tc-DMSA(III) adsorption rates of 36 and 30%, respectively, and for one brand with a (99m)Tc-nanocolloid adsorption rate of 27%. Adsorption of (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid reaches critical levels in syringes produced by two brands, potentially causing poor image quality--for example, in DMSA scans using pediatric radiopharmaceutical doses. It is advised to check the compatibility of any radiopharmaceutical with syringes as an integral part of the quality assurance program. PMID:24569706

  9. Biodistribution studies of {sup 99m}Tc-labeled myoblasts in a murine model of muscular dystrophy

    Colombo, F.R. E-mail: colombof@policlinico.mi.it; Torrente, Y.; Casati, R.; Benti, R.; Corti, S.; Salani, S.; D' Angelo, M.G.; DeLiso, A.; Scarlato, G.; Bresolin, N.; Gerundini, P

    2001-11-01

    The purpose of this study was twofold: first, to evaluate the myoblast labeling of various {sup 99m}Tc complexes and to select the complex that best accomplishes this labeling, and second to evaluate the biodistribution of myoblasts labeled with this complex using mice with MDX muscular dystrophy (the murine homologue of Duchenne's muscular dystrophy). The following ligands were used to prepare the corresponding {sup 99m}Tc complexes: hexakis-methoxy-isobutyl-isonitrile (MIBI), bis(2-ethoxyethyl)diphosphinoethane (Tf), (RR,SS)-4,8-diaza-3,6,6,9-tetramethyl-undecane-2,10-dione-bisoxime (HM-PAO), bis(N-ethyl)dithiocarbamate (NEt), and bis(N-ethoxy, N-ethyl)dithiocarbamate (NOEt). One million murine myoblasts were incubated for 30-60 minutes with 5 mCi of each of the 99mTc complexes prepared from the above ligands. Viability was assessed by microscopic counting after trypan blue staining, and the radioactivity absorbed in the cells was measured after centrifugation. The compound with the highest uptake in cellular pellets was [{sup 99m}Tc]N-NOEt. The biodistribution of myoblasts labeled with this complex was evaluated after intraaortic injection in dystrophic mice. Such an approach has the potential of effecting widespread gene transfer through the bloodstream to muscles lacking dystrophin.

  10. Sup(99m)Tc compounds for diagnostic purposes

    The applications of sup(99m)Tc in nuclear medicine are discussed, such as sodium pertechnetate in thyroid and brain scintigraphy, complex compounds in lungs and liver diao.nosis. Technetium generators are classified according to the method of separating sup(99m)Tc from 99Mo. Adsorption generators are used, molybdate-99 is adsorbed on an Al2O3-packed column while pertechnetate-99m is eluted with 0.9% NaCl solution. Also used is continuous pertechnetate-99m extraction with methyl ethyl ketone from 0.5 M potassium molybdate and 2.5 M of potassium carbonate. The manufacture is described of kits for sup(99m)Tc radiopharmaceuticals preparation, eg., Diagos I, a gluconate complex, a lyophilisate for sup(99m)Tc-sodium pyrophosphate injections, a diagnostic kit for lung scintiscanning. (H.S.)

  11. Novel 99mTc labeled

    FAN; Caiyun

    2006-01-01

    ,Nucl.Med.Biol.,2003,30:273-284.[33]John,C.S.,Lim,B.B.,Geyer,B.C.Et al.,99mTc-labeled σ-receptor-binding complex:Synthesis,characterization,and specific binding to human ductal breast carcinoma (T47D) cells,Bioconj.Chem.,1997,8:304-309.[34]Choi,S-R.,Yang,B.,P(o)ssl,K.Et al.,Development of a Tc-99m labeled sigma-2 receptor-specific ligand as a potential breast tumor imaging agent,Nucl.Med.Biol.,2001,28:657-666.[35]Zhang,Y.,Williams,W.,Torrence-Campbell,C.et al.,Characterization of novel N,N′-disubstituted piperazines as sigma receptor ligands,J.Med.Chem.,1998,41:4950-4957.[36]Maeda,D.N.,Williams,W.,Kim,W.E.et al.,N-arylalkylpi-peridines as high-affinuty sigma-1 and sigma-2 receptor ligands:Phenylpropylamine as potential leads for selective sigma-2 agents,Bioorg.Med.Chem.Lett.,2002,12:497-500.[37]Moore,T.S.,Boyle,M.,Thorn,V.M.et al.,N-substituted derivatives of piperazine and ethylenediamine,Part Ⅰ.The preparation of N-monosubstituted derivatives,J.Chem.Soc.,1929:39.[38]Stewart,H.W.,Turner,R.J.,Denton,J.J.et al.,Experimental chemotherapy of filariasis,Ⅳ.The preparation of derivatives of piperazine,J.Org.Chem.,1948,13:134-143.[39]O'Neil,J.P.,Wilson,S.R.,Katzenellenbogen,J.A.,Preparation and structural characterization of monoamine-monoamide bis(thio) oxo complexes of technetium(V) and rhenium(V),Inorg.Chem.,1994,33:319-323.[40]Bowen,W.D.,Sigma receptors:Recent advances and new clinical potentials,Pharm.Acta Helv.,2000,74:211-218.[41]Deuther-Conrad,W.,Patt,J.T.,Feuerbach,D.et al.,Norchloro-fluoro-homoepibatidine:Specificity to neuronal nicotinic acetylcholine receptor subtypes in vitro,IL Farmaco,2004,59:785-792.[42]Vilner,B.J.,Bowen,W.D.,Modulation of cellular calcium by sigma-2 receptors:Release form intracellular stores in human SK-N-SH neuroblastoma cells,J.Pharmacol.Exp.Ther.,2000,292:900-911.[43]Cheng,Y.,Prusoff,W.H.,Relationship between the inhibition constant (Ki) and the concentration of inhibitor which cause 50% inhibition (IC50) of an enzymatic reaction

  12. Localizacao de glandulas paratireoides ectopicas e supranumerarias em pacientes com hiperparatireoidismo secundario e terciario: descricao cirurgica e correlacao com ultrassonografia e cintilografia Tc99m-Sestamibi pre-operatorios

    Jose Santos Cruz de Andrade

    2014-01-01

    Full Text Available Introdução: O hiperparatireoidismo é uma consequência metabólica esperada na doença renal crônica (DRC. Paratireoides (PT ectópicas e/ou supranumerárias podem ser causa de falha cirúrgica nos pacientes submetidos à paratireoidectomia total (PTX. Objetivo: Definir cirurgicamente a localização das PT, em pacientes com hiperparatireoidismo associado à DRC, e correlacionar esses achados com os exames pré-operatórios. Materiais e métodos: Foi conduzido um estudo retrospectivo com 166 pacientes submetidos à PTX. A localização das PT no intraoperatório foi registrada, sendo classificada como tópica ou ectópica. A localização pré-operatória, definida pela ultrassonografia (USG e pela cintilografia Tc99m-Sestamibi (MIBI, foi comparada com aos achados cirúrgicos. Resultados: Nos 166 pacientes, foram identificadas 664 PT. Foram classificadas como tópicas e ectópicas 577 (86,4% e 91(13,6% glândulas, respectivamente. Oito PT supranumerárias foram encontradas (7 tópicas e 1 ectópica. As localizações mais comuns de PT ectópicas foram as regiões retroesofágica e tímica. Associadas, a USG e a MIBI não identificaram 56 glândulas (61,5% ectópicas. Entretanto, a MIBI foi positiva para 69,7% daquelas localizadas nas regiões tímicas e mediastinal. Conclusão: A presença de glândulas ectópicas e supranumerárias em pacientes com hiperparatireoidismo associado à DRC é significativa. Os exames de imagem pré-operatórios não localizaram a maioria das glândulas ectópicas. A MIBI pode ter importância na identificação de PT nas regiões tímica e mediastinal.

  13. Studies of labelling of melphalan with technetium-99m

    Melphalan is an alkylating agent widely used in the treatment of neoplastic diseases. However, being an α-amino acid it cannot be labeled with Tc-99m by the use of SnCl2 for pertechnetate reduction. The N-carboxy methyl - derivative of melphalan was obtained and its complexing by technetium-99m was examined. A procedure for labelling of melphalan derivative with Tc-99m has been developed. (author). 18 refs, 8 figs, 8 tabs

  14. Imaging bone infection using Tc-99m infecton: case studies

    Tc-99m infecton (ciprofloxacin) was introduced recently as an infection imaging agent which is specific for bacteria. If successful, this may prove superior to labelled leucocyte imaging, antibodies and other nonspecific agents in terms of logistics, cost and efficacy. We had recently acquired few kits for Tc-99m infecton preparation. Our preliminary experience suggests that it has high specificity for the infected bone and may be useful in bone tuberculosis. Three cases are presented where both Tc-99m MDP scanning and Tc-99m infecton study were undertaken to highlight the potential of this new agent. (author)

  15. 99mTc-ciprofloxacin for diagnosis of bacterial infection

    Aungurarat, A.; Ngamprayad, T.; Dangprasert, M.; Phumkem, S.; Jowanaridhi, B.

    2015-05-01

    Preparation of 99mTc-ciprofloxacin for diagnosis of bacterial infection was investigated by varying factors which affected this compound. The optimum conditions for preparation of 99mTc-ciprofloxacin and a lyophilized kit for Tc-99m labelling were studied. The results from biodistribution study showed that the percentages of the injected dose per gram tissues of infected area at 1 and 3 hours after injection were around 0.25-0.56. 99mTc-ciprofloxacin was found sterile, pyrogen-free and non-toxic. Radiochemical purity was greater than 90% with greater than 6 hours of stability.

  16. Tc99m-Sestamibi: Development of Radiopharmaceutical Kit For Heart Imaging

    A development and comparison study of the Nuclear Malaysia's Tc99m-sestamibi heart imaging agents (NM kits) and the commercial products is reported. Three batches of kits labelled as B1, B2 and B3 were produced by freeze drying technique. The commercial products such as sestamibi Cardiolite, Polatom, ChiMIBI and tetrofosmin Myoview were used in this study. The quality control testing which included microbiology testing, radiochemical and animal biodistribution study were conducted accordingly. The NM sestamibi kits passed the sterility and pirogen test. The Radiochemical Purity testing (RCP) was assessed by the Instant Thin Layer Chromatography (ITLC) and High-Performance Liquid Chromatography (HPLC) methods after the reconstitution of the Tc99m-sestamibi. The RCP results were above 90 % and the kits were stable for 52 weeks. The animal biodistribution studies were carried out on Sprague-Dawley rats at 5, 30, 60, 120 and 1440 minutes post injection time intervals. The percentage injected dose per gram organ in heart for Tc99m-B1 were 4.722 ± 0.343 %, 3.752 ± 0.438 %, 4.564 ± 0.664 %, 4.180 ± 1.293 % and 1.090 ± 0.230 % at 5, 30, 60, 120 and 1440 minutes respectively. This is followed by the Tc99m-B2; 3.852 ± 0.406 %, 3.268 ± 0.425 %, 3.366 ± 0.316 %, 4.324 ± 1.044 % and 1.038 ± 0.144 %, Tc99m-B3; 5.404 ± 0.351 %, 4.818 ± 0.579 %, 6.015 ± 0.774 %, 5.028 ± 1.353 % and 1.623 ± 0.692 % at the same time intervals. Independent T Test showed that heart uptake was significant as compared to the control (p<0.05). The biodistribution study also showed that the radiopharmaceuticals localized selectively in the myocardium of rats. The NM sestamibi kits were comparable to the commercial products. Blood, lung, kidney and intestines washout were found to be fast and efficient. The biodistribution and analysis of heart-to-lung and heart-to-liver uptake ratios showed that NM sestamibi kits has a potential and could be used as heart imaging agents. (author)

  17. Direct {sup 99m}Tc labeling of Herceptin (trastuzumab) by {sup 99m}Tc(I) tricarbonyl ion

    Chen, W.-J.; Yen, C.-L.; Lo, S.-T.; Chen, K.-T. [Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan (China); Lo, J.-M. [Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan (China)], E-mail: jmlo@mx.nthu.edu.tw

    2008-03-15

    By simply incubating Herceptin (trastuzumab) with [{sup 99m}Tc(CO){sub 3}(OH{sub 2}){sub 3}]{sup +} ion in saline, a significant yield of {sup 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 {sup 99m}Tc(I) tricarbonyl ion can be strongly bound. For practical {sup 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 [{sup 99m}Tc(CO){sub 3}(OH{sub 2}){sub 3}]{sup +}. Retention of bioactivity of the {sup 99m}Tc(I)-labeled trastuzumab was validated using a cell binding test.

  18. Direct 99mTc labeling of Herceptin (trastuzumab) by 99mTc(I) tricarbonyl ion

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

  19. The role of Sesta-Mibi-SPECT in angiographically documented coronary heart disease

    131 patients were studied to compare the results of 99mTc-Mibi-SPECT with coronary angiography (CAG). 127 patients remained for final evaluation. A scar was falsely diagnosed in 17. 13 patients had a normal CAG and pathologic Sesta-Mibi-SPECT. 5 of them suffered from cardiomyopathy. 2 patients have had a myocarditis, at 2 others a PTCA was perfomred. 1 patient had a 20% LCA-stenosis and another one a left ventricular hypertrophy. Two times the reason for the pathologic Sesta-Mibi-SPECT could not be found. 1 patient had a normal Sesta-Mibi-SPECT despite of a pathologic CAG, angina pectoris and pathologic ECG. We got congruent results in 113 patients. 7 patients showed a left bundle branch block (LBBB), in 5 of them the Mibi-SPECT corresponded well with the CAG. 2 patients with dilated cardiomyopathy and no CHD showed an exercise induced ischemia in the anteroseptal wall. In patiens with angiographically documented CHD Sesta-Mibi-SPECT gives reliable diagnostic information concerning the myocardial perfusion. (orig./MG)

  20. GAMMAGRAFÍA CON 99TC-MIBI PARA DETERMINAR LA EFECTIVIDAD DE LA HEBERQUINASA PARA REPERFUNDIR LA ARTERIA RELACIONADA CON EL INFARTO / 99tc-mibi gammagraphy to determine Heberkinase effectiveness in the reperfusion of the infarction-related artery

    Marilyn Ramírez Méndez

    2010-12-01

    Full Text Available Resumen Introducción y objetivos: La utilización de técnicas nucleares para la determinación de la permeabilidad de la arteria relacionada con el infarto, es de gran importancia clínica. El objetivo de esta investigación fue conocer el estado de la perfusión miocárdica del territorio dependiente de la irrigación de esa arteria y determinar la presencia o no de su reapertura después de la trombólisis. Método: Se realizó una investigación experimental puntual con una muestra de 10 pacientes consecutivos, de ambos sexos y cualquier edad, que ingresaron en la Unidad de Cuidados Intensivos del Hospital Universitario "Dr. Celestino Hernández Robau" de Santa Clara, con el diagnóstico clínico y electrocardiográfico de infarto agudo de miocardio a los que se les administró tratamiento trombolítico con Estreptoquinasa Recombinante Cubana. Resultados: El 60 % pertenece al sexo masculino y el 70 % de la muestra presentaba edades superiores a los 50 años. Fue más frecuente la localización inferior del infarto (50 %, y el 70 % de la serie recibió tratamiento trombolítico en las primeras 6 horas de evolución. La evaluación gammagráfica de la perfusión miocárdica demostró 12 defectos de captación, la tercera parte de ellos (33,3 % se consideraron leves. Después de la aplicación del tratamiento trombolítico hubo una reducción del 50 % de los defectos de captación. Conclusiones: El estudio gammagráfico con 99Tc-MIBI fue útil para demostrar la recanalización de la arteria relacionada con el infarto, tras la utilización de tratamiento trombolítico con Estreptoquinasa Recombinante Cubana. / Abstract Introduction and objectives: Of great clinical importance is the use of nuclear techniques for determining the permeability of the infarction-related artery. The objective of this research was to know the myocardial perfusion state of the area dependent on the irrigation of this artery and to determine whether or not a reopening

  1. Comparative scintigraphic study of renal function with 99mTc-Mercaptoacetyl-triglycine and 99mTc-Ethylenedicysteine

    Beiki D.; Eftekhari M; Fallahi B.; Gheisari F.; Hozhabrosadati M.; Fard-Esfahani A.; Takavar A; Gholamrezanezhad A.; Saghari M. Ansari Gilani K.

    2008-01-01

    99mTc-MAG3 is a standard radiotracer for renal dynamic functional study. Despite its"nproperties for clinical uses, it has numerous technical limitations. 99mTc-EC is also a tubular"nradiotracer for renal imaging, which has not been used worldwide. In this study, the use of 99mTc-EC"nand 99mTc-MAG3 for renal functional study were compared."nMethods: Thirty five patients (20 male, 15 female; mean age of 34.63 ±10.69 years) were entered in"nthe study. About 1...

  2. Influence of background correction in the estimation of myocardial uptake of 99mTc labelled perfusion imaging agents

    The effects of different corrections for background activity in the estimation of low organ uptake of radiopharmaceuticals have been examined using myocardial perfusion imaging agents. Estimates of myocardial uptake of 99mTc-labelled MIBI and tetrofosmin were made both at rest and after exercise. Patients were given one or other of the agents (12 MIBI; 17 tetrofosmin) and the measurements at rest and after exercise were made within a week of each other using a planar gamma camera method incorporating an attenuation-corrected, geometric mean technique. Myocardial uptakes were estimated using two different background corrections and also with no background subtraction. Mean values were in the range 1.3 to 3.0% and showed that, for both agents, uptakes estimated with and without background correction could differ by a factor of two. Although the study was not designed to compare myocardial uptakes of the two agents, a background correction which accounted separately for activity in tissue over- and under-lying the heart resulted in similar mean values for tetrofosmin (1.7% both at rest and after exercise) and for MIBI (1.8% rest; 1.9% exercise). For both agents, no significant difference was observed between myocardial uptakes at rest and after exercise measured at about two hours post-injection. (author) The effects of different corrections for background activity in the estimation of low organ uptake of radiopharmaceuticals have been examined using myocardial perfusion imaging agents. Estimates of myocardial uptake of Tc-labelled MIBI and tetrofosmin were made both at rest and after exercise. Patients were given one or other of the agents (12 MIBI; 17 tetrofosmin) and the measurements at rest and after exercise were made within a week of each other using a planar gamma camera method incorporating an attenuation-corrected, geometric mean technique. Myocardial uptakes were estimated using two different background corrections and also with no background subtraction

  3. Preparation and characterization of a hetero functional system of gold nanoparticles labeled with {sup 99m}Tc and conjugated to the sequence Arg-Gly-Asp for detection in vivo of angio genesis and evaluation of their toxicity in Hyalella aztec; Preparacion y caracterizacion de un sistema heterofuncional de nanoparticulas de oro marcadas con Tecnecio-99m y conjugadas a la secuencia Arg-Gly-Asp para la deteccion in vivo de angiogenesis y la evaluacion de su toxicidad en Hyalella azteca

    Morales A, E.

    2012-07-01

    Integrin s play critical roles in many physiological processes including angio genesis and also contribute to pathological events such as tumor invasion and metastasis. The {alpha}{sub v}{beta}{sub 3} integrin is expressed in normal endothelial cells but it is over-expressed in the tumor neo vasculature. Peptides based on the Arginine-Glycine-Aspartic acid (RGD) sequence have been reported as molecules with high affinity and selectivity for the {alpha}{sub v}{beta}{sub 3} integrin. Recent studies have demonstrated that conjugating peptides to gold nanoparticles (AuNP) produces biocompatible and stable multifunctional systems with target-specific molecular recognition due to multivalent effects produced by multiple simultaneous interactions between peptides and their receptors. The first aim of this research was to prepare a m ultimeric system of {sup 99m}Tc labeled gold particles conjugated to c[RGDfK(C)] and to evaluate its biological behavior as a potential radiopharmaceutical for molecular imaging of {alpha}{sub v}{beta}{sub 3} tumor expression. Hidrazinonicotinamide-G GC (HYNIC-G GC) and C[RGDfK(C)] peptides were synthesized and conjugated to AuNP (20 nm) by means of spontaneous reaction of the thiol groups of cysteine. The nano conjugate was characterized by transmission electron microscopy, Fourier transform-infrared, Ultraviolet-vis, X-ray photoelectron spectroscopy and Raman spectroscopy. To obtain {sup 99m}Tc-HYNIC-G GC-AuNP-c[RGDfK(C)], the {sup 99m}Tc-HYNIC-G GC radio peptide was first prepared and added to the AuNP solution followed by c[RGDfK(C)]. Radiochemical purity (Rp) was determined by size-exclusion HPLC and I TLC-Sg analyses. In vitro binding studies were carried out in {alpha}{sub v}{beta}{sub 3} receptor-positive C6 glioma cancer cells. Biodistribution studies were accomplished in athymic mice with C6-induced tumors with blocked and non blocked receptors, and images were obtained using a micro-SPECT/CT. Transmission electron microscopy and

  4. (99m)Tc-labeled porphyrin-lipid nanovesicles.

    Lee, Jae-Ho; Shao, Shuai; Cheng, Kenneth T; Lovell, Jonathan F; Paik, Chang H

    2015-01-01

    Porphyrin-lipid nanovesicles (PLN) have been developed with intrinsic capabilities as activatable multimodal photonic contrast agents. Radiolabeling of PLN encapsulating drugs could eventually be able to provide quantitative in vivo information for diagnosing and treating diseases. In this study, we developed (99m)Tc-labeled porphyrin-lipid nanovesicles ((99m)Tc-PLN) as a cargo-encapsulated formulation without significant impact on liposome integrity and encapsulation stability. 50 mM calcein was encapsulated into PLN by probe sonication. The size of the PLN was about 150 nm. The PLN were then reacted with (99m)Tc using SnCl2 dissolved in 1 mM HCl as a reducing agent and incubated for 10 min at 22 °C. The radiolabeling efficiency and stability of (99m)Tc-PLN were evaluated by instant thin-layer chromatography and low-pressure liquid chromatography (LPLC). (99m)Tc labeling was successful with a >92% labeling efficiency. LPLC showed that the liposomal elution peaks of the porphyrin-lipid and the calcein overlapped with the radioactivity elution peak of (99m)Tc-labeled PLN. The (99m)Tc-labeling procedure did not change the size of PLN. Encapsulated calcein remained inert inside PLN. Thus, this work lays out a simple and effective radiolabeling method using SnCl2 in HCl in the preparation of (99m)Tc-PLN. PMID:24963601

  5. Labelling of gentamicin sulphate with99mTc

    The labelling of gentamicin sulphate with99mTc and its optimization is shown. The Quality control of gentamicin sulphate -99mTc, and a study about PH and mass variation of SnCl2 are described. (M.J.C)

  6. Quality control of techetium 99m radiopharmacentical in nuclear medicine

    Gel chromatography column scanning (GCS) is a new method for radiochemical quality control. GCS techniques for Technetium-99m radiopharmaceuticals in nuclear medicine have been developed for use in both research and routine clinical work. The dependence on several of the parameters of the GCS method have been investigated, e.g. type of gel, column dimensions, eluent, equilibration, elution volume, flow rate and resolution of the recording system (radiochromatographic scanner or scintillation camera). The GCS method has been compared with conventional gel filtration, thinlayer cromatography (TLC) and paper cromatography (PC). The GCS method is to be preferred due to few artifacts, much information, good reproducibility, rapidity, simplicity and the convenience of the test. The GCS method has been applied to the development of labelling techniques for the new radiopharmaceuticals Tc-99m plasmin and Tc-99m unithiol (2.3 dimercaptopropane sodiumsulphonate), use for investigating deep vein thrombosis and renal cortical morphology respectively. The GCS method has also been applied for studying some labelling parameters, the radiochemical purity and the labelling of Tc-99m macroaggregated albumin, Tc-99m pyrophosphate, Tc-99m methylenedisphosphate, in addition to Tc-99m plasmin and Tc-99m unithiol. (Author)

  7. Initial experience with 99mTc-tetrofosmin scintimammography

    Full text:99mTc-tetrofosmin prone scintimammography was performed in 12 patients with palpable breast lesions and abnormal mammography findings. Right and left lateral prone and anterior supine views were obtained starting at 10 min of intravenous injection of 20 mCi 99mTc labelled tetrofosmin. Focal increased concentration of radiopharmaceutical as compared to surrounding normal breast tissue was considered positive for malignant disease. Patients underwent surgery with histopathological examination. 7 of the eight malignant lesions showed accumulation of 99mTc-tetrofosmin. Involved lymph nodes were also seen to concentrate the radiopharmaceutical. Four benign breast masses did not show focal 99mTc-tetrofosmin uptake. Initial results suggest that 99mTc-tetrofosmin could play a useful role in evaluation of breast tumours

  8. Preparation and evaluation of third generation technetium-99m radiopharmaceuticals

    The preparation and evaluation of three different 99mTc labelled peptides as third generation radiopharmaceuticals is presented. Lys3-Bombesin ([Lys3]BN), ubiquicidin 29-41(UBI 29-41) and Tyr3-octreotide (TOC) were prepared as instant kit formulations to be labelled by direct or indirect methods with 99mTc in order to evaluate in vivo prostate malignancies, infection processes and lung cancer respectively. Radiochemical purity of >93% was obtained. Also, high in vitro and in vivo stabilities and preservation of the molecular recognition were observed. It is demonstrated that 99mTc-EDDA/ HYNIC-[Lys3]BN detects GRP receptor positive tumours in mice, 99mTc-UBI 29-41 detects infection foci in humans and 99mTc-EDDA/HYNIC-TOC is useful in patients with lung cancer. (author)

  9. Comparative scintigraphic study of renal function with 99mTc-Mercaptoacetyl-triglycine and 99mTc-Ethylenedicysteine

    Beiki D.

    2008-03-01

    Full Text Available 99mTc-MAG3 is a standard radiotracer for renal dynamic functional study. Despite its"nproperties for clinical uses, it has numerous technical limitations. 99mTc-EC is also a tubular"nradiotracer for renal imaging, which has not been used worldwide. In this study, the use of 99mTc-EC"nand 99mTc-MAG3 for renal functional study were compared."nMethods: Thirty five patients (20 male, 15 female; mean age of 34.63 ±10.69 years were entered in"nthe study. About 10 mCi of 99mTc-EC and 99mTc-MAG3 were administered in different days within 7"ndays intervals and serial images were obtained for 30 minutes. Serum creatinine and visual"nscintigraphic findings of all patients were within normal limits."nResults: In this study, the renal uptake of 99mTc-EC was significantly higher than 99mTc-MAG3 (6.20%"nvs 4.39% of the injected dose, while the hepatic activity of 99mTc-EC was significantly lower (307 vs"n439 mean pixel count, p<0.0001. Also the absolute values for some other quantitative parameters"nsuch as right and left kidney transit times and ERPF were different for each radiotracer. In spite of"nthese differences most quantitative parameters (except for right kidney transit time, liver uptake and"nTmax of both kidneys showed good correlations for both agents."nConclusion: The calculated ERPF with 99mTc-EC as compared to 99mTc-MAG3 is in closer proximity"nto the true values. Also the use of 99mTc-EC compared to 99mTc-MAG3 in clinic due to simplicity of"npreparation, higher stability, higher renal uptake, and lower hepatobiliary activity is better. Therefore"nthe use of 99mTc-EC as an appropriate substitute or ever preferred radiopharmaceutical for 99mTc-"nMAG3 radiopharmaceutical for renal function studies is recommended.

  10. Comparative radioanalytical and biokinetic studies of 99mTc-Tin and 99mTc-sulphur colloid kits

    Gel chromatography scanning technique (GCS) was used to study the radioanalytical behaviour of 99mTc-tin colloid and 99mTc-sulphur colloid kits. Sepharose has been found to be more accurate and versatile than the other conventional analytical procedures for radioanalytical evaluation of 99mTc-labelled colloids. The obtained radioanalytical results showed that 99mTc-sulphur colloid is more susceptible than the 99mTc-tin colloids to change due to the analytical environment. This is related to the nature of oxidation state of technetium atom in both colloids. The formation of 99mTc-tin colloid is achieved within few minutes after pertechnetate addition, while labeling of sulphur colloid is accomplished through a rather slow process. The organ distribution in mice shows that more than 90% of the injected dose of both colloids are accumulated in the liver, which proved the colloid labeling and optimal size particle. The minor size difference in the blood residual activity is due to the presence of hydrophilic stabilizer in 99mTc-sulphur colloid. The blood clearance study in rabbits showed that the biological half-times of activity disappearance of fast phase are longer periods extend to 125 and 65 minutes to 99mTc-tin and 99mTc-sulphur colloids, respectively. The in vitro plasma protein binding studies revealed by the GSC method showed that about 85% of 99mTc-tin colloid and 16% of 99mTc-sulphur colloid were bound to plasma protein, which proved that it does not influence the in vivo kinetics of both colloids

  11. Study on the preparation and biological evaluation of 99mTc-gatifloxacin and 99mTc-cefepime complexes

    The aim of this work is the development of new radiopharmaceuticals for imaging infection and inflammation in human. Gatifloxacin (fluoroquinolone derivative) and cefepime (cephalosporine derivative) are antibiotics used to treat bacterial infections were investigated to label with one of the most important radioactive isotopes (technetium-99m). The reaction parameters that affect the labeling yield such as substrate concentration, stannous chloride dihydrate concentration, pH of the reaction mixture, and reaction time were studied to optimize the labeling conditions. Maximum radiochemical yield of 99mTc-gatifloxacin (90 ± 1.8%) complex was obtained by using 50 μg SnCl2 · 2H2O and 2.5 mg gatifloxacin at pH 10 while 99mTc-cefepime was prepared at pH 8 with a maximum radiochemical yield of 98 ± 1.4% by adding 99mTc to 5 mg cefepime in the presence of 50 μg SnCl2 · 2H2O. Biological distribution of 99mTc-gatifloxacin and 99mTc-cefepime was carried out in experimentally induced infection rats, in the left thigh, using Escherichia coli. Both thighs of the rats were dissected and counted and the ratio of bacterial infected thigh/contralateral thigh was then evaluated. T/NT for both 99mTc-gatifloxacin and 99mTc-cefepime was found to be 4.5 ± 0.3 and 8.4 ± 0.1, respectively, which was higher than that of the commercially available 99mTc-ciprofloxacin. The abscess to normal muscle ratio indicated that 99mTc-cefepime could be used for infection imaging. Besides, in vitro studies showed that 99mTc-cefepime can differentiate between bacterial infection and sterile inflammation. (author)

  12. Evaluation of adenosine preconditioning with 99mTc-His10-annexin V in a porcine model of myocardium ischemia and reperfusion injury: preliminary study

    Purpose: The goal of this study was to evaluate the feasibility of 99mTc-His10-annexin V for the detection of acute myocardial cell death and to assess the effect of adenosine preconditioning in a porcine model of myocardium ischemia and reperfusion injury (RI). Materials and Methods: 99mTc-His10-annexin V was prepared by one-step direct labeling, and RCP and radiostability were tested. The binding of 99mTc-His10-annexin V to apoptosis was validated in vitro using camptothecin-induced Jurkat cells. In vivo biodistribution was determined in mice by the dissection method. Ischemia of 20-30 min was induced by balloon occlusion of the epicardial coronary artery of the porcine model (n=14). Adenosine was infused intravenously in six pigs before coronary occlusion. 99mTc-His10-annexin V (n=12) was injected intravenously at 1 h after reperfusion. SPECT/CT was acquired at 3 h postinjection. Myocardial perfusion imaging (MPI) with 99mTc-MIBI was also performed 1 day after His10-annexin V imaging. Cardiac tissues were analyzed postmortem using hematoxylin-and-eosin and TUNEL staining. Caspase-3 activity was measured to confirm the presence of apoptosis. Results: 99mTc-His10-annexin V had a RCP >98% and high stability 2 h after radiolabeling; it could bind to apoptotic cells with high affinity. Biodistribution of 99mTc-His10-annexin V showed a predominant uptake in the kidney and relatively low uptake in the myocardium, liver and gastrointestinal tract; rapid clearance from blood and kidney was observed. In the untreated group, intense uptake of His10-annexin V was visualized in the defect which was shown in MPI, whereas in the adenosine group a mild uptake of 99mTc-His10-annexin was found in the risk area which showed no defects in the 99mTc-MIBI image. TUNEL staining and activated caspase-3 confirmed the ongoing apoptosis in RI. Adenosine preconditioning significantly diminished the level of apoptosis. Uptake of His10-annexin V in RI correlated with TUNEL-positive nuclei

  13. Evaluation of the absorbed dose to the kidneys due to Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3) and Tc{sup 99m} (Dmsa); Evaluacion de la dosis absorbida en los rinones debido al Tc{sup 99m} (DTPA) / Tc{sup 99m} (MAG3) y Tc{sup 99m} (DMSA)

    Vasquez A, M.; Murillo C, F.; Castillo D, C.; Rocha J, J.; Sifuentes D, Y.; Sanchez S, P. [Universidad Nacional de Trujillo, Av. Juan Pablo II s/n, Trujillo (Peru); Idrogo C, J.; Marquez P, F., E-mail: marvva@hotmail.com [Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos 2520, Lima (Peru)

    2015-10-15

    The absorbed dose in the kidneys of adult patients has been assessed using the biokinetics of radiopharmaceuticals containing Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3) or Tc{sup 99m} (Dmsa).The absorbed dose was calculated using the formalism MIRD and the Cristy-Eckerman representation for the kidneys. The absorbed dose to the kidneys due to Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3), are given by 0.00466 mGy.MBq{sup -1} / 0.00339 mGy.MBq{sup -1}. Approximately 21.2% of the absorbed dose is due to the bladder (content) and the remaining tissue, included in biokinetics of Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3). The absorbed dose to the kidneys due to Tc{sup 99m} (Dmsa) is 0.17881 mGy.MBq{sup -1}. Here, 1.7% of the absorbed dose is due to the bladder, spleen, liver and the remaining tissue, included in biokinetics of Tc{sup 99m} (Dmsa). (Author)

  14. Evaluation of 99mTc-erythromycin and 99mTc-streptomycin sulphate for the visualization of inflammatory lesions

    99mTc-erythromycin (E) and 99mTc-streptomycin sulphate (SS) were prepared with > 98% labelling efficiency. The labels were stable up to 24 h of testing, using ITLC-SG strips and acetone and saline as solvents. The biodistributions of both radiopharmaceuticals versus 67Ga-citrate were studied in mice with turpentine-induced abscesses at 6 days post-induction. The mice were sacrificed at 1, 3 and 6 h post injection of 15 MBq of 99mTc-E or 99mTc-SS. Mice injected with 67Ga-citrate were sacrificed at 4 and 24 h. The maximum abscess-to-muscle ratios obtained by biodistribution studies were 2.36 ± 1.04 (6 h), 2.38 ± 0.38 (6 h) and 4.76 ± 2.04 (4 h) with 99mTc-E, 99mTc-SS and 67Ga-citrate, respectively. The maximum abscess-to-contralateral tissue ratios by ROIs over respective areas on scintigrams were 2.38 + 0.16 (6 h), 3.21 ± 0.14 (3 h) and 3.24 ± 0.92 (24 h) for 99mTc-E, 99mTc-SS and 67Ga-citrate, respectively. The uptake mechanism might be infiltration into interstitial space due to increased capillary permeability. (Author)

  15. 99mTc-MAG3: can it be a viable alternative to 99mTc-DTPA ?

    The purpose of this study was to assess the potentials of 99mTc MAG3 to replace universally used 99mTc-DTPA as a routine renal agent. Five patients with different nephrological problems were first studied with 99mTc MAG3 and then reinvestigated with 99mTc-DTPA two to seven days later. Renal MAG3 gamma camera images were found to be almost identical with those of 99mTc-DTPA images except high hepatic and splenic uptake of the former compound in four out of five patients (80%) irrespective of kidney function. MAG3 and DTPA renograms showed identical differential renal uptake function (r=0.87) with slightly higher uptake in right kidneys. Time to reach the peak correlated well (r=0.91). Time to reach half maximum renal activity was also found to be almost identical (r=0.97) for MAG3 and DTPA. It was felt that the age old 99mTc-DTPA is as good a compound as 99mTc MAG3 with regard to imaging and assessment of renal uptake, drainage and differential renal functions. 99mTc-DTPA is much cheaper, readily available in India and stable to suit the logistics in a busy nuclear medicine department for routine renography. (author). 10 refs., 2 figs., 3 tabs

  16. Scintigraphic and intraoperative scintimetric localization of an ectopic parathyroid adenoma with Tc-99m Tetrofosmin and Tc-99m Sestamibi

    Background: We report on a case of preoperative scintigraphic and intraoperative scintimetric confirmation of an ectopic parathyroid adenoma with Tc-99m Tetrofosmin in a 52-year old patient with persistent hyperparathyroidism after unsuccessful primary preoperative localization and reoperation. Methods: In preoperative localization study, dynamic, sequential static scans and SPECT of the neck and mediastinum were performed using Tc-99m Sestamibi and Tc-99m Tetrofosmin. Reoperation was performed by help of a hand-held gamma-probe for intraoperative scintimetric localization after preoperative injection of Tc-99m Tetrofosmin. Results: An ectopic adenoma could be detected preoperatively with both tracers. Tc-99m Tetrofosmin showed no significant difference in image quality vs. Tc-99m Sestamibi. The adenoma could also be detected scintimetrically by elevated count-rates. Conclusions: This case gives promise for Tc-99m Tetrofosmin to be a possible alternative in parathyroid imaging with similar imaging properties and slight theoretical advantages concerning background clearance, radiation exposure and constitution over Tc-99m Sestamibi. Intraoperative localization and confirmation of ectopic parathyroid adenoma, eventually with a geometrically adapted gamma-probe, seems to be possible. Whether there are significant advantages resulting in a possible reduction of operating time, should be evaluated in further studies. (author)

  17. Breast-milk radioactivity after a Tc-99m DTPA aerosol/Tc-99m MAA lung study

    Measurements were made of the concentration of Tc-99m activity in samples of breast milk following an administration of Tc-99m DTPA aerosol for a lung ventilation image and one of Tc-99m MAA for lung perfusion. The activity was 222 nCi/ml of milk (8.2 kBq/ml) at 2 hr after the MAA injection, and it was found to be excreted exponentially with an effective half-life of 4.6 hr. There was a small incorporation of Tc-99m into breast-milk protein. The authors conclude that the combined use of these two Tc-99m agents did not indicate the interruption of breast feeding beyond 24 hr after administration of the MAA, and that for an aerosol ventiliation study alone, breast feeding need not be interrupted for more than 4 hr after the test

  18. The chemistry of 99mTc-labeled radiopharmaceuticals

    The subject of the chemistry of 99mTc-radiopharmaceuticals consists of a collection of bits and pieces of information without a unifying theme. Since the initial impetus to the field of organ imaging was provided by radiochemists, nuclear chemists, and clinician-investigators, using easily prepared 99mTc-compounds from available off-the-shelf ligands, complete chemical characterization was not carried for the 99mTc-radiopharmaceuticals and their metabolites. The influx of coordination, organic, and analytic chemists and their systematic studies clarified some of the structures of these tracers, and promoted the general synthetic methods of a variety of ligands and the corresponding 99mTc-chelates as well as understanding of the nature of their metabolites. Although major developments for organ-imaging radiopharmaceuticals had been made, future studies will result in the simplified methodology of protein-labeling, fine-tuning of the currently available radiopharmaceuticals for higher organ-extraction, and replacement of expensive 123I-labeled tracers with the corresponding 99mTc-tracers. In general, the Tc-complexes are thermodynamically less stable and kinetically more labile than the corresponding Re-complexes. The well established chemistry of Re-compounds, the similarity of Tc-chemistry to that of Re compounds, and structure-activity relationships of a few classes of 99mTc-labeled compounds, may promote the development of new generation of 99mTc-labeled radiopharmaceuticals.69 references

  19. {sup 99m}Tc-sestamibi. Clinical applications

    Bucerius, Jan [Maastricht Univ. Medical Center (Netherlands). Dept. of Nuclear Medicine and Cardiovascular Research Institute Maastricht; Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [Universitaetsklinikum Bonn (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2012-07-01

    {sup 99m}Tc-sestamibi is a single-photon emission computed tomography (SPECT) radiotracer that was introduced into clinical routine for myocardial perfusion imaging more than two decades ago. Although today the main application of {sup 99m}Tc-sestamibi SPECT remains the imaging of myocardial perfusion, it is also an accepted and well-proven imaging technique for a variety of oncologic and non-oncologic applications, including brain, breast, and thyroid cancer and thyroid and parathyroid adenoma. Its efficacy in a range of indications ensures that {sup 99m}Tc-sestamibi SPECT will remain widely used despite the rapid diffusion of 18F-FDG PET. {sup 99m}Tc-Sestamibi - Clinical Applications provides a detailed and informative overview of almost all the oncologic and non-oncologic applications of {sup 99m}Tc-sestamibi SPECT, including several relatively rare indications. Different disease-related protocols for {sup 99m}Tc-sestamibi SPECT are presented, and for each disease a comprehensive summary of the relevant pathology and epidemiology is provided. Throughout, there is a strong emphasis on the practical aspects of use of this popular tracer, including instructions for the preparation of several commercially available tracer kits. Clinical practitioners will find this book to be an invaluable guide to the application and benefits of {sup 99m}Tc-sestamibi SPECT in both the inpatient and the outpatient setting. (orig.)

  20. New preparation method for /sup 99m/Tc-phytate

    A new method is described in which Pt-Sn or Sn-Sn electrodes are used to activate /sup 99m/TcO4-. The /sup 99m/Tc is incorporated into phytic acid by stannous ion released from a tin anode by the corrosive reaction. The most suitable pH for labeling phytic acid by this method was below 5 and the /sup 99m/Tc-phytate formed could be precipitated with Ca+2 at a pH above 3.5. Though /sup 99m/Tc-phytate is soluble in aqueous solution, it forms an insoluble species with Ca+2 in vivo and is trapped in the reticuloendothelial system. More than 93 percent of the /sup 99m/Tc-phytate localized in the liver of mice; here its biologic half-time is about 112 hr. The /sup 99m/Tc-phytate prepared by this method promises to be useful as a liver-scanning agent. Since our method does not require an applied electric potential, it appears to be one of the most convenient methods for labeling compounds with /sup 99m/Tc

  1. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Lee, Min Kyung; Hwang, Kyung Hoon [Gachon University Gil Hospital, Incheon (Korea, Republic of); Yoon, Min Ki [Good Samaritan Hospital, Pohang (Korea, Republic of); Choe, Won Sick [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2010-06-15

    Tc-99m ciprofloxacin is available for imaging infection. However, there has been no study on employing single photon emission computed tomography (SPECT) with using Tc-99m ciprofloxacin to image active pulmonary tuberculosis. Therefore, we conducted this study to assess the efficacy of Tc-99m ciprofloxacin SPECT for imaging active pulmonary tuberculosis. Twenty-one participants were enrolled in this prospective study. They were divided into two groups according to the clinical and radiological assessment. Group one (Gr. 1) consisted of five normal volunteers and six patients with inactive pulmonary tuberculosis. Group two (Gr. 2) consisted of ten patients with active pulmonary tuberculosis. SPECT was performed 3 h after injecting 555 MBq (15 mCi) of Tc-99m ciprofloxacin. The findings of Tc-99m ciprofloxacin SPECT were interpreted by a nuclear medicine specialist and then the results were analyzed according to the patients' clinical and radiological classifications. The results of Tc-99m ciprofloxacin SPECT were as follows: eight true-positive cases, ten true-negative cases, one false-positive case and two false-negative cases. The sensitivity and specificity was 80.0% and 90.0%, respectively. The positive predictive value was 88.9% and the negative predictive value was 83.3%. Conclusions Tc-99m ciprofloxacin SPECT is feasible for imaging active pulmonary tuberculosis. It is a useful nuclear-imaging method for discriminating between the active and inactive tuberculosis states in patients with a past medical history of pulmonary tuberculosis.

  2. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Tc-99m ciprofloxacin is available for imaging infection. However, there has been no study on employing single photon emission computed tomography (SPECT) with using Tc-99m ciprofloxacin to image active pulmonary tuberculosis. Therefore, we conducted this study to assess the efficacy of Tc-99m ciprofloxacin SPECT for imaging active pulmonary tuberculosis. Twenty-one participants were enrolled in this prospective study. They were divided into two groups according to the clinical and radiological assessment. Group one (Gr. 1) consisted of five normal volunteers and six patients with inactive pulmonary tuberculosis. Group two (Gr. 2) consisted of ten patients with active pulmonary tuberculosis. SPECT was performed 3 h after injecting 555 MBq (15 mCi) of Tc-99m ciprofloxacin. The findings of Tc-99m ciprofloxacin SPECT were interpreted by a nuclear medicine specialist and then the results were analyzed according to the patients' clinical and radiological classifications. The results of Tc-99m ciprofloxacin SPECT were as follows: eight true-positive cases, ten true-negative cases, one false-positive case and two false-negative cases. The sensitivity and specificity was 80.0% and 90.0%, respectively. The positive predictive value was 88.9% and the negative predictive value was 83.3%. Conclusions Tc-99m ciprofloxacin SPECT is feasible for imaging active pulmonary tuberculosis. It is a useful nuclear-imaging method for discriminating between the active and inactive tuberculosis states in patients with a past medical history of pulmonary tuberculosis.

  3. (99m)Tc-labeled therapeutic inhaled amikacin loaded liposomes.

    Lee, Jae-Ho; Cheng, Kenneth T; Malinin, Vladimir; Li, Zhili; Yao, Zhengsheng; Lee, Sung-Jin; Gould, Christine M; Olivier, Kenneth N; Chen, Clara; Perkins, Walter R; Paik, Chang H

    2013-12-01

    The radiolabeling of the liposome surface can be a useful tool for in vivo tracking of therapeutic drug loaded liposomes. We investigated radiolabeling therapeutic drug (i.e. an antibiotic, amikacin) loaded liposomes with (99m)Tc, nebulization properties of (99m)Tc-labeled liposomal amikacin for inhalation ((99m)Tc-LAI), and its stability by size exclusion low-pressure liquid chromatography (LPLC). LAI was reacted with (99m)Tc using SnCl2 dissolved in ascorbic acid as a reducing agent for 10 min at room temperature. The labeled products were then purified by anion exchange resin. The purified (99m)Tc-LAI in 1.5% NaCl solution was incubated at 4 °C to assess its stability by LPLC. The purified (99m)Tc-LAI was subjected to studies with a clinically used nebulizer (PARI eFlow®) and the Anderson Cascade Impactor (ACI). The use of ascorbic acid at 0.91 mM resulted in a quantitative labeling efficiency. The LPLC profile showed that the liposomal peak of LAI detected by a UV monitor at both 200 nm and 254 nm overlapped with the radioactivity peak of (99m)Tc-LAI, indicating that (99m)Tc-LAI is suitable for tracing LAI. The ACI study demonstrated that the aerosol droplet size distribution determined gravimetrically was similar to that determined by radioactivity. The liposome surface labeling method using SnCl₂ in 0.91 mM ascorbic acid produced (99m)Tc-LAI with a high labeling efficiency and stability that are adequate to evaluate the deposition and clearance of inhaled LAI in the lung by gamma scintigraphy. PMID:23879241

  4. Asialoglycoprotein receptor targeted imaging using Tc-99m galactosylated chitosan

    Kim, E. M.; Jeong, H. J.; Kim, B. C.; Kim, C. K [Wonkang University College of Medicine, Iksan (Korea, Republic of)

    2004-07-01

    The asialoglycoprotein receptor (ASGP-R) is expressed on liver hepatocytes. Chitosan conjugates of galactose have shown to be specifically taken up by liver parenchymal cells via ASGP-R. In this study, Tc-99m hydrazino nicotinamide (HYNIC)-galactosylated chitosan (HYNIC-GC) was synthesized and evaluated as a targeted agent for the imaging of hepatocytes. GC was obtained after coupling of lactobionic acid as the galactose moiety and coupled with HYNIC. HYNIC-GC was radiolabeled with Tc-99m using stannous chloride and tricine as reducing agent and coligand respectively. Hepatic uptake property of Tc-99m HYNIC-GC was studied in female Balb/C mouse. Tc-99m HYNIC--GC and Tc-99m HYNIC-Chitosan as a control were intravenously injected into mice. Receptor binding was identified by coinjection with 50 mM and 80mM free galactose respectively. Biodistribution was determined at three different time points. The level of galactose substitution was 7.6%. Labeling efficiency was >90% both in vitro and serum up to 24 h. Tc-99m HYNIC-GC injected via tail vein of mice showed high selectivity of liver. On the other hands, Tc-99m HC without galactose group showed low uptake (Fig. 1A, 1B). Hepatic uptake of Tc-99m HYNIC-GC was dramatically blocked by 50 mM and 80 mM free galactose coinjection (Fig. 1C, 1D). The liver accumulated about 14 percent injected dose per gram (%ID/g) up to 120 min after injection. Tc-99m HYNIC-GC showed specific and rapid targeting to liver. It is a promising specific radiopharmaceutical with potential applications in the imaging of liver parenchymal cells.

  5. Asialoglycoprotein receptor targeted imaging using Tc-99m galactosylated chitosan

    The asialoglycoprotein receptor (ASGP-R) is expressed on liver hepatocytes. Chitosan conjugates of galactose have shown to be specifically taken up by liver parenchymal cells via ASGP-R. In this study, Tc-99m hydrazino nicotinamide (HYNIC)-galactosylated chitosan (HYNIC-GC) was synthesized and evaluated as a targeted agent for the imaging of hepatocytes. GC was obtained after coupling of lactobionic acid as the galactose moiety and coupled with HYNIC. HYNIC-GC was radiolabeled with Tc-99m using stannous chloride and tricine as reducing agent and coligand respectively. Hepatic uptake property of Tc-99m HYNIC-GC was studied in female Balb/C mouse. Tc-99m HYNIC--GC and Tc-99m HYNIC-Chitosan as a control were intravenously injected into mice. Receptor binding was identified by coinjection with 50 mM and 80mM free galactose respectively. Biodistribution was determined at three different time points. The level of galactose substitution was 7.6%. Labeling efficiency was >90% both in vitro and serum up to 24 h. Tc-99m HYNIC-GC injected via tail vein of mice showed high selectivity of liver. On the other hands, Tc-99m HC without galactose group showed low uptake (Fig. 1A, 1B). Hepatic uptake of Tc-99m HYNIC-GC was dramatically blocked by 50 mM and 80 mM free galactose coinjection (Fig. 1C, 1D). The liver accumulated about 14 percent injected dose per gram (%ID/g) up to 120 min after injection. Tc-99m HYNIC-GC showed specific and rapid targeting to liver. It is a promising specific radiopharmaceutical with potential applications in the imaging of liver parenchymal cells

  6. QC studies and biological evaluations of three locally produced renal pharmaceutical preparations: 99mTc-DTPA, 99mTc-GH, and 99mTc- DMSA

    Quality control (QC) studies were done of three locally produced renal preparations of 99mTc- DTPA, 99mTc-GH and 99mTc-DMSA, as part of the production activity before the Gulf war. These studies were performed using gel chromatography column scanning (GCS) technique, although there are other alternative techniques. These kits were tested for radiochemical purity, and the labeling yields were found to be excellent. Biological studies included the following parameters: organ distribution (in mice, rats and rabbits), blood clearance in rabbits, and plasma protein binding in rats at different time intervals. Poor renal concentration of three agents in mice was significant at two time intervals. The tissue distribution in mice of DTPA, GH, and DMSA kits, which were stored at 37 deg. C for 30 days, after intravenous injection of the radioactivity at 5, 30, and 60 minutes, respectively, is presented. Blood retention of the renal agents was considerably low compared to those in rats and rabbits at the respective time intervals. The blood clearance of 99mTc-DMSA was relatively slow, and 99mTc-GH has rapid blood clearance, identical with that of 99mTc-DTPA for the first 20 minutes but slower thereafter. The binding of DTPA, GH and DMSA with plasma protein was 5, 65, 95 % at 1 h, respectively. Various amounts of tin (II) (as SnCl2), were used in the kits, with up to 10 times more of the usual dose for respective tin-complex. It was observed that there was no significant variation of the organ distribution in mice

  7. Labelling of red blood cells with 99m pertechnetate

    This paper describes a method for labelling red blood cells with 99mTc in vitro, using electrolytically generated stannous ions as the reducing agent for 99mTc-pertechnetate. A labelling of 95% was found. A method for the in vivo labelling of red blood cells is also reported. This involves an injection of a stanno-DTPA-complex followed 20 minutes later by a 99mTc-pertechnetate solution scintillation camera images show more background activity when the in vivo method of labelling is used

  8. Study of 99mTc-ECD instant kit

    The authors report the preparation of 99mTc-ECD instant kit, and a comparison of the instant kit with the ligand exchange kit. The radiochemical purity, stability, animal experiment and preliminary clinical trial showed that the instant kit possessed the following advantages: (1) The labelling yield (greater than 95%) and stability of 99mTc-ECD (the liberation of 99mTc 5 hr after preparation was less than 1%) were high; (2) The labelling method was simple, convenient and effective; (3) The quality of brain SPECT images was good. This instant kit is more suitable for the clinic application than the 2-step kit

  9. Comparison of carrier-added [99mTc] EDTMP and carrier-free preparations of [99mTc] EDTMP and [99mTc] DPD

    Full text: High uptake of bone-seeking radiopharmaceuticals in malignant bone lesions is a prerequisite for adequate bone scanning. Visual image analysis is impaired due to high soft-tissue activity with currently available [99mTc]-EDTMP-kits. This study aimed to compare carrier-added [99mTc]-EDTMP with carrier-free [99mTc]-EDTMP and [99mTc]-DPD preparations in clinical routine. 15 μg and 150 μg perrhenic acid respectively were added to [99mTc]-pertechnetate (>6 GBq in 3 ml phys. saline). The solution was then transferred into a vial, containing 1 mg of EDTMP, 3.6 mg stannous(II)chloride and 10 mg ascorbic acid under inert conditions. Under vigorous stirring the reaction mixture was heated to 45 oC for 10 min. After cooling down to room temperature the labelling mixture was sterile filtrated (millipore 0.22 μm). Quality control was performed using radio-ITLC (Whatman SG; acetone or ethanol: Rf perrhenate/pertechnetate 0.87, colloid/product 0.05; phys. saline: Rf colloid 0.00, perrhenate/pertechnetate and product 0.9) allowing rapid and efficient assessment of the product. Carrier free [99mTc]-EDTMP and [99mTc]-DPD were prepared according to instructions of the manufacturer. Clinical studies were performed in 29 patients according to a routine bone scanning protocol by injecting 700-800 MBq of the respective tracer and whole body imaging 3 h thereafter. Radiochemical purity and radiochemical yield relied on various parameters such as concentration of carrier and reducing agent and reaction conditions (pH, reaction time, temperature). Means of the labelling yield were 22 % for the preparation using 150 μg of carrier (5 preparations), 80 % for the preparation using 15 μpg of carrier (10 preparations) and 91 % for the carrier free products (5 preparations). Radiochemical purity was >96 % in all experiments. Colloid was formed in very low amounts, and was completely removed by sterile filtration. In clinical studies quantitative analysis demonstrated a significant

  10. 99mTc-interleukin-2 and 99mTc-HMPAO granulocyte scintigraphy in patients with inactive Crohn's disease

    Crohn's disease (CD) is a chronic inflammatory bowel disease that may involve the whole gut. Marked intestinal T cell and macrophage activation is a key feature of the disease. Polymorphonuclear cell infiltration is also observed in the diseased gut, mainly during active inflammation. Scintigraphic detection of granulocytes and activated lymphocytes infiltrating the gut wall may be useful in identifying a subgroup of patients with clinically inactive CD who are undergoing early clinical relapse. The aims of the present study were (a) to compare the effectiveness of scintigraphy with 99mTc-labelled interleukin-2 (99mTc-IL2) and with 99mTc-HMPAO labelled granulocytes (99mTc-WBC) in detecting the presence and extent of bowel inflammation in patients with long-term inactive CD (>12 months) and (b) to assess the accuracy of these techniques in predicting future disease relapse. We studied 29 patients with ileal and/or colonic CD in stable clinical remission (Crohn's Disease Activity Index 99mTc-IL2 and 99mTc-WBC scintigraphy in order to evaluate the extent of acute and chronic inflammation in the bowel. Planar and single-photon emission tomography images were acquired in each patient at 1 h p.i. For quantitative analysis of 99mTc-IL2 uptake, the abdomen was divided into 32 regions of interest. Despite the absence of symptoms, 18 patients (62%) showed a positive 99mTc-IL2 and 18 (62%) a positive 99mTc-WBC scan. Only 12 patients (41.4% of the total group) were positive on both scans, and the sites of IL2 and granulocyte bowel uptake were usually located in different segments, indicating that in CD, acute and chronic inflammation can be present in different sites. As far as the prognostic role of the two scans in predicting future disease relapse is concerned, both 99mTc-IL2 and 99mTc-WBC scintigraphy showed a high negative predictive value (1.00 and 0.91, respectively) but a weak positive predictive value (0.44 and 0.39, respectively). Nevertheless, Kaplan-Meier curves

  11. {sup 99m}Tc-tetrofosmin or {sup 99m}Tc-sestamibi for double-phase parathyroid scintigraphy?

    Froeberg, Alida C.; Valkema, Roelf [Department of Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam (Netherlands); Bonjer, Jaap H. [Department of Surgery, Erasmus MC, Rotterdam (Netherlands); Krenning, Eric P. [Department of Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam (Netherlands); Department of Internal Medicine, Erasmus MC, Rotterdam (Netherlands)

    2003-02-01

    Several years ago technetium-99m tetrofosmin was reported to localise parathyroid adenomas. The aim of this study was to compare the sensitivity of this radiopharmaceutical with that of {sup 99m}Tc-sestamibi using a double-phase parathyroid scintigraphy protocol. Scans of 12 patients were evaluated visually and lesion to thyroid ratios were calculated. Nine of the patients were subsequently operated on; a total of eight parathyroid adenomas or hyperplastic glands were histologically confirmed in seven of the patients, while in one patient a parathyroid carcinoma was histologically proven. All of these patients had positive {sup 99m}Tc-sestamibi scintigrams, whereas only two {sup 99m}Tc-tetrofosmin scintigrams were positive. With {sup 99m}Tc-sestamibi there was a significant increase in the lesion to thyroid ratio from 10 min to 90 min and 150 min p.i. which was not seen on scintigraphy with {sup 99m}Tc-tetrofosmin. This makes {sup 99m}Tc-tetrofosmin less suitable for double-phase parathyroid scintigraphy. (orig.)

  12. Determination of Brain Death by 99mTc DTPA and 99mTc HMPAO Images

    To evaluate availability of cerebral radionuclide imaging for diagnosis of brain death, we examined 25 patients with a suspected clinical diagnosis of brain death. 8 patients were studied by Tc-99m-DTPA and 15 patients were by Tc-99m-HMPAO (Hexamethyl propyleneamine oxime). Seven patients with Tc-99M-DTPA studies revealed absence of cerebral blood flow and sagittal sinus activity. All of 15 patients with Tc-99m-HMPAO studies revealed complete absence of cerebral perfusion. The results of the cerebral radionuclide studies of brain death correlated with other clinical conditions, such as intracranial pressure(ICP), EEG, transcranial doppler sono-graphy(TCDS), and neurologic examination. The ICP of 8 patients, who are confirmed by brain death with Tc-99m-HMPAO study are elevated in all cases. In conclusion, cerebral radionuclide imaging for diagnosis of brain death is available. Tc-99m-HMPAO imaging is unequivocal, easily interpreted, well reflect the physiologic state of increased ICP, and provides adequate assessment of posterior fossa activity. In addition, the SPECT imaging with Tc-99m-HMPAO produces more accurate results due to it's superiority of image contrast and proper localization of radiopharmaceutical distribution than conventional planar imaging.

  13. Determination of Brain Death by {sup 99m}Tc DTPA and {sup 99m}Tc HMPAO Images

    Kim, Jong Kyu; Sohn, Hyung Sun; Kim, Sung Hoon; Yang, Woo Jin; Lee, Sang Yong; Chang, Soo Kyo; Park, Seog Hee; Kim, Choon Yul; Bahk, Yong Whee; Shinn, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1995-03-15

    To evaluate availability of cerebral radionuclide imaging for diagnosis of brain death, we examined 25 patients with a suspected clinical diagnosis of brain death. 8 patients were studied by Tc-99m-DTPA and 15 patients were by Tc-99m-HMPAO (Hexamethyl propyleneamine oxime). Seven patients with Tc-99M-DTPA studies revealed absence of cerebral blood flow and sagittal sinus activity. All of 15 patients with Tc-99m-HMPAO studies revealed complete absence of cerebral perfusion. The results of the cerebral radionuclide studies of brain death correlated with other clinical conditions, such as intracranial pressure(ICP), EEG, transcranial doppler sono-graphy(TCDS), and neurologic examination. The ICP of 8 patients, who are confirmed by brain death with Tc-99m-HMPAO study are elevated in all cases. In conclusion, cerebral radionuclide imaging for diagnosis of brain death is available. Tc-99m-HMPAO imaging is unequivocal, easily interpreted, well reflect the physiologic state of increased ICP, and provides adequate assessment of posterior fossa activity. In addition, the SPECT imaging with Tc-99m-HMPAO produces more accurate results due to it's superiority of image contrast and proper localization of radiopharmaceutical distribution than conventional planar imaging.

  14. Binding of Technetium-99m to plasma proteins: influence on the distribution of Tc-99m phosphate agents

    Plasma protein binding of Tc-99m was assessed in man after injection of various Tc-99m-labeled bone imaging agents. Of the five methods in which plasma proteins were precipitated to determine protein binding no correlation between them could be established. The ammonium sulfate method seemed to correlate well with dialysis filtration. Plasma obtained from patients injected with Tc-99m phosphate compounds was reinjected to rats. The bone uptake in these animals correlated linearly with the unbound activity in the injected plasma. Provided that no protein binding would occur, the bone uptake as well as the urinary excretion proved to be identical for Tc-99m HEDP, MDP, and PPi. Electrophoresis of Tc-99m PPi indicated that the intact complex may be uncharged, whereas at low ligand concentrations uncharged as well as negatively charged Tc-99m species are formed. Better methods are needed, however, to establish the presence of various Tc-99m species and their relative role in the kinetics of these compounds, and plasma protein binding

  15. 99mTc-tetrofosmin or 99mTc-sestamibi for double-phase parathyroid scintigraphy?

    Several years ago technetium-99m tetrofosmin was reported to localise parathyroid adenomas. The aim of this study was to compare the sensitivity of this radiopharmaceutical with that of 99mTc-sestamibi using a double-phase parathyroid scintigraphy protocol. Scans of 12 patients were evaluated visually and lesion to thyroid ratios were calculated. Nine of the patients were subsequently operated on; a total of eight parathyroid adenomas or hyperplastic glands were histologically confirmed in seven of the patients, while in one patient a parathyroid carcinoma was histologically proven. All of these patients had positive 99mTc-sestamibi scintigrams, whereas only two 99mTc-tetrofosmin scintigrams were positive. With 99mTc-sestamibi there was a significant increase in the lesion to thyroid ratio from 10 min to 90 min and 150 min p.i. which was not seen on scintigraphy with 99mTc-tetrofosmin. This makes 99mTc-tetrofosmin less suitable for double-phase parathyroid scintigraphy. (orig.)

  16. Radiolabelling of monoclonal antibodies with technetium-99 m via metallothionein

    Metallothionein (MT), a small cysteine-rich protein, was used as a bifunctional chelating agent in the radiolabelling of monoclonal antibodies with Tc-99m. The efficiency of the conjugation reaction of MT with antibodies (Ab) was found as 58%. The yield of radiolabelling of Tc-99m to MT-Ab by reduction method was higher than 90%, while the unspecific radiolabelling occurred less than 10%. The Tc-99m-MT-Ab has proven to be satisfactory stable in Vitro in the presence of a couple of strong chelating agents. The preliminary biological experimental results in tumor-bearing nude mice indicated that the Tc-99m-labelled anti-colorectal carcinoma monoclonal antibody 2C10 had strong affinity toward tumor and was stable in vivo

  17. Preparation of 99mTc-HYNIC-Annexin V

    LAN Xiao-Li; ZHANG Yong-Xue

    2005-01-01

    99mTc-HYNIC-Annexin V was prepared for apoptosis radionuclide imaging in vivo. The expression plasmid of human Annexin V was constructed and expressed in E. coli. HYNIC was prepared and used as bifunctional chelating agent for 99mTc labeling. The radiochemical purity, radiolabeling yield and stability of 99mTc-HYNIC-Annexin V were studied. The coding sequence of human Annexin V gene was successfully cloned into the expression vector, and highly expressed in E. coli. A protein with a molecular weight of about 36kD could be induced and confirmed by Western Blotting and SDS-PAGE. Annexin V could be labeled with 99mTc using HYNIC, and showed high radiochemical purity of more than 90%. The radiolabeling yield could reach more than 90%. The reaction condition was moderate. It suggested that 99nTc-HYNIC-Annexin V may be a promising agent for apoptosis imaging and clinical application.

  18. [Diagnosis of achalasia using 99m-Tc pertechnetate scintigraphy].

    Mikosch, P; Gallowitsch, H J; Kresnik, E; Lind, P

    1997-06-01

    A 73-year-old patient presented a 99mTc scintiscan with a focal tracer accumulation left and caudal of the thyroid gland. Further investigations with sonography, CT, esophagoscopy and barium swallow provided the diagnosis of achalasia as the reason for focal 99mTc retention caudal of the thyroid gland. Explanation for 99mTc accumulation within the esophagus may be the nonspecific accumulation of 99mTc not only in the thyroid gland but also in the salivary glands. Excretion of the tracer follows with the saliva. Structural and motor disorders of the esophagus can thus lead to focal tracer retention within the esophagus simulating thyroid tissue. PMID:9395425

  19. Development of Tc-99m Imaging Agents for Abeta Plaques

    Development of SPECT imaging agents based on Tc-99m targeting Aβ plaques is useful for diagnosis of Alzheimer's disease (AD). A stilbene derivative, [11C]SB-13, showing promise in detecting senile plaques present in AD patients has been reported previously. Based on the 4(prime)-amino-stilbene core structure we have added substituted groups through which a chelating group, N2S2, was conjugated. We report herein a series of Tc-99m labeled stilbene derivative conjugated with a TcO[N2S2] core. The syntheses of stilbenes containing a N2S2 chelating ligand are achieved by a scheme shown. Lipophilic 99mTc stilbene complexes were successfully prepared and purified through HPLC. Preliminary results of in vitro labeling of brain sections from transgenic mice showed very promising plaque labeling. These 99mTc stilbene derivatives are warranted for further evaluations as potential imaging agents targeting amyloid plaques.

  20. Achalasia diagnosed by 99mTc pertechnetate scintigraphy

    A 73-year-old patient presented a 99mTc scintiscan with a focal tracer accumulation left and caudal of the thyroid gland. Further investigations with sonography, CT, esophagoscopy and barium swallow provided the diagnosis of achalasia as the reason for focal 99mTc retention caudal of the thyroid gland. Explanation for 99mTc accumulation within the esophagus may be the nonspecific accumulation of 99mTc not only in the thyroid gland but also in the salivary glands. Excretion of the tracer follows with the saliva. Structural and motor disorders of the esophagus can thus lead to focal tracer retention within the esophagus simulating thyroid tissue. (orig.)

  1. Characteristic of 99mTc-glutathione radiopharmaceutical

    Technetium-99m glutathione labelled compound is a radiopharmaceutical which is used in nuclear medicine for cancer diagnoses by imaging method. The distribution and accumulation of radiopharmaceutical in the body depend on its physicochemical and biological characteristic. Therefore, the determination of its characteristic was carried out in order to assure the successful utilization of this radiopharmaceutical. The radiochemical purity was determined with thin layer chromatography (TLC-SG) using dried acetone and 0.9% of NaCl solution as a mobile phase. The charge of 99mTc-GSH was tested by electrophoresis method and its lipophilicity (P) was obtained by determination of octanol-water partition. The plasma binding protein of this radiopharmaceutical was in-vitro investigated with precipitation method using 5% of trichloro acetic acid solution. Beside that, studies on the effect of 99mTc radioactivity to the stability of 99mTc-GSH and its stability in plasma has been in-vitro carried out. From the experiment it was obtained that 99mTc-GSH has 99.08 ± 0.26% of radiochemical purity; neutral (no charge); the lipophilicity (P) = 0.03 ± 0.002; the plasma binding protein of 30.31 ± 0.04%. Utilization of 99mTc radioactivity concentration up to 21 mCi/2 mL resulted 99mTc-GSH radiopharmaceutical which was remained stable up to 5 hours with ≥ 95% of radiochemical purity. In-vitro stability test of 99mTc-GSH in plasma indicated that in the first hour of storage, the radiochemical purity drastically decreased and until 5 hours of storage, its radiochemical purity did not change significantly, that was about 50%. (author)

  2. Migration pathways of hypodermically injected technetium-99 m in dogs

    Hypodermic injection of technetium-99 m (99mTC-pertechnetate) at points of low electrical resistance give rise to rapid, longitudinal, and progressive diffusion of the radioactive tracer. We assessed the effect of cutaneous incisions that did not intersect the migration trajectory of 99mTc-pertechnetate and the re-establishment of pathways after the suture of incisions that intersected the migration trajectory. Linear and rapid migration of 99mTc-pertechnetate was not altered or prevented by incisions that did not intersect the migration pathway. Different patterns of 99mTc-pertechnetate spread were found when incisions intersected the radioactive pathways until restoration of the normal migration pathway observed in undamaged skin occurred. In all experiments in which migration of 99mTc-pertechnetate was observed, lavage of surgical wounds was followed by disappearance of the 99mTc-pertechnetate migration observed around the suture. Linear migration of the tracer was not observed when the incision was left uncovered, filled with petroleum jelly, or with a solid silicone sheet, but it was seen when non-sutured incisions were filled with transonic or silicone gel or covered with a solid silicone sheet parallel to the cutaneous plane. These data show that after a cutaneous incision that intersected the diffusion trajectory of the radioactive tracer, linear migration of 99mTc-pertechnetate hypodermically injected at points of low electrical resistance was restored before healing of the cutaneous incision and was independent of incisions made on the skin not overlying the radioactive pathway. A mechanism similar to that of capillary electrophoresis is suggested to explain the hypodermic diffusion of inert particles through specific and constant linear pathways. (orig.)

  3. Labelling of biological structures with technetium 99 m

    The labelling of red blood cells (RBC) with technetium 99m (99m Tc) depends on several factors, as the stannous ion (Sn++) concentration, the time and temperature of incubation, the anticoagulant utilized, the presence of plasma proteins (PP) and others. Although the blinding of 99m Tc with hemoglobin and PP are similar, they appear to have specific characteristics as demonstrated by precipitation with alcohol, acetone, trichloroacetic acid, hydrochloric acid and mercury chloride. The bacterial cultures labeled with Technetium-99m, at optimal Sn++ ion concentration, presents a large stability and their viability is not altered by this treatment. The electrophoretic mobility, the hydrophobicity, the cationized ferritin distribution and the adherence to human buccal epithelial cells are not modified either. The possibility of labelling with 99m Tc of planaria and cercariae of Schistossoma mansoni evaluative cycle increases the utilization of this radionuclide to an experimental level. The results described with the labelling of these biological structures with 99m Tc demonstrated that stable labeled and viable operations are obtained. (author)

  4. 99mTc-Dextran-70: preparation and quality control

    Dextran-70 labelled with 99m Tc is used for lymphocintigraphy in Nuclear Medicine. The aims of this work were: the lyophilized kit formulation; the radiochemical quality control determination and the biodistribution studies in Wistar rats. Each lyophilized vial contains: 50 mg Dextran-70 (Sigma); 750 μg Sn Cl2. 2 H2 O, pH = 4.0. For the radiochemical determination the following parameters were assayed: Chromatography systems (Whatman 3MM, TLC-SG (Silica-gel) e TLC-A1 (aluminium); the 99m Tc activities (37, 111 and 1850 MBq); the 99m Tc volumes (1,3,5 and 8 mL) and the stability after the lyophilization process (1, 3, 6, 12 and 24 months). The Whatman 3MM chromatography system using acetone as solvent presented a purity yield of 99.88; 99.70; 99.00 and 98.92% using 1, 3, 5 and 8 mL of 99m Tc, respectively. The yield of labelling showed 99.80 % of radiochemical purity using 1850 MBq of 99m Tc, after 24 months. The biological studies were performed in Wistar rats, average weight 250g, after intravenous administration of 99m Tc-Dextran-70 (2.96 MBq). A slow blood decrease with high hepatic uptake was mesured. The high kidney uptake observed, during the experiment, was due the experiment, was due the fact that the animals were kept under anaesthesic effect. (author). 4 refs., 2 figs., 4 tabs

  5. Tumour imaging using technetium-99m-citrate

    Sixteen patients with soft tissue malignancy or fibroadenoma of the breast (Group A) were imaged using 99mTc-citrate. Majority of the patients (n=14) has new untreated lesions. Appreciable skeletal uptake of the tracer was serendipitously noticed in all cases. One of these had widespread bone metastases seen almost identically in 99mTc-citrate and 99mTc-MDP studies. Accordingly, 10 patients (Group B) having more than 40 malignant lesions on the bone scan underwent 99mTc-citrate study. In group A, accumulation of the tracer was seen in all malignant breast nodules and axillary lymphnode mass (n=4), medullary carcinoma of the thyroid along with its metastasis and a carcinoid (n=4) and an ovarian malignancy. Uptake and outflow pattern could differentiate fibroadenoma (n=3) from carcinoma of the breast. No significant uptake was seen in liver secondaries (n>10), lymphoma lesions (n=5), papillary carcinoma of thyroid, renal cell and embryonal cell carcinoma. In group B patients, the radiotracer accumulated well in the metastatic lesions while there was distinctly lesser uptake in normal/degenerated joints compared to the bone scan. The study shows potential of the tracer in imaging soft tissue malignancies. Bone scanning with 99mTc-citrate is an interesting possibility since mechanism of its uptake appears to be different to 99mTc-MDP. (author)

  6. Technetium-99m pentavalent dimercaptosuccinic acid imaging for pituitary adenomas

    The authors performed scintigraphy using 99mTc(V)-DMSA (Technetium-99m pentavalent dimercaptosuccinic acid) on patients with pituitary adenomas. Three non-functioning (100%), 2 GH-secreting (67%), 4 PRL-secreting (80%), and zero ACTH-secreting (0%) adenomas concentrated the 99mTc(V)-DMSA, but all 5 of the non-adenomatous lesions and 1 normal pituitary gland did not. There was no significant relationship between tumor-to-background ratios and tumor sizes, or the serum hormone level. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 69% (9/13) in detecting pituitary adenomas, which increased to 82% for non-functioning, GH-secreting and PRL-secreting adenomas. In conclusions, 99mTc(V)-DMSA was found to be a suitable radiotracer for detecting pituitary adenomas. But further studies are necessary to define the processes that concentrate 99mTc(V)-DMSA and their role in pituitary adenomas. (author)

  7. Biodistribution of free 99mTc-ovalbumin and 99mTc-ovalbumin encapsulated in liposomes

    The oral administration of proteic antigens, like ovalbumin, may result in the induction of oral tolerance or immunization. The aim of this work was to label a protein antigen with 99m Technetium, encapsulate it in liposomes and investigate its absorption and tissue distribution after oral administration in mice. Ovalbumin was labeled with 99mTechnetium and encapsulated in small unilamellar vesicles. 99mTc-OVA encapsulated or not in liposomes was administrated to mice that were sacrificed after different times. The radioactivity was measured in various organs of the animals. Differences concerning the biodistribution of 99mTc-OVA were noticed. The technique may represent alternatives for the induction of immunization or oral tolerance.(author)

  8. Comparative Study Between 99mTc-Kanamycin And 99mTc-Gentamicin As Diagnostic Agents For Bacterial Infection

    Kanamycin and gentamicin are aminoglycosides antibiotics indispensable in the therapy of acute infections. Labelling with Tc-99m depends on the ligand and reducing agent concentrations, pH and the reaction time. Radiochemical yield and stability were determined by paper and thin layer chromatography. Biodistribution studies of 99mTc-kanamycin and 99mTc-gentamicin were performed in rats. The localization of radioactivity of both complexes in infected sites induced by Staphylococcus aureus indicated the high binding affinity of these drugs. 99mTc-gentamicin has an effective bacterial action against gram positive bacteria S. aureus which confirms the efficacy of this complex as diagnostic agent for bacterial infections.

  9. Poor Tc-99m dimercaptosuccinic acid uptake, re-evaluation with Tc-99m MAG3 scintigraphy in Lowe syndrome

    Koca, Gokhan; Atilgan, Hasan Ikbal; Demirel, Koray; Diri, Akif; Korkmaz, Meliha

    2011-01-01

    Tc-99m dimercaptosuccinic acid (DMSA) is filtered through the glomeruli and reabsorbed by the proximal tubules as low molecular weight proteins. In Lowe syndrome this mechanism is impaired and so poor DMSA uptake is seen. Poor DMSA uptake was shown in very few studies, but none mentioned normal Tc-99m MAG3 uptake. In this case, the patient had poor DMSA uptake, normal MAG3 uptake and a neurogenic bladder in anterior to the left kidney that attenuates left kidney.

  10. Comparison of renal scintigraphy with sup(99m)Tc-gluconate and sup(99m)Tc-DMS

    Recently sup(99m)Tc-gluconate and sup(99m)Tc-dimercaptosuccinic acid (DMS) have been developed and used clinically as radiopharmaceuticals for renal scintigraphy. The author studied the renal uptake and body distribution of these two radio-pharmaceuticals experimentally using rats. A scinticamera equipped with a computer was utilized for dynamic curves in the clinical studies. sup(99m)Tc-gluconate was rapidly cleared from the blood and excreted in the urine. Renal uptake was rapid initially and then showed a gradual decrease. sup(99m)Tc-DMS, on the other hand, was slowly cleared and excreted. Renal uptake increased slowly and then levelled off. In clinical studies, sup(99m)Tc-gluconate provided valuable additional information about the renal collecting system in the early phase after injection. And the late scintigraphy with sup(99m)Tc-DMS was beneficial in demonstrating the kidneys of a patient with severe renal damage. Although some differences could be found in the distribution of these agents, both gave good renal images and seemed to be suitable radiopharmaceuticals for renal scintigraphy. (J.P.N.)

  11. Advances in 99mTc-labeling of antibodies

    Several methods have been developed to label antibodies with 99mTc. Direct labeling results in 99mTc binding to multiple sites of various affinities that are often weaker than the binding to strong chelating agents. Attempts to overcome this disadvantage involve conjugation of strong chelating agents to the antibodies. While stability is usually enhanced, this approach suffers from alteration of antibody properties as well as non-specific binding of 99mTc to the antibody instead of to the conjugation chelating agent. This has been of concern for studies with DTPA as the chelating agent. In this study the loss of 99mTc by N2S2 challenge shows that a fraction to the 99mTc is nonspecifically bound to the antibody. An advantage of the approach of labeling antibodies containing a bifunctional chelating agent is the simplicity of the labeling procedure and the apparent high yields that in reality are the sum of chelating agent and non-specifically bound radioactivity. The last approach described in our work of conjugation of a preformed chelate has advantages of characterizable 99mTc complex chemistry and conjugation by standard protein derivatization chemistry. Slow chelation kinetics can be overcome in the small molecule stage and then conjugation performed under mild conditions with respect to the antibody of fragments. This approach, however, suffers from greater complexity of the labeling process including multiple steps, purifications and non-quantitative yields. The use of ligands for 99mTc in which the complexes are of high stability and predictable chemistry is likely to result in eventual optimal labeling technologies. Processes which are non-specific may work in some cases, but are likely to present difficulties in optimization and general applicability from antibody to antibody. (orig.)

  12. Is Tc-99m sestamibi scintimammography useful in the prediction of neoadjuvant chemotherapy responses in breast cancer? A systematic review and meta-analysis.

    Guo, Cui; Zhang, Chengpeng; Liu, Jianjun; Tong, Linjun; Huang, Gang

    2016-07-01

    To evaluate the accuracy of Tc-99m sestamibi (MIBI) scintimammography in the prediction of neoadjuvant chemotherapy response in breast cancer. 'PubMed' (MEDLINE included) and Embase database were searched for relevant publications in English. Methodological quality of the included studies was assessed with Quality Assessment of Diagnosis Accuracy Studies (QUADAS), and 'Meta-Disc' and 'Stata' software were used to determine pooled sensitivity, specificity, and diagnostic odds ratio (DOR), and construct a summary receiver-operating characteristic curve. Fourteen studies (a total of 503 individuals) fulfilled the inclusion criteria. The pooled sensitivity was 0.86 [95% confidence interval (CI): 0.78-0.92] and the pooled specificity was 0.69 (95% CI: 0.64-0.74). Pooled likelihood ratio (LRp), negative likelihood ratio (LR-), and DOR were 2.64 (95% CI: 1.81-3.85), 0.26 (95% CI: 0.15-0.46), and 12.06 (95% CI: 6.94-20.96), respectively. The area under the summary receiver-operating characteristic curve was 0.86. For the prediction of pathological complete response (10 studies included), the pooled sensitivity and specificity and DOR were 0.86 (95% CI: 0.77-0.93), 0.67 (95% CI: 0.62-0.72), and 11.43 (95% CI: 5.95-21.97). Our results indicated that Tc-99m MIBI scintimammography had acceptable sensitivity in the prediction of neoadjuvant chemotherapy respons