[The usefulness of bone marrow scintigraphy in the detection of bone metastasis from prostatic cancer].
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Biomedical subjects
Publications and source records attributed to A Muranaka.
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By using a RIA Kit for squamous cell carcinoma (SCC) antigen, extracted and purified this substance from liver metastasis of SCC of the uterine cervix, a fundamental and clinical study has been done. Based on the fundamental study, it was shown that this kit was useful clinically. High concentrations of serum SCC related antigen were observed in squamous cell carcinoma of the lung, head and neck, and uterus. It was recognized that the measurement of serum SCC related antigen was useful in not only diagnosis, but also in the evaluation of effectiveness of therapy or prediction of recurrence. In particular, as there is a lack of reliable tumor markers in head and neck tumors, good results can be anticipated from the measurement of SCC related antigen in such cases.
Tissue polypeptide antigen (TPA) concentrations in patients with breast cancer were measured using a radioimmunoassay (RIA) kit. Although this RIA kit presented some problems in the dilution test of high-concentration samples, it was found to be adequate for clinical use. It was shown that the measurement of serum TPA concentration was useful in monitoring the local recurrence, for the early diagnosis of distant metastasis and for evaluating the therapeutical effect after surgery. TPA concentration showed no correlation with CEA concentration. Therefore, in order to raise the rate of diagnostic success, simultaneous measurement of both TPA and CEA was essential.
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The effect of FeCl3 on 67Ga uptake by HeLa S3 cells was studied in vitro. Uptake of 67Ga by HeLa S3 cells was influenced by the concentrations of serum in the medium and especially that of transferrin added to the medium. Therefore, it is assumed that a mechanism of 67Ga uptake exists mediated by transferrin. However, when 10(-2)--10(-1) mM FeCl3 was added to the medium in the same experimental system, a remarkable increase of 67Ga uptake was noted. Results of equilibrium dialysis, showed that binding of 67Ga to transferrin was inhibited by the administration of FeCl3. Moreover, the formation of a complex of 67Ga and FeCl3, which did not pass through the cellulose membrane, was observed. A correlation was found between an increase in 67Ga uptake by HeLa S3 cells and the formation of the 67Ga--Fe complex. These results indicate that another mechanism of 67Ga accumulation, namely the formation of a 67Ga--Fe complex plays a role in the uptake of 67Ga by tumor cells in the presence of iron.
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Lymphoscintigraphy with SC injection of 67Ga-citrate was carried out on patients with lymph node metastasis and malignant lymphoma. The dose given at each injection site was about 200 muCi and scintigraphy was started about 5 min after injection. Metastatic lymph nodes and malignant lymphoma were successfully imaged. This positive delineation corresponded well to cold lesions detected by lymphoscintigraphy with 99mTc-rhenium colloid in metastatic lymph nodes. Hotter lesions in malignant lymphoma were scanned positively with 99mTc-rhenium colloid by this method. In in vitro studies, incorporation of 67Ga-citrate in HeLa S3 cells was about 4 times that in macrophages, when the incubation time was 1 h, while colloidal uptake by macrophages was 13 times that by HeLa S3 cells. The binding of 67Ga to transferrin in lymph and pinocytosis are suggested mechanisms of localization. A combination of colloid- and sc 67Ga-lymphoscintigraphy would be of value in the diagnosis of lymph node disease.
The degree of deposition of small-particle colloids such as 99mTc-antimony sulfide colloids (ASC-group) and 99mTc-rhenium colloid (Tc-Re) in the bone marrow and lymph node was studied. H-ASC that was prepared in our laboratory was concentrated to a higher degree both in the bone marrow and lymph nodes, compared with other colloids. The H-ASC were mostly from 5 to 12.5 nm and the shape was uniform and spherical. The degree of deposition of Tc-Re in rabbit lymph nodes was not higher, however, the label was considered to be valuable clinically. The degree of deposition of Tc-Re in the bone marrow was not satisfactory. The size of Tc-Re was much smaller than H-ASC, ranging from 3 to 5 nm. From these results, it is considered that factors affecting deposition in the marrow are not identical to those in the lymph nodes.
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The kinetics in tumor cells and various factors affecting the tumor accumulation of 67Ga-citrate and 201Tl-chloride were studied in vitro. 67Ga was taken up gradually by tumor cells and its excretion from the cells decreased with time. 201Tl was taken up rapidly by tumor cells. Its excretion was very rapid, indicating that the two nuclides had entirely different kinetics in tumor cells. The uptake of 201Tl by culture cells correlated with that of 42KCl and was inhibited by Ouabain. 201Tl was hardly taken up by nonviable tumor cells. These facts indicate that active transport involving Na-K ATPase is involved in the tumor accumulation of 201Tl. The uptake of 67Ga and 201Tl by tumor cells was not affected by the administration of anticancer agents. The uptake of 67Ga by tumor cells was dependent upon the concentration of transferrin in the medium, which apparently plays a role as one of the pathways of tumor accumulation of 67Ga.
The correlation between prostaglandin E (PgE) and scintigrams of bone (Tc-99m MDP) and bone marrow (Tc-99m SC) was investigated in normal and VX-2-bearing rabbits. PgE in plasma of normal rabbits was 486.2 +/- 185.7 pg/ml (n = 86) and the maximum-to-minimum (max/min) ratio was 1.85 +/- 0.26 at 4 wk after tumor implantation. In rabbits with VX-2 transplanted into femoral muscles, PgE was in the normal range unless the tumor invaded bone. PgE did not increase significantly in rabbits when the tumor was transplanted into the marrow cavity. When tumor invaded bone, PgE increased markedly (to 1335 +/- 584 pg/ml). Elevation of PgE did not necessarily coincide with the appearance of positive bone scans. PgE in an indomethacin-treated group was not higher than in the untreated group. There was no significant difference between the two groups regarding the time of appearance of abnormal bone scans. However, when the number of transplanted cells in the bone marrow was reduced, the treatment with indomethacin delayed the increase in tracer uptake in the affected bone and resulted in a photon-deficient area. Indomethacin may suppress the local acceleration of calcium metabolism.