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PubMed1977

[Our experiences with the gallium-scintigraphy in case of sarcoidosis of the lungs (author's transl)].

The comparing examinations of patients suffering from a sarcoidosis of the lungs by the help of roentgenograms, scintigraphies of lung perfusion of 67-gallium and bioptic examinations admit to conclude as follows: In the stages I and II the activity-accumulation of radioactive gallium corresponds nearly to the alterations becoming visible in the X-ray-graph. Consequently, increases of lymph nodes and active granulomatous interstitial or centriform infiltrations may be presented. In case of a successful treatment the activity-incorporation is not to be proved anymore. As to time the alterations also coincide with the radiogram. In single cases the epithelioid nodule may be proved bioptically and microscopically when the active process already has stabilized spontaneously or by a treatment. In these cases the radioactive gallium is incorporated no more. The proof of 67-Ga-activity has a special signification in case fibrotic alterations have already appeared. The examinations prove that a granulomatosis may continue to exist when already distinct X-ray-symptoms of a fibrosis are present. Consequently, the granulomas may appositionally develop and cause an additional fibrosis. Therefore, in case of an existing infiltration of the lungs the combination of a definite lesion in the form of a fibrosis and a persisting formation of granulomas rather means a rule than an exception. A perfusion scintigram may be altered pathologically by a granuloma as well as by a fibrosis. Disorders in perfusion caused by granulomas are reversible.

Acute Disease↗
PubMed1984

[Significance of gallium scintigraphy in tumors and granulomatosis of the skin].

Scintigraphy with gallium has proved useful as a screening method for the diagnosis of certain malignant tumors and systemic diseases. One single scintigraphic investigation is able to detect almost all organs of a man. We checked this radiopharmacon with regard to its usefulness in dermatology. Gallium scintigraphy shows high sensitivity concerning verification and localization of metastases of malignant melanome as well as B- and T-cell lymphomas. Moreover, gallium is effective in controlling the therapie of sarcoidosis.

Diagnosis, Differential↗
PubMed1984

Gallium-67 scanning in Sjögren's syndrome: concise communication.

We performed gallium-67 scans in 12 patients with primary or secondary Sjögren's syndrome (SS). Salivary-gland uptake of gallium-67 was noted in four of five patients with primary SS. Pulmonary uptake was observed in ten of 12 patients. Chest radiographs were essentially normal in all patients, although 60% complained of significant dyspnea with exertion. The gallium-67 scan may prove to be a sensitive noninvasive diagnostic test for lung and mediastinal involvement by either primary or secondary SS, and for salivary-gland involvement in primary SS.

Adult↗
PubMed1984

The spectrum of gallium-67 renal activity in patients with no evidence of renal disease.

Thirty-seven gallium-67 images were reviewed retrospectively to determine relative renal gallium activity ( RGA ) in patients with no evidence of renal disease. Twenty-four patients were classified as having no evidence of renal disease (NRD). RGA was identified in 50.0% (12/24) of patients in the NRD group. We conclude that the presence of RGA neither suggests nor rules out renal disease. Altered nonrenal biological factors (such as saturation of iron-binding capacity) may decrease soft-tissue gallium accumulation while activity in the kidney remains unchanged. The latter provides renal images with better signal-to-noise ratio. Current imaging equipment may allow renal visualization in these patients.

Adolescent↗
PubMed1978

A melting-point-of gallium apparatus for thermometer calibration.

We have investigated the equilibrium melting point of gallium as a temperature fixed-point at which to calibrate small thermistor thermometers, such as those used to measure temperature in enzyme reaction analysis and other temperature-dependent biological assays. We have determined that the melting temperature of "6N" (99.999% pure) gallium is 29.770 +/- 0.002 degrees C, and that the constant-temperature plateau can be prolonged for several hours. We have designed a simple automated apparatus that exploits this phenomenon and that permits routine calibration verification of thermistor temperature probes throughout the laboratory day. We describe the physics of the gallium melt, and the design and use of the apparatus.

Chemical Phenomena↗
PubMed1982

Use of tricatecholamide ligands to alter the biodistribution of gallium-67: concise communication.

The effect of the intravenous administration of the synthetic siderophore LI-CAM-C on the biodistribution of Ga-67 was investigated. The ligand was found capable of the in vivo complexing with Ga-67, which hastened the renal clearance of the nuclide. The gallium concentration was decreased in all organs, with the exception of the liver and spleen, where we suggest that hydroxide precipitates interfere with gallium sequestration by LICAM-C. The gallium in abscess tissue was only slightly affected, giving rise to an increase in the Ga-67 abscess-to-soft-tissue concentration ratio when LICAM-C is administered. Dosimetry calculations show that the siderophore decreases the radiation burden from Ga-67 citrate. The advantage of clinical application of LICAM-C are discussed.

Abscess↗
PubMedDate not supplied

Indications for Gallium 67 in surgical oncology.

Until recently, the diagnosis of primary neoplasms and metastasis required different and complicated tests, many of which were invasive. Several radiopharmaceuticals have been tried in the diagnosis and management of neoplasms, but so far, the only radiopharmaceutical which gives satisfactory results is Gallium 67. Scintigraphy with this compound allows localization of the primary neoplasm and metastasis. It is also useful in the staging and follow-up and, in particular, in ascertaining the efficacy of treatment. Gallium scintigraphy is a very sensitive procedure, but not very specific; active inflammatory processes can produce an abnormal localization of the Gallium 67 in the infected area.

Gallium Radioisotopes↗
PubMed1981

[The diagnosis of sarcoidosis with gallium-67. A case report].

Uptake of gallium-67 in the chest is a relatively nonspecific indicator of active disease. In patients with suspected sarcoidosis a specific diagnosis can often be made if the head and neck are included during imaging. Seventy-five per cent of patients with sarcoid lesions in the lungs and mediastinum show uptake of the isotope in the salivary glands. If, in addition, the lacrimal glands concentrate the gallium, a diagnosis of sarcoidosis may be made with confidence. A case of mediastinal sarcoidosis, illustrating uptake of gallium-67 in the parotid and lacrimal glands, is discussed.

Adult↗
PubMed1994

Gallium scintigraphy in the diagnosis and total lymphoid irradiation of Takayasu's arteritis.

Takayasu's arteritis (TA) in children causes appreciable morbidity and mortality, predominantly as a result of the complication of renovascular hypertension (RVH). Ten children with TA, complicated by RVH, were treated at our centre over the past decade. An initial raised erythrocyte sedimentation rate (ESR) and a purified protein derivative greater than 15 mm were present in every case. More recently, gallium scintigraphy has been used to demonstrate sites of active inflammation in affected vessels (3/4 patients) which became negative after total lymphoid irradiation (TLI). The latter was used in the last 6 children, and appeared to be effective in controlling disease activity as evinced in the normalisation of their ESRs and negative findings on gallium scintigraphy (in all 3 patients with prior active inflammation). Because of vascular damage caused by the vasculitic process, surgical intervention is often required to improve organ perfusion, particularly of the kidney/s. Renal autografting (or allografting) seems preferable (6/11 kidneys functional) to renal bypass grafting (5/5 kidneys clotted). Patient survival improved when TLI was used in addition to standard surgical and medical therapy; this included steroids and antituberculous therapy with TLI, and steroids and cyclophosphamide in the two relapses. Five of 6 patients treated with TLI were alive after 32-54 months' follow-up, while 4 patients who received standard medical and surgical therapy but not TLI all died within 18 months of diagnosis. Gallium scintigraphy is a helpful diagnostic tool in assessing vasculitic activity in TA; TLI is an important mode of immunosuppression, but still needs to be compared with cyclophosphamide as the major immunosuppressive.

Child↗
PubMed1994

Discrepancy between gallium-67 citrate scans and chest X-rays in patients with miliary tuberculosis.

Two patients were admitted to our hospital with a diagnosis of miliary tuberculosis (TB). Gallium-67 citrate (Ga) scans and chest X-rays were used to localize the TB lesions. One case showed normal chest X-ray with significant gallium uptake in the lung while the other showed diffuse interstitial infiltrations of both lungs in chest X-ray with negative result in gallium scan. We suggest that the combination of Ga scans and chest X-rays might be indicated to avoid the discrepancy between the two images and missing early diagnosis of miliary TB.

Adult↗
PubMed1994

Gallium-67 uptake in a mass of benign transformation mimicking recurrence of nodular lymphocytic predominance Hodgkin's disease.

Gallium-67 is now widely used in the management of lymphoma patients. It is not, however, tumor-specific and reasons for uptake in nonmalignant and premalignant lesions associated with lymphoma should be recognized. Gallium-67 uptake in a mass of progressively transformed germinal centers and sarcoid-like reaction, mimicking recurrence in a 31-yr-old man with nodular lymphocytic predominance Hodgkin's disease, is described. Gallium-67 was taken up on two occasions and a recurrence was suspected. On the first occasion, abnormal uptake was present in axillary lymph nodes and on the second in mediastinal and parahilar lymph nodes. Histology of the lesions on both occasions showed progressively transformed germinal centers and sarcoid-like reaction but no evidence of Hodgkin's disease (HD). Bilateral parahilar abnormal uptake of 67Ga disappeared spontaneously without treatment after several months. The mass on CT regressed but did not disappear. This case demonstrates that the appearance of a new mass which takes up 67Ga in lymphocytic-predominance HD during a continuous clinical remission does not necessarily indicate recurrence and the need for treatment. It suggests that a biopsy should be performed to determine the nature of the lesion.

Adult↗
PubMed1993

Distribution of gallium-67 in normal and hypotransferrinemic tumor-bearing mice.

The mechanism by which 67Ga accumulates in tumors is controversial. The most popular theory is that 67Ga binds to transferrin and gains access to cells by the transferrin receptor. However, substantial evidence suggests that uptake of 67Ga may not be universally mediated by transferrin in tumors. To determine whether transferrin is required for uptake of 67Ga in vivo, we compared the uptake of 67Ga by two types of implanted tumors and by normal tissues in normal and severely hypotransferrinemic strains of Balb/C mice. One type of tumor was strongly gallium-avid in normal mice; the other was not. Uptake of 67Ga by normal soft tissues was markedly less in hypotransferrinemic than in normal mice. Uptake of 67Ga by bone was equivalent in the two types of mice. For the more gallium-avid tumor, uptake of 67Ga was similar and the ratio of tumor-to-background activity was substantially higher in the hypotransferrinemic than in the normal mice. For the less gallium-avid tumor, uptake was significantly less in hypotransferrinemic than in normal mice. These data suggest that uptake of 67Ga by bone and by some tumors may be a transferrin-independent process.

Animals↗
PubMed1977

The gallium melting-point standard: its role in our temperature measurement system.

The latest internationally-adopted temperature scale, the International Practical Temperature Scale of 1968 (amended edition of 1975), is discussed in some detail and a brief description is given of its evolution. The melting point of high-purity gallium (stated to be at least 99.99999% pure) as a secondary temperature reference point is evaluated. I believe that this melting-point temperature of gallium should be adopted by the various medical professional societies and voluntary standards groups as the reaction temperature for enzyme reference methods in clinical enzymology. Gallium melting-point cells are available at the National Bureau of Standards as Standard Reference Material No. 1968.

Chemistry, Clinical↗
PubMed1993

[Gallium-67 scintigraphy in malignant lymphoma].

The presence of a residual mass is a frequent and difficult problem in the treatment of Hodgkin's or non-Hodgkin's lymphoma: since it is of major importance to determine whether the lesion is a fibrous mass or a still progressing tumour requiring additional therapy. Gallium-67 scanning, performed in a series of 52 patients, provides an answer to this question since there is an excellent correlation between gallium uptake by the tumoral masses and their progressiveness. Magnetic resonance imaging was carried out in half of our patients: the finding of a low-intensity signal on T2-weighted sequences proved that the residual mass was fibrous, whereas a high-intensity signal on T2-weighted sequences did not distinguish between fibrous and tumour masses. The priceless information provided by the simple and non invasive method that is gallium scanning is extremely useful to evaluate the extension of lymphomas and to determine whether residual masses are tumoral or fibrous.

Adult↗
PubMed1996

Evaluation of sequential thallium and gallium scans of the chest in AIDS patients.

UNLABELLED: With decreasing incidence of pneumocystis carinii pneumonia (PCP) in AIDS as a result of prophylactic regimens, there is a higher incidence of tuberculosis (TB), mycobacterium avii complex (MAC), kaposi sarcoma and malignant lymphoma. There is a need for differentiating these various pathological entities. The purpose of this study was for a retrospective evaluation of sequential thallium and gallium scans in AIDS patients for differentiating intrathoracic kaposi sarcoma from malignant lymphoma and opportunistic infections. METHODS: A total of 181 patients had both studies completed between March 1992 and May 1994. The final diagnosis was verified only in 83 patients. Results were correlated with the CD4 counts, bronchoscopic and chest radiograph findings. RESULTS: In patients with pulmonary kaposi sarcoma and no opportunistic infections (19 patients), a thallium-positive, gallium-negative pattern was detected in 17 patients with a sensitivity of 89%. In the presence of kaposi sarcoma plus opportunistic infections, this pattern was only detected in 7 of 19 patients (sensitivity dropped to 37%). In 45 patients with opportunistic infections and no kaposi sarcoma, only two false-positive findings were found in patients with cytomegalic virus pneumonia for a specificity of 96%. For the whole group of 83 patients, sensitivity was 63%; specificity 95%; positive predictive value 92%; accuracy 81%; and negative predictive value 75%. CONCLUSION: A thallium-positive, gallium-negative pattern in AIDS patients has a high specificity for the diagnosis of kaposi sarcoma, however, the sensitivity dropped from 89% to 37% in the presence of opportunistic infections.

AIDS-Related Opportunistic Infections↗
PubMed1996

2-year clinical evaluation of a gallium restorative alloy.

PURPOSE: To assess the clinical performance of 2-year old gallium alloy restorations. Parameters evaluated include: (1) fracture at the margins, (2) tarnish, (3) surface roughness, (4) tooth fracture, (5) fracture through the body of the restoration, and (6) any medical or dental conditions arising during the study. MATERIALS AND METHODS: Nine patients received 30 Class I restorations of Galloy gallium alloy. These were placed as conservatively as possible under a rubber dam. Fifteen of the preparations were lined with a Bis-GMA resin to seal the restoration from moisture. The other 15 preparations were sealed with Amalgambond. After placement of the gallium alloy, the exposed surfaces of all restorations were sealed with the Bis-GMA resin, and the occlusion was checked. The restorations were examined at 2 weeks, 3 months, 6 months, 1 year and 2 years. RESULTS: At the 2-year recall, all restorations were intact with the exception of one tooth fracture (cause unknown). Forty-five percent of the restorations exhibited tarnish and 60% had a rough surface. The fracture at the margins of these restorations was minimal, and no significant difference could be found between those using Amalgambond and those sealed with the resin system. No medical problems were reported by the patients, and postoperative sensitivity was minimal.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1998

Transferrin receptor-dependent and -independent iron transport in gallium-resistant human lymphoid leukemic cells.

Recent studies showed that gallium and iron uptake are decreased in gallium-resistant (R) CCRF-CEM cells; however, the mechanisms involved were not fully elucidated. In the present study, we compared the cellular uptake of 59Fe-transferrin (Tf) and 59Fe-pyridoxal isonicotinoyl hydrazone (PIH) to determine whether the decrease in iron uptake by R cells is caused by changes in Tf receptor (TfR)-dependent or TfR-independent iron uptake. We found that both 59Fe-Tf and 59Fe-PIH uptake were decreased in R cells. The uptake of 59Fe-Tf but not 59Fe-PIH could be blocked by an anti-TfR monoclonal antibody. After 59Fe-Tf uptake, R cells released greater amounts of 59Fe than gallium-sensitive (S) cells. However, after 59Fe-PIH uptake 59Fe release from S and R cells was similar. 125I-Tf exocytosis was greater in R cells. At confluency, S and R cells expressed equivalent amounts of TfR; however, at 24 and 48 hours in culture, TfR expression was lower in R cells. Our study suggests that the decrease in Tf-Fe uptake by R cells is caused by a combination of enhanced iron efflux from cells and decreased TfR-mediated iron transport into cells. Furthermore, because TfR-dependent and -independent iron uptake is decreased in R cells, both uptake systems may be controlled at some level by similar regulatory signal(s).

Biological Transport↗
PubMed1998

Uptake of gallium-67 in transfected cells and tumors absent or enriched in the transferrin receptor.

UNLABELLED: Gallium-67 has been a controversial tumor-imaging agent in nuclear medicine for decades. This controversy centers on why tumors are variable in gallium-avidity, whether 67Ga uptake is a transferrin-independent or dependent process, and whether tumors and normal tissues differ in mechanism of uptake. If the factors that control uptake of 67Ga were understood better, then efforts to improve oncologic imaging with 67Ga by increasing the tumor activity, or by decreasing the background, may be warranted. METHODS: Conventional systems for evaluating the mechanism and control of 67Ga uptake have significant limitations. We have endeavored to circumvent these by developing a pair of transfected cell lines. One cell line has no transferrin receptor. In the other, the human transferrin receptor has been restored by transfection and is over-expressed constitutively, without the necessity to manipulate factors such as cell growth or iron content. The uptake of 67Ga, both as a citrate salt and as a gallium-transferrin complex, was examined in these pairs of cells in vitro. The effect of calcium and of soluble (ionic) iron concentration on 67Ga uptake also was determined. Tumors were grown as explants of these cells in nude mice and comparisons of uptake of 67Ga by these tumors in vivo were made. RESULTS: The in vivo uptake of 67Ga is significantly increased in tumors in which the transferrin receptor is overexpressed, compared to those without a functional transferrin receptor. However, a notable amount of accumulation of 67Ga also occurs, both in vitro and in vivo, by a transferrin-independent route. In vitro experiments demonstrate that the uptake of 67Ga by the transferrin-independent route can be enhanced further to levels that equal or exceed those achieved by the transferrin-dependent route by increasing the content of calcium or iron salts in the incubation medium. CONCLUSION: Significant transferrin-independent uptake of 67Ga occurs both in vitro and in vivo. This uptake can be stimulated further in vitro, suggesting that in vivo enhancement might also be possible to enhance the utility of the radiometal for tumor imaging.

Animals↗