Search PubMed⌕ Search

Biomedical subjects

B D Collier

Publications and source records attributed to B D Collier.

At least 55 records · Page 3Linked to original sources

Imaging of regional spread of breast cancer by internal mammary lymphoscintigraphy, CT, and MRI.

Forty women with breast cancer underwent imaging by internal mammary lymphoscintigraphy (IMLS), which was correlated with the results of CT and MRI of the chest. IMLS was performed and interpreted using the previously described methods of Ege. It identified 22 instances of ipsilateral internal mammary nodal involvement, none of which corresponded to cases of abnormally enlarged (diameter greater than 1.0 cm) internal mammary nodes on CT and/or MRI. Positive IMLS was associated with axillary nodal metastases in 15 out of 22 instances. The authors conclude that IMLS provides information on regional nodal spread of breast cancer that is not available with either CT/MRI imaging or axillary biopsy.

Antimony↗

Immunoscintigraphy performed with In-111-labeled CYT-103 in the management of colorectal cancer: comparison with CT.

Immunoscintigraphy performed after intravenous administration of indium-111-labeled CYT-103, an immunoconjugate of monoclonal antibody B72.3, was evaluated in patients with suspected primary or recurrent colorectal cancer at 25 centers in the United States. Gamma camera imaging, computed tomography (CT), and confirmatory surgical exploration were completed in 169 of 227 patients who received single infusions of In-111 CYT-103. Eight patients (3.5%) had reversible, nonserious adverse reactions, and 39% developed antimurine antibodies. Surgery revealed that 155 of 169 patients had colorectal carcinoma. In these 155 patients, immunoscintigraphy and CT demonstrated similar sensitivity (69% and 68%, respectively) and specificity (77%). However, immunoscintigraphy had greater sensitivity in detection of pelvic tumors (74% vs 57%, P = .035) and extrahepatic abdominal tumors (66% vs 34%, P less than .001); CT enabled detection of a greater proportion of liver metastases (84% vs 41%, P less than .001). These results indicate that In-111 CYT-103 can be administered safely and that immunoscintigraphy performed with this agent frequently enables identification of extrahepatic abdominal sites of disease not visualized with CT.

Adult↗

Iodine-131 contamination from thyroid cancer patients.

High-dose radioactive iodine therapy using 131I is the treatment of choice for patients with thyroid cancer following thyroidectomy. Because of the large amount of activity which is excreted during hospitalization, contamination hazard from 131I excretion via perspiration, saliva, breath and urine may arise. In eight patients treated with doses of 131I ranging from 3.7 to 14.8 GBq (100-400 mCi), activity levels were measured in room air, from room surfaces, the toilet, the patients' exhaled breath, skin, saliva and toothbrushes, and the gloves used by medical staff. Thyroid bioassays were also performed on medical staff personnel caring for these patients both before and two days after administration of the treatment dose. Removable activity from the skin was positively correlated with treatment dose and reached a maximum at 24 hr post-therapy. Removable activity from room surfaces exceeded the level of contamination which requires clean-up in a restricted area during the patient's hospitalization. Thyroid bioassays on medical staff showed no significant uptake 2 days after treatment. The relatively high activities present in the saliva, urine and on the skin of these patients emphasizes the need for all individuals coming in contact with these patients to be made aware of the contamination hazard present.

Adolescent↗

Immunoscintigraphy of prostatic cancer: preliminary results with 111In-labeled monoclonal antibody 7E11-C5.3 (CYT-356).

A phase 1 study was conducted with the investigational immunoscintigraphic agent, 111In-CYT-356, a radiolabeled, site-specific immunoconjugate of monoclonal antibody 7E11-C5.3, in 40 patients with prostatic carcinoma and known distant metastases. Each patient received a single intravenous infusion of CYT-356 (dose range, 0.1-5 mg) radiolabeled with approximately 5 mCi of 111In. None of the patients experienced adverse reactions. One patient who received a 5-mg dose developed antibodies to the CYT-356 immunoconjugate. 111In-CYT-356 immunoscintigraphy detected bony metastases in 21 of 38 patients (55%), including 12 of 14 (86%) receiving concomitant hormonal therapy, and soft tissue lesions in four of six patients (67%). Antibody imaging detected occult lesions in the bony pelvis and lumbar spine, which were confirmed by follow-up imaging tests, in one patient. Higher CYT-356 doses may clear the blood pool more slowly. These results suggest that 111In-CYT-356 can be safely administered to patients with prostatic carcinoma and that further clinical investigation of this agent is warranted.

Aged↗

Concentration of Tc-99m MDP in ovarian carcinoma and its soft tissue metastases.

A patient with ovarian carcinoma was evaluated for skeletal metastasis with a routine whole body bone scan. Although no bone metastases were visualized, there was dramatic accumulation of tracer in the soft tissues of the abdomen. CT revealed calcifying soft tissue metastases on the liver surface, the bowel serosa, and in the pelvis corresponding to the abnormal areas of Tc-99m MDP uptake. Tumor necrosis and ongoing calcification within the metastatic sites are possible explanations for this unusual soft tissue concentration of the bone-seeking radiopharmaceutical. In patients with metastatic ovarian carcinoma, careful review of extraosseous regions on bone scan images may provide valuable diagnostic information.

Abdominal Neoplasms↗

Right aortic arch: demonstration by first-pass and multigated radionuclide ventriculography.

Right aortic arch is a rare congenital anomaly associated with abnormal development of the paired embryological aortic arches. While various abnormalities of the great vessels have been described using both first-pass and multigated radionuclide ventriculographic studies, diagnosis of a right-sided aortic arch has typically required a radiographic contrast technique. We present a case of a patient with a suspected right-sided aortic arch diagnosed by radionuclide methods.

Adult↗

Isolated muscular sarcoidosis causing fever of unknown origin: the value of gallium-67 imaging.

An unusual case of a patient with a long-standing fever of unknown origin (FUO) is presented whose gallium-67 (67Ga) images revealed increased activity only in the calf muscles bilaterally. Other imaging modalities also failed to show chest or other abnormal findings. Subsequent biopsy of the right gastrocnemius muscle revealed noncaseating granulomas consistent with the diagnosis of sarcoidosis. When using 67Ga to evaluate a patient with a FUO, imaging of the extremities should always be included. Also, when abnormal Ga-67 uptake is present in the extremities, sarcoidosis should be included in the differential diagnosis.

Adult↗

Bone scan: a useful test for evaluating patients with low back pain.

For many years it has been known that the sensitivity of bone scanning to the presence of destructive bony lesions favors its use in screening for bone metastases and osteomyelitis. More recently bone scanning has been routinely employed in evaluating benign skeletal pathology that may be the cause of low back pain. Bone scanning can play an important part in (1) identifying the cause of pain, (2) clarifying the significance of radiographic findings, and (3) evaluating the results of spinal surgery. This expansion of the role of nuclear medicine in diagnosing and managing low back pain is based in part upon novel diagnostic applications of 99mTc-methylene diphosphonate, a radiopharmaceutical that has been available for over 15 years. Equally important for this development, however, has been the recent availability of SPECT, a tomographic imaging technique that can be used to display the spine in a series of 6- to 8-mm thick sections. Slightly more than one-half of newly purchased gamma cameras are rotating systems suitable for bone SPECT studies. Thus, many community hospitals can now perform state-of-the-art bone scans for low back pain.

Adult↗

The value of oblique angle reorientation in SPECT bone scintigraphy of the hips.

SPECT bone scintigraphy has been shown useful for detecting avascular necrosis (AVN) of the femoral heads. Because the femoral necks project in a 15-20 degree posterior angulation from the coronal plane, the femoral head is partially superimposed upon the acetabulum in standard coronal SPECT images. To avoid this problem, the authors now perform oblique angle reorientation of all hip SPECT studies. This new technique, which allows display of the hip in a more anatomic fashion and better definition of hip abnormalities, is described. No new data acquisition is needed, and only a small amount of extra time is required for reconstruction.

Adult↗

The radioactive handkerchief sign. A contamination artifact in I-131 imaging for metastatic thyroid carcinoma.

False-positive findings suggestive of metastatic functioning thyroid carcinoma have been well documented in I-131 whole-body imaging. These artifacts are often associated with contamination from radioiodine-containing body secretions. Recently, a contaminated handkerchief on an iodine-131 whole-body scan was reported. In the following study, two additional cases involving the sequestration of I-131 contaminated handkerchiefs in patients' pockets are presented, and the literature regarding these false-positive findings is reviewed. Although rare, this "radioactive handkerchief sign" may cause serious misinterpretation of a focal radioiodine accumulation.

Adult↗