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V R McCready

Publications and source records attributed to V R McCready.

At least 127 records · Page 7Linked to original sources

Gray scale ultrasound imaging. The anatomy and pathology of the liver.

Gray scale ultrasound imaging circumvents some of the limitations of other diagnostic tools. The authors have extended this technique to the investigation of hepatobiliary disease. The details of their equipment are described and their results in relation to various parameters of the disease are discussed. A major feature of the gray scale technique is the enhanced signal-noise ratio, which allows low-level echoes to be displayed.

Cysts↗

A clinical evaluation of grey-scale ultrasonography.

Recent technical improvements in grey-scale ultrasound imaging have resulted in the visualization of the internal consistency of soft tissues. This permits the diagnosis of diffuse pathology and detection of small space-occupying lesions. The new technique can be used with advantage in the currently accepted obstetrical applications for ultrasound imaging as well as for new non-obstetrical applications. The method has been found to be a most informative, non-intrusive means for investigating hepatobiliary disease and for the differential diagnosis of chronic splenomegaly.

Breast Neoplasms↗

The concentration of 67Ga and 45Ca in the lactating mammary gland and its relevance to the tumor uptake of 67Ga citrate.

67Ga is known to concentrate in the breasts of pregnant and postpartum women, and a case is now described in which 67Ga uptake was seen in the breasts of a woman who was neither pregnant nor postpartum, but was receiving chemotherapy for Hodgkin's disease. Comparative studies of the uptake of 67Ga and 45Ca in lactating dogs have shown that both nuclides are secreted in the milk in similar amounts and in protein-bound form. The concentration of 67Ga in mammary tissue is about one-half of that found in the milk at 5 hr postinjection but, by 48 hr, the concentrations are approximately equal. There were similarities in the subcellular distributions of 67Ga and 45Ca in the lactating mammary gland at 5 and 48 hr. Although there was a correlation between 67Ga and 45Ca in individual pieces of a lactating mammary gland at 5 hr after injection, no such correlation was seen between the two nuclides in multiple samples of a transmissible venereal tumor measured at various time intervals. The rate of dispersion of 67Ga and 45Ca from the lactating mammary gland was similar but, in the tumor, 67Ga was present in very much greater amounts than 45Ca and was retained longer. It is concluded that, although there may be similarities in the metabolic pathways of gallium and calcium in the lactating mammary gland, there is no similarity in the mechanism of uptake of these two elements into tumors.

Animals↗

Indium (111In)-labelled bleomycin for the detection of intracranial lesions.

Brain scans with 99mTc pertechnetate were compared with scans made after administration of 111Indium bleomycin in 38 patients scanned on 41 occasions. They gave similar results in 34 pairs of examinations, including cases in which both failed to detect the tumour. In seven cases, the two agents differed. In two of these bleomycin distinguished residual tumour from the effects of craniotomy more clearly than did pertechnetate; in three bleomycin apparently detected tumour not seen with pertechnetate, and in two the differences may have been due to technical factors, or are unexplained.

Adult↗

Tumour imaging radiopharmaceuticals.

32P, 131I-labeleed human serum albumin, 75Se-seleno-methionine, 107Hg-chlormerodrin, 67Ga-citrate and labelled bleomycin compounds, among others are discussed with particular respect to their observed clinical characteristics and suggested mechanisms of uptake. It is shown that there are striking similarities in the kinds of tumours demonstrable by these agents and that all of them may be taken up into inflammatory exudates. It is suggested that, while differences in the metabolism of each agent clearly exist, their mechanism of tumour uptake may be predominantly non-specific. It is concluded that radionuclide tumour imaging is of potential value mainly from the point of view of ease of whole body scanning for follow-up purposes and whereas other diagnostic methods may be more accurate in specific areas, ease of whole body screening is rarely a feature of these techniques. Methods for studying human cancer are necessarily restricted and the tumour imaging technique provides a unique, dynamic means of tumour observation. From the clinical point of view, the questions of why some tumours image well and others do not, what is the effect of treatment on uptake and how specific is the technique, are of most importance. In order to improve tumour imanging, more emphasis must be given to improving the lesion: background radioactivity ratio of the agents rather than attempting to improve detection equipment.

Animals↗

A clinical comparison of the tumour-imaging radiopharmaceuticals 67Gallium-citrate and 111Indium-labelled bleomycin.

Two tumour-imaging agents, 67Gallium-citrate and 111Indium-bleomycin have been assessed in a clinical trial. Both the quality of tumour image and correlation with known sites of disease has been compared by scanning with the two agents in a variety of malignant diseases. In addition, comparative uptakes of the agents have been measured in biopsy samples. In 28 scanning examinations using the agents sequentially, 67Gallium-citrate provided a more satisfactory tumour image and had closer clinical correlation with known sites of disease in 14 cases. Scans were felt to be of similar quality in 14 cases. There were no examples where 111Indium-bleomycin scans were found to be superior to 67Gallium-citrate. A number of biopsy samples of spleen, liver and lymph nodes were obtained from patients undergoing staging laparotomies for lymphomas in whom small doses of 67Gallium-citrate and 111Indium-bleomycin had been injected shortly before operation. Seven of the spleen samples were infiltrated with tumour and five of these contained less 67Ga than 111In; in contrast four of the five tumour-infiltrated lymph nodes showed 67Ga concentrations greater than those of 111In. It is concluded that 67Gallium-citrate is a more useful tumour-imaging agent than 111Indium-bleomycin, at least for lesions situated above the diaphragm. The value of 111Indium-bleomycin in the demonstration of abdominal malignancies has not been fully assessed in this study. Trials of new tumour imaging agents should as far as possible be compared directly with the best available alternative agent in a controlled study.

Adult↗