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PubMed1977

Gallium imaging in pediatrics.

Gallium-67 citrate imaging was carried out in 59 children from 3 mo to 20 yr of age. Indications for the study included the search for occult inflammatory disease and the detection and staging of malignant disease. The Ga-67 citrate scan had a 96% reliability in confirming or excluding the site of purulent material as a cause of sepsis, and 76% reliability in detecting malignant disease. Tissue distributions in children differ from those in adults primarily in that the epiphyseal plates, spleen, and thymus may show increased activity normally and in the presence of sepsis. These variations are illustrated as possible sources of incorrect interpretation. "Cold" defects may be seen in sterile collections and avascular masses. Experience in this age group seems sufficiently encouraging to continue the use of gallium-67 citrate for the purposes described.

Adolescent↗
PubMed1990

A new myocardial imaging agent: synthesis, characterization, and biodistribution of gallium-68-BAT-TECH.

In order to develop a new myocardial perfusion agent for positron emission tomography (PET), a new lipid-soluble gallium complex was evaluated. Synthesis, radiolabeling, characterization, and biodistribution of a unique gallium complex, [67Ga]BAT-TECH (bis-aminoethanethiol-tetraethyl-cyclohexyl), are described. The complex formation between Ga+3 and BAT-TECH ligand is simple, rapid, and of high yield (greater than or equal to 95%). This process is amenable to kit formulation. The complex has a net charge of +1 and a Ga/ligand ratio of 1:1. Biodistribution in rats shows high uptake in the heart as well as in the liver. When [68Ga] BAT-TECH was injected into a monkey, the heart and liver are clearly delineated by PET imaging, suggesting that this complex may be a possible tracer for myocardial perfusion imaging.

Animals↗
PubMed1990

Haemophilus parainfluenzae bacteremia associated with a pacemaker wire localized by gallium scan.

A young woman with a history of sick sinus syndrome and placement of a permanent pacemaker 6 months before admission had fever and Haemophilus parainfluenzae bacteremia. A gallium scan localized the infection to the site of the pacemaker wire. Echocardiograms were negative for any vegetations. The patient responded to cefotaxime and trimethoprim-sulfamethoxazole therapy. We believe that this is the first case of H. parainfluenzae bacteremia associated with a pacemaker wire and localized by gallium scan.

Administration, Oral↗
PubMed1990

[Determination of traces of gallium in air by oscillographic polarography].

Gallium and its compounds in air collected by millipore filter membrane are leached by 10% HNO3 at room temperature. After being adjusted with ammonia solution to pH8-9, the leachate is filtered and the filtrate is evaporated to dryness on a water bath. The residue is dissolved with 2 ml of 10% HNO3 and then into the solution are added 0.5 ml of 5% hydroxylamine hydrochloride solution, 0.20 ml of 5% sulfosalicyclic acid solution, 0.5 ml of NaF solution (1mg F/ml) and 1 drop of methyl red solution. Let it stand for 5 min after the color of the solution turns orange by addition of 1:1 NH4OH solution. Add 0.20ml of 0.20% cupferron solution, 0.20ml of 0.5% diphenyl-guanidine solution (prepared in 95% ethanol) and 0.5ml of acetic acid-ammonium acetate buffer (pH 7.0). Then add water to make the final volume of the test solution to be 10ml and measure the height of the second derivative polarographic wave at -1.08V (vs.SCE). The sensitivity of the method is 0.005-0.10 microgram/ml, the coefficient of variation 6.8%, recovery 97.8%. Within 0.005-0.10 microgram/ml, the wave height is linear with the concentration of gallium.

Air↗
PubMed1990

Myopericarditis in acquired immunodeficiency syndrome diagnosed by gallium scintigraphy.

Myocarditis is among the cardiac complications of acquired immunodeficiency syndrome and, yet, is often not discovered until autopsy. Gallium scintigraphy has been employed in diagnosing this entity, but few data are available about its diagnostic accuracy and value. Here, the authors report two cases of myopericarditis as diagnosed by gallium scan.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Manipulation of gallium restorative materials. 1. Control of wetting action of mixture by mulling with ethanol].

The wetting action of gallium alloy is a handicap when handling the material. Ethanol mulling after mixing was assayed in an attempt to control the wetting action of such mixtures. A mixture of gallium and Ag-Sn-Cu spherical alloy particles was mulled with a small piece of an ethanol-soaked sponge for 10 seconds following mixing by an amalgamator. The effect of this mulling on the adherence of the mixture to the capsules, physical properties and microstructures was determined. Mulling with ethanol effectively controlled the wetting action of the mixture, and reduced adherence to the capsules without affecting physical properties. A decreased reaction phase around the alloy particles was observed in the microstructure of the ethanol-mulled specimen.

Dental Alloys↗
PubMed1989

The effect of aluminum and gallium ions on the mineralization process.

Metal ions have various and significant effects on the skeletal system. Aluminum accumulation in renal dialysis patients causes osteomalacia, while gallium is an effective therapeutic agent for treating the hypercalcemia accompanying certain malignancies. Using in-vitro systems that stimulate in-vivo mineralization, the authors have investigated the physical-chemical mechanisms of the actions of aluminum and gallium and report some of their findings.

Adsorption↗
PubMed1986

Comparison of clinical parameters, bronchoalveolar lavage, gallium-67 lung uptake, and serum angiotensin converting enzyme in assessing the activity of sarcoidosis.

A major problem in pulmonary sarcoidosis is the assessment of disease activity. We established a clinical score system composed of degree of dyspnea, chest radiographic stage, forced vital capacity, and clinical assessment of disease activity (normal = 0, maximum = 16). We evaluated this score in 50 patients with sarcoidosis along with other proposed measures of disease activity: bronchoalveolar lavage percent lymphocytes (% lymphs), Gallium-67 lung uptake measured as total lung to background ratio (TL/B ratio), and serum angiotensin converting enzyme (SACE) levels. The patients we studied had an average clinical score of 5.6 +/- 2.7 (+/- SD). Though bronchoalveolar lavage % lymphs (32 +/- 20%), TL/B ratio (192 +/- 73), and SACE (137 +/- 66) were all significantly elevated in these patients, Gallium-67 uptake was most frequently abnormal (80% of patients). However, the TL/B ratio was higher in smokers (231 +/- 91) than nonsmokers (178 +/- 64, p less than 0.05). There was no correlation between our clinical score, or any part of the clinical score, and other laboratory measures of alveolitis. Bronchoalveolar lavage % lymphs and TL/B ratio correlated weakly (n = 50, r = 0.36, p less than 0.02), while % lymphs and SACE correlated less well (n = 29, r = 0.36, p = 0.051). There was no correlation between TB/L ratio and SACE.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Thoracic imaging with gallium-67.

In the past, gallium-67 imaging has undergone several ups and downs related to its clinical importance. After a period of initial enthusiasm, its role and indications are now established. At present, there are two fields of clinical interest for 67Ga-imaging: (1) mediastinal staging in bronchogenic carcinoma and the staging of malignant lymphoma; (2) assessment of activity in interstitial lung diseases, especially sarcoidosis and inflammatory lung disorders. The advantage of 67Ga-imaging is that it is highly sensitive for the detection of neoplastic and inflammatory processes, independent of anatomical barriers. Particularly with the challenge of AIDS, 67Ga-imaging will gain increasing importance in the future. The low specificity of gallium for detecting underlying disorders precludes its use as a primary diagnostic tool. Therefore, and because of the cost and radiation load, the indications for application will have to be selected very carefully.

Adenocarcinoma↗
PubMed1988

Gallium-67 citrate localization in osteoclast nuclei of Paget's disease of bone.

Gallium-67 citrate scintigraphy has been used to indicate the extent of bone involvement in patients with Paget's disease of bone and is an excellent marker in monitoring the effects of specific therapy. Since gallium uptake is dependent on cellular function, autoradiographic techniques can be applied to cells of Paget's lesions to understand better the mechanism of [67Ga]citrate uptake. Bone biopsies were obtained from sites of increased uptake using [67Ga]citrate scintigraphy in two patients with Paget's disease. In both patients electron microscopic autoradiographs demonstrated a high concentration of silver grains over the nuclei of osteoclasts. The cellular mechanism is unknown but may be related to the known inhibitory effect of calcitonin on osteoclast activity. The association of [67Ga]citrate with the nucleus of the osteoclasts is unique and different from tumor cells in which there is a high association of [67Ga]citrate with the lysosome fraction within the cytoplasm.

Autoradiography↗
PubMed1988

Lymphocytic interstitial pneumonitis: a cause of pulmonary gallium-67 uptake in a child with acquired immunodeficiency syndrome.

Lymphocytic interstitial pneumonitis (LIP) is currently recognized as a frequent pediatric manifestation of the acquired immunodeficiency syndrome (AIDS). We report the gallium scan findings in a 3-yr-old girl with this disorder and review its clinical, radiologic, and pathologic features. LIP must be a prime consideration in the differential diagnosis of diffuse pulmonary gallium uptake in pediatric AIDS patients. Further experience will afford greater perspective on the diagnostic role that nuclear medicine will ultimately play in this disease.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Patterns of gallium-67 scintigraphy in patients with acquired immunodeficiency syndrome and the AIDS related complex.

Thirty-two patients with AIDS related complex (ARC) or acquired immunodeficiency syndrome (AIDS) underwent 67Ga scans as part of their evaluation. Three patterns of 67Ga biodistribution were found: lymph node uptake alone; diffuse pulmonary uptake; normal scan. Gallium-67 scans were useful in identifying clinically occult Pneumocystis carinii pneumonia in seven of 15 patients with ARC who were asymptomatic and had normal chest radiographs. Gallium scans are a useful ancillary procedure in the evaluation of patients with ARC or AIDS.

AIDS-Related Complex↗
PubMed1986

Mechanism of gallium-67 accumulation in tumors.

Neoplasms are characterized by increased perfusion, increased permeability of their capillary beds to macromolecules, and a delay in new lymphatic vessel growth. These lead to the increased entry and residency time of macromolecules in the interstitial space of tumors. Multiple factors contribute to the localization of 67Ga in tumors. Adequate blood supply is essential; at areas with no blood supply such as the necrotic center of a large tumor, there is no 67Ga accumulation. Gallium-67, mainly in the form of transferrin-67Ga complex, is delivered to the tumor through capillaries with increased permeability. In tumors, some 67Ga is taken up by tumor cells; some may also be taken up by inflammatory cells when they are present. Gallium-67 binding proteins, such as lactoferrin or ferritin, may also contribute to the accumulation and retention of 67Ga in tumors; however, their roles are less clear. The intensity of these various factors determine their relative contribution and the degree of 67Ga accumulation in tumors.

Animals↗
PubMed1986

Phase II evaluation of bolus gallium nitrate in lymphoproliferative disorders: a Southeastern Cancer Study Group trial.

Gallium nitrate was administered as a 700-mg/m2 iv bolus infusion over 15-30 minutes every 2 weeks to 138 patients with malignant lymphoproliferative diseases. Responses occurred in patients with well-differentiated lymphomas (five responses among eight patients), but the drug produced few responses in any other group of patients. Toxic effects were primarily gastrointestinal and reversible renal abnormalities and anemia. As a single agent, bolus gallium nitrate has little activity in lymphoproliferative diseases.

Adolescent↗
PubMed1987

Analysis of homogeneity of alveolitis in pulmonary sarcoidosis by bilateral bronchoalveolar lavage, gallium-67 lung uptake, and chest radiograph.

The use of unilateral lobar bronchoalveolar lavage (BAL) to assess disease activity in pulmonary sarcoidosis assumes that the alveolitis is homogeneous throughout the lung parenchyma. Three studies were used to evaluate this premise in 21 patients with sarcoidosis who had a broad range of abnormalities: bilateral BAL cell counts, quantitated regional gallium-67 lung uptake, and analysis of chest radiographs. Based on results of these studies, we conclude that the alveolitis in sarcoidosis is homogeneous in the majority of patients, although lavage of the lingula may give erroneous results due to the frequently increased proportion of neutrophils. The only moderate level of correlation between the BAL % lymphocytes and gallium-67 lung uptake, even when the same regions of the lung are studied, suggests that these tests may measure different aspects of disease activity.

Adult↗
PubMed1987

Tumoral calcinosis associated with sarcoidosis and positive bone and gallium imaging.

A 63-year-old female with biopsy proven tumoral calcinosis presented with progressive and recurrent swelling and tenderness of the right hip, thigh, elbow, and wrist. Both gallium and bone imaging demonstrated intense, congruent uptake in these areas. This is the third case of tumoral calcinosis with sarcoidosis documented in the literature. However, these are the first published bone and gallium scans in a patient with a history of sarcoidosis and tumoral calcinosis.

Calcinosis↗
PubMed1987

[Contribution of pulmonary gallium scintigraphy to the diagnosis of pulmonary tuberculosis].

Radioisotope scanning of the lungs with gallium 67 was performed in 13 patients whose radiological images were suggestive of pulmonary tuberculosis. The purpose of the study was to assess the value of that method as a complement to bacteriology in active pulmonary tuberculosis. Provided the lung tissue is not totally destroyed, gallium 67 is strongly taken up by the tuberculous lesions. However, scanning cannot be regarded as a routine examination, as it is costly and delivers a non-negligible dose of radiations. All it can do is to serve as a guide for more invasive investigations.

Adult↗
PubMed1986

Differential uptake of gallium-67-labeled liposomes between tumors and inflammatory lesions in rats.

The differential gallium-67 (67Ga) accumulation in tumors and inflammatory lesions in rats after i.v. injection of liposome encapsulated 67Ga ([67Ga]liposomes) was studied. The 67Ga accumulation in the tumor was much greater than that in the granulation tissue regardless of the surface charge of liposomes; however, the difference between the two tissues was the greatest when using positive charged liposomes. Gallium-67 delivery to tumors by liposomes was greater than that to granulation tissue in all stages of growth. After i.v. injection, the accumulation of 67Ga in the tumor reached a maximum at 12 hr, whereas in the granulation tissue it was delayed to 24 hr postinjection. In the study of tissue distribution of 67Ga in rats bearing both tumor and granulation tissue, positively charged liposomes preferentially delivered 67Ga to the tumor than to the granulation tissue. These results suggest that [67Ga]liposomes are able to discriminate between the tumor and the inflammatory lesion.

Animals↗