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Biomedical subjects

D A Goodwin

Publications and source records attributed to D A Goodwin.

At least 73 records · Page 4Linked to original sources

In-111-leukocyte scanning in inflammatory renal disease.

In-111-leukocyte scanning has recently been introduced as a clinically effective method for detecting inflammatory disease and abscesses. The authors present six cases that demonstrate the usefulness of this new technique in suspected inflammatory renal disease. Two patients had renal abscesses, two had acute pyelonephritis, one had acute focal bacterial nephritis (acute lobar nephronia), and one had a transitional cell carcinoma with associated acute and chronic inflammation.

Abscess↗

Ultrasonography and indium 111 white blood cell scanning for the detection of intraabdominal abscesses.

Ultrasound and indium 111 white blood cell scanning were performed on 163 patients with suspected intraabdominal abscesses. In all but one case, intraabdominal abscesses were correctly identified by one or both tests; conversely, no patient was falsely diagnosed by both tests to have an abscess. Sonography was useful in those patients with focal symptoms, and frequently identified nonabscess causes for fever. White cell scanning was valuable when focal signs were absent, and frequently identified extraabdominal sources of sepsis. The two imaging modalities are complementary and provide a highly accurate and sensitive means of intraabdominal abscess detection.

Abdomen↗

Clinical studies with In-111 BLEDTA, a tumor-imaging conjugate of bleomycin with a bifunctional chelating agent.

Indium-111 BLEDTA, a bleomycin analog containing an EDTA group, was used for tumor imaging in 110 patients with cancer. Scans with In-111 BLEDTA agreed with biopsy results in 75 of 95 patients (79% accuracy). A positive scan was obtained in 71 of 88 patients with a positive biopsy (81% sensitivity). In 21 of 95 patients (22%), the scan revealed tumor sites that had not been detected. The main limitation of visualization was the size of the tumor (1.5--2.0 cm diameter was the smallest size seen). Background radioactivity in the liver, spleen, and bone marrow also made tumor detection in these areas more difficult. The cause of this background, and of false-positive uptake in sites of inflammation, is correlated with specific radiolabeling of polymorphonuclear leukocytes by In-111 BLEDTA. Means of eliminating this background are discussed.

Adult↗

Increased renal accumulation of Tc-99m-MDP in renal artery stenosis.

Abnormal increased renal accumulation of Tc-99m-MDP was observed in a patient found subsequently to have stenosis of the ipsilateral renal artery. The case is both interesting in itself and for its possible implications regarding the use of radiolabeled phosphates in renal ischemia.

Aged↗

Evaluation of catheter thrombogenicity in vivo with indium-labeled platelets.

Platelets labeled with a lipid-soluble indium-111 8-hydroxyquinoline (oxine) complex were evaluated as an agent to measure the rate and degree of in vivo platelet accumulation on catheters. Polyethylene catheters and Teflon-coated guidewires were inserted into the femoral arteries or veins of dogs that had been injected with indium-labeled platelets. The catheters were passed to either the abdominal aorta or inferior vena cava and left in situ for 30 minutes to three hours. Images were obtained every five minutes with a gamma camera. This labeling technique is reproducible, allows multiple testing with a single preparation, and is relatively noninvasive. The results are easily quantitated to allow testing of different materials and coatings.

Animals↗

BLEDTA: tumor localization by a bleomycin analogue containing a metal-chelating group.

Two different Co(III) complexes of the antitumor antibiotic bleomycin have been prepared, and their in vivo distribution in mice has been investigated. The more thermodynamically stable of the Co(III)-bleomycin complexes has been modified by reaction with the bifunctional chelating agent 1-(p-bromoacetamidophenyl)ethylenedinitrilotetraacetic acid, to give a bleomycin derivative (BLEDTA) containing a powerful metal-chelating group. BLEDTA was radiolabeled with 111In(III) and its in vivo distribution in mice was examined. The potential of 111In-labeled BLEDTA as a tumor-visualizing agent was also investigated in humans with biopsy-proven cancers, predominantly (70%) squamous carcinoma of the head and neck. All of the 29 patients studied had at least one clinically proven site of the disease visualized with 111In-BLEDTA. These clinical results are significantly better than results we obtained in a comparable group of patients using directly labeled 111In-bleomycin and are similar to those reported by Nouel for 57Co-bleomycin [GANN Monogr. Cancer Res., 19, 301 (1976)].

Adult↗

A review of carotid cavernous fistula including diagnosis and evaluation by nuclear medicine angiography.

The various causes and differential diagnosis of carotid cavernous fistula are discussed as well as the description of the use of radionuclide angiography in the diagnosis and evaluation of patients with carotid cavernous fistulas. Radionuclide angiography has proven extremely useful in the diagnosis and follow-up of patients with carotid cavernous fistulas. The procedure is of maximum benefit in situations where repeat studies are required at frequent intervals. Five cases are described in which the nuclear medicine technique was instrumental in primary diagnosis and follow-up.

Adult↗

Indium-111-labeled autologous platelets for location of vascular thrombi in humans.

Twenty-two patients suspected of having either venous or arterial thrombi were studied with In-111-labeled autologous platelets. Whole-body scans were performed 3, 24, and 48 hr following i.v. injection. Twelve patients studied with saline-washed platelets had unsatisfactory 15-min recovery and biologic half-time. When the labeling was carried out in plasma, these values compared favorably with normal values reported for Cr-51-labeled autologous platelets. Of ten patients studied using platelets labeled in plasma, three had normal scans, six had abnormal scans, and one had an equivocal scan. All six abnormal scans were confirmed with corresponding positive findings in either the venogram, arteriogram, or lung scan. J Nucl Med 19: 626-634, 1978.

Adult↗

Radiolabeled antitumor agents.

Bleomycin serves as a useful prototype for a study of the various properties required in a radiopharmaceutical for tumor imaging. Both in vitro and in vivo results using bleomycin labeled with a large number of different radionuclides have now been reported. In general, it has not been possible to predict in vivo biologic behavior solely from in vitro data. For example, 57Co-bleomycin and 111In-bleomycin both have identical patterns in several different chromatographic systems and do not break down with prolonged storage in saline, exposure to heat, or other cations. However, when the labeled bleomycin is exposed to serum transferrin (and to other as yet unidentified ligands in the body) a difference in stability becomes obvious. The stability and biologic activity of 57Co-bleomycin in humans demonstrate the validity of metal chelation as a labeling technique for this specific molecule, and also suggests that other stable chelates will have useful applications. Although 57Co-bleomycin has the most desirable biologic characteristics of all the chelates of bleomycin, the extremely long physical half-life of 57Co of 270 days creates a significant contamination problem in the hospital. Because of this, the use of 57Co-bleomycin is limited to a few specialized centers. All users have emphasized the need for a better radionuclide to produce a labeled bleomycin with the same or superior biologic characteristics to 57Co-bleomycin. Unfortunately, the elements forming the most stable chelates with bleomycin (copper, zinc, cobalt, and nickel) do not have radionuclides with suitable physical characteristics for scanning. Copper-67 may become available in the future from high-energy linear accelerators. However, even if it were available, copper will probably not have as good chemical properties as cobalt.

Abdominal Neoplasms↗

Covalent attachment of metal chelates to proteins:the stability in vivo and in vitro of the conjugate of albumin with a chelate of 111indium.

Human serum albumin has been conjugated to 1-(p-bnezenediazonium)-(ethylenedinitrilo)tetraacetic acid, a powerful chelating agent, and radioactive 111indium ions have been added specifically to the chelating groups. The product, with a specific radioactivity of about 1 mCi/mg of protein, was employed as a radiotracer in scintillation scanning studies with human volunteers. Results show that 48 hr after injection, practically all of the label remains attached to albumin. This is confirmed by electrophoresis of serum proteins; 7 days after injection, 85% of the radioactivity in the serum is still in the albumin fraction. These observations agree with in vitro studies of the labeled albumin in human serum, where loss of the metal ion from the chelating group to the protein transferrin amounts to less than 3% after 1 week and less than 5% after 2 weeks. Measurements of the distribution of label in mice up to 23 days after injection suggest that metabolism of the labeled protein does not lead to binding of indium ions by transferrin. The binding of indium and other metal ions by transferrin has previously posed a major impediment to the use of metal chelates for in vivo diagnostic procedures. Demonstration of the kinetic inertness of the chelate in these experiments suggests the use of related chelates as physical probes of biological systems.

Animals↗

Pulmonary distribution of an inhaled radioaerosol in obstructive pulmonary disease.

Pulmonary distribution of an inhaled radioaerosol was analyzed in 20 cases of chronic obstructive pulmonary disease (COPD) and 8 of other OPD. Nonciliary/ciliary partition of the distribution correlated with the severity of airway obstruction and approximated 3:1 in mild and 1:3 in very severe obstruction. In nuclear images, the distribution featured contrast abnormalities of hyperdeposition and hypodeposition. Intense hyperdeposition most commonly occurred in hilar and perihilar large airways. In isolated instances, hyperdeposition almost certainly occurred focally at sites of partial bronchial obstruction and diffusely by expiratory trapping; hypodeposition occurred distally to bronchial obstruction and in areas of parenchymal loss.

Adult↗

Bifunctional chelates for radio-pharmaceutical labeling.

The use of the first of a new class of chelating agents for the binding of metal ions to macromolecules as a novel approach to radiopharmaceutical labeling is described. Advantages are mild reaction conditions, large variety of accessible radionuclides and reactive groups, and separation of synthetic organic chemistry from radiochemistry. Human serum albumin and bovine fibrinogen labeled with 111Indium using this technique were relatively stable in vitro and in vivo, showed little alteration in function, and have potential as tumor localizing agents in humans.

Animals↗