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PubMed1997

Clinical significance of thallium-201 and gallium-67 scintigraphy in pulmonary tuberculosis.

One hundred and thirty-nine patients with pulmonary tuberculosis were evaluated by means of gallium-67 and thallium-201 scintigraphy. The disease was clinically active in 83 and inactive in 56. The uptake ratio between the lesion and the contralateral normal lung field was calculated. The ratio determined by 67Ga scintigraphy was expressed as GR, and that determined by 201T1 scintigraphy (early or delayed) as ER or DR. The 201T1 retention index (RI) was calculated using the following equation: RI = DR - ER/ER x 100. The sensitivity, specificity and accuracy of 201T1 scintigraphy with respect to the activity of pulmonary tuberculosis were better than those of 67Ga scintigraphy (the figures for 201T1 scintigraphy were 88.0%, 82.1% and 85.6%, respectively, and those for 67Ga scintigraphy, 83.1%, 60.7% and 74.1%). We found a significant correlation between GR and ER, but there was no significant correlation between RI and ER. When the relationships between ER, C-reactive protein and 1-h erythrocyte sedimentation rate were examined among patients with abnormal uptake, no significant relationships were noted. In the 27 patients who could be followed up, GR and ER decreased with duration of the therapy, indicating a decrease in disease activity which was consistent with clinical findings. The RI was significantly higher in the early stages of therapy than in the later stages (P < 0.01), suggesting a temporary delay in 201T1 washout in the early stages. The washout seemed to be promoted by the effects of the therapy. Overall, it is concluded that 201T1 scintigraphy is more useful and more suitable than 67Ga scintigraphy for the evaluation of disease activity and therapeutic effects in patients with pulmonary tuberculosis.

Blood Sedimentation↗
PubMed2006

Retrospective review: usefulness of a number of imaging modalities including CT, MRI, technetium-99m pertechnetate scintigraphy, gallium-67 scintigraphy and F-18-FDG PET in the differentiation of benign from malignant parotid masses.

OBJECTIVE: The aim of this study is to evaluate an imaging approach using computed tomography (CT), magnetic resonance imaging (MRI), technetium-99m pertechnetate scintigraphy (99mTc pertechnetate scintigraphy), gallium-67 scintigraphy (67Ga scintigraphy) and fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET). MATERIAL AND METHODS: We reviewed retrospectively 59 patients with parotid masses. CT, MRI, 67Ga scintigraphy, 99mTc pertechnetate scintigraphy, and 18F-FDG PET were performed. RESULTS: All of the benign tumors had smooth margins on CT and MRI. Patients with inflammatory lesions and malignant lesions showed well-defined margins or ill-defined margins. All Warthin's tumors showed high technetium accumulation. Many of malignant tumors showed high FDG accumulation. Both pleomorphic adenomas and Warthin's tumors showed high accumulation in some cases on 18F-FDG PET. Among 15 patients with pleomorphic adenoma, 14 patients showed marked hyperintensity relative to CSF on T2-weighted images and partial enhancement on contrast-enhanced T1-weighted images. Combination of several imaging modarity offered usefulness of differential diagnosis for parotid masses. CONCLUSION: An efficient combination of imaging methods may be helpful for achieve the correct diagnosis.

Adolescent↗
PubMed1989

Effect of gallium on the in vitro formation, growth, and solubility of hydroxyapatite.

Gallium (Ga) is an effective treatment for the hypercalcemia of malignancy. The mechanism of action of the metal in blocking bone resorption in humans is not well understood. This paper examines the effect of Ga on the in vitro formation of hydroxyapatite (HA) in three test systems that have possible biological relevance in a pH-stat at pH 7.4, 37 degrees C, and 0.15 M NaCl: (1) the direct precipitation of HA; (2) the transformation of amorphous calcium phosphate to HA; and (3) the growth of HA seeds. In addition, the effect of Ga on HA solubility was measured at pH 5.0, the approximate pH of osteoclastic bone resorption. Ga decreased the HA formation and/or growth kinetics in a dose-related manner in all three test systems. In addition, the time to the onset of HA formation was increased in systems 1 and 2. Also, the adsorption of Ga on the surface of HA crystals was measured. Ga reduced the dissolution kinetics of HA compared with Ga-free control. The mechanism reported herein--the significant adsorption of Ga on forming and growing HA nuclei and on the surface of HA crystals--is believed to be responsible for the effects of the metal on HA proliferation and solubility. Accumulation of the metal on newly formed metaphyseal bone can now be explained by this adsorption of Ga. These in vitro results partly explain the in vivo action of Ga in treating hypercalcemia by decreasing bone apatite solubility.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium Phosphates↗
PubMedDate not supplied

A pilot study of antitumor effect of gallium ethylenediaminetetramethylene phosphonate [Ga(III)-EDTMP] in tumor-bearing rats.

The inhibitory effects of gallium ethylenediamine-N,N,N',N'-tetrakismethylene phosphonate [Ga(III)-EDTMP] was studied on a malignant tumor and metastatic bone lesion model induced with Walker carcinosarcoma 256 (WCS 256) in Wistar rats weighing 120 to 135 g. A water-soluble chelate, Ga(III)-EDTMP, was prepared for injection in a tumor-bearing model. Radiographic analysis at 14 days indicated that the bone invasion and osteolysis were markedly reduced in animals treated with Ga(III)-EDTMP. The calculated tumor inhibitory rates were 33.16+/-0.38% at a dosage of 5 mg/kg and 47.75+/-0.74% at 10 mg/kg. Biochemical markers such as serum calcium decreased by 23% (P<.05) and by 31% (P<.01) at dosages of 5 mg/kg and 10 mg/kg, respectively, whereas serum alkaline phosphatase (ALPase) activity decreased by 47% (P<.01) and 69% (P<.01) at the 2 dosages.

Animals↗
PubMed1984

Gallium-positive tumor thrombus.

A case is presented in which both a clear cell renal tumor and its accurate intravenous propagation were preoperatively depicted by combined information from tomographic gallium imaging and CT scanning.

Gallium Radioisotopes↗
PubMed2005

Mismatch between gallium-67 uptake and CT findings in a case of pulmonary alveolar proteinosis.

Gallium-67 citrate (67Ga) scintigraphy has been used as an indicator of activity of diffuse interstitial lung diseases. However, little has been mentioned in pulmonary alveolar proteinosis (PAP). Here we present a 53-year-old man with PAP showing patchy 67Ga uptake by single photon emission computed tomography (SPECT). Interestingly, the strong 67Ga uptake was observed in areas where ground-glass opacities were faint on chest CT. The uptake persisted after whole-lung lavage while the ground-glass opacity improved markedly. Although the precise mechanism of 67Ga uptake remains unclear, 67Ga SPECT findings may reflect the different pathological condition of PAP than that shown by CT.

Citrates↗
PubMed2000

Gallium-67 scintigraphic findings in a patient with breast lymphoma complicated with Sjögren syndrome.

We report here a patient with mucosa associated lymphoid tissue (MALT)-lymphoma of the breast complicated with Sjögren syndrome. It is speculated that Ga-67 could accumulate not only in lymphoma lesions but also in benign lymphoproliferative locations of Sjögren syndrome. Gallium-67 scintigraphy might be useful for the diagnosis and therapeutic monitoring of MALT-lymphoma complicated with Sjögren syndrome.

Adult↗
PubMed2001

Inexplicable suppression of hepatic uptake of gallium-67, a case report.

We describe here a case report of a patient with acute lymphocytic leukemia in whom hepatic gallium-67 (Ga-67) uptake was suppressed. The patient was hospitalized with increasing dyspnea. In Ga-67 scintigraphy, there was no hepatic uptake, although other physiological uptake was clearly observed. In addition, the scintigraphy showed increased accumulation in the right lung consistent with infection. We considered possible reasons for these findings. The patient had no history of chemotherapy or blood transfusion, and his iron metabolism was almost normal. He was not receiving any medication which might reduce hepatic blood flow. Blood chemistry suggested normal hepatic and renal function. The patient died from pneumonia 6 weeks later. The autopsy revealed extensive infiltration of the right lung with Bacillus cereus (B. cereus). Metabolic acidosis and/or iron utilization of B. cereus may induce both increased Ga-67 accumulation in the infected lesion and suppressed uptake in the liver, but these mechanisms could not explain normal physiological uptake in the other organs. This case warranted the further study of the hepatic Ga-67 uptake mechanism.

Aged↗
PubMed2003

Comparison of gallium-67 citrate and technetium-99m tetrofosmin scan to detect Hodgkin's disease.

OBJECTIVE: The purpose of this study was to compare the usefulness of gallium-67 citrate (67Ga) and technetium-99m tetrofosmin (Tc-TF) scan to detect Hodgkin's disease (HD). METHODS: In this study, 24 patients with HD underwent 67Ga and Tc-TF scan before receiving any therapy. RESULTS: 67Ga scan could detect HD in all 24 (100%) patients. Tc-TF scan could detect HD in 22/24 (91.6%) patients, but it was false-negative in one case of infradiaphragmatic HD and in another case with chemotherapy resistance. There was no significant difference in detection sensitivity between 67Ga and Tc-TF scan. CONCLUSIONS: We conclude that Tc-TF scan can not replace conventional 67Ga scan to detect HD.

Adult↗
PubMed1989

Gallium-67 citrate imaging for the assessment of radiation pneumonitis.

In order to evaluate its usefulness in the assessment of radiation pneumonitis, gallium-67 citrate (67Ga) imaging was performed before and after radiation therapy (RT) on 103 patients with lung cancer. In 23 patients with radiation pneumonitis detected radiographically, abnormal 67Ga uptake in sites other than tumors was found in all post-RT 67Ga lung images. Three patterns of uptake were found: (A), focal uptake corresponding to the RT field (n = 10); (B), diffuse uptake including the RT field (n = 4), and (C), diffuse uptake outside the RT field (n = 9). The area of 67Ga uptake was consistent with that of interstitial pneumonitis as revealed histopathologically in 7 cases. 67Ga uptake in pattern (C) was an indicator of poor prognosis for the patients with radiation pneumonitis. 67Ga uptake in the patients with reversible pneumonitis disappeared with steroid therapy. Sixteen (20%) of 80 asymptomatic patients, in whose chest radiographs there was no finding of radiation pneumonitis, showed transient 67Ga uptake. These were considered to occur in the subclinical radiation pneumonitis. These data suggest that 67Ga imaging is more sensitive than chest radiography in the detection of radiation pneumonitis and is useful in the assessment of the extent and clinical course of radiation pneumonitis.

Adult↗
PubMed1998

The evolutional stage changes in sarcoidosis on gallium-67 scintigraphy.

UNLABELLED: Gallium-67 scintigraphy has been proven as the imaging modality of choice in monitoring the presence of active disease in sarcoidosis. The purpose of this study is to analyze the patterns of evolutional stage changes of sarcoidosis while on steroid therapy by Ga-67 scintigraphy. METHODS: Eighty-six consecutive patients with biopsy-proved sarcoidosis are evaluated by Ga-67 scintigraphy. Thirty-six of 86 patients have had a baseline and one to eight follow-up Ga-67 scintigraphs (total 136 studies). The initial follow-up scintigraphs are obtained on average about 4-12 months after the baseline study. RESULTS: Seventeen of 36 patients (47.2%) are in stage IV at the time of the baseline study. Following their first course of corticosteroid therapy, 13 patients remained in the same stage and activity distribution pattern while 13 patients have shown reversion to other stages, eight patients showed complete remission while two patients became active from inactive stage. CONCLUSION: Evolutional stage changes are seen in 23 patients (63.9%), including eight patients (22.2%) who showed complete scintigraphic remission. The evolutionary stage changes remain quite variable and unpredictable. This, however, should not detract from the usefulness of Ga-67 scintigraphy in the diagnosis and prognostic evaluation of sarcoidosis, particularly when extrapulmonary involvement (Stage IV disease) is present.

Adrenal Cortex Hormones↗
PubMed1998

Gallium-67 scintigraphy in the treatment and prognosis of acute adult T-cell lymphoma.

The case of a 77-year-old male patient who complained of left upper quadrant pain and progressive vomiting. Laboratory examination showed extremely high lactic acid dehydrogenase (LDH) and adult T-cell leukemia antibody (ATLA). The anatomical studies CT, MRI, US and upper GI series substantiated an omental lymphadenopathy which was causing a circumferential compression of portions of the duodenum and jejunum. Gallium-67 citrate (Ga-67) scintigraphy showed high uptake at LUQ. Ultrasound guided biopsy failed to confirm the diagnosis. Irradiation was performed. Ga-67 scintigraphy had a contributory role in clinical subtyping of the disease, planning of treatment, posttreatment assessment and prognostication of adult T-cell lymphoma.

Aged↗
PubMed1989

Gallium-67 SPECT image in gastric lymphoma.

Gastric non-Hodgkin lymphoma was unexpectedly detected by gallium-67 scanning in initial staging of the lesions. Single photon emission computed tomography was very useful in determining the accumulation site and indicating further appropriate examinations.

Citrates↗
PubMed1997

Gallium nitrate suppresses lupus in MRL/lpr mice.

Gallium (Ga) nitrate, a drug which prevents a variety of experimental autoimmune diseases, was investigated in a murine model of systemic lupus erythematosus (SLE). In one experiment, female MRL/Mp lpr/lpr (MRL/lpr) mice were randomized into 2 groups of 6: 1) vehicle (trisodium citrate) and 2) Ga. Subcutaneous injections began at 3 weeks of age and continued weekly until the mice were euthanized a week after the thirteenth injection. The loading dose of Ga (calculated as elemental Ga) was 45 mg/kg, followed by 15 mg/kg/week. In another experiment (n = 18) with 3 males and 3 females per group, mice received 1) vehicle, 2) Ga x 1 (one 45 mg/kg dose), and 3) Ga x 13. In the experiment with 12 mice, axillary lymph nodes from Ga-treated mice were significantly smaller than those from vehicle-treated mice (91+/-42 and 360+/-358 mg respectively, mean+/-SD), and spleens as well as lymph nodes from the former showed significantly less lymphoid infiltrate. In the experiment with 18 mice, prescapular lymph nodes weighed 312+/-98, 217+/-52, and 42+/-34 mg, and spleens weighed 732+/-492, 409+/-164, and 192+/-93 mg in the groups which received vehicle, Ga x 1, and Ga x 13 respectively. Control mice had significantly more lymphoid infiltrates in the lungs, spleen, and lymph nodes and, unlike Ga x 13 mice, exhibited glomerulitis and renal vasculitis. Within groups, females developed more severe disease than males. The Ga x 13 group had increased percentages of CD4-bearing and CD8-bearing lymphocytes in lymph nodes and increased CD4-bearing lymphocytes in the spleen, with an increased proliferative response to mitogen stimulation in vitro in lymph nodes, although not in the spleen. The Ga x 13 group also gained less weight and developed osteosclerosis. Although preliminary, our findings suggest that clinical trials with Ga in SLE are merited.

Animals↗
PubMed2000

The value of gallium-67 and thallium-201 whole-body and single-photon emission tomography images in dialysis-related beta 2-microglobulin amyloid.

The aim of this study was to investigate the value of gallium-67 and thallium-201 whole-body and single-photon emission tomography (SPET) images in long-term dialysis patients in whom dialysis-related beta 2-microglobulin amyloid (beta 2-MA) was clinically suspected. Twenty-three patients who had received dialysis for at least 10 years were included in the study. A technetium-99m methylene diphosphonate (MDP) whole-body scan was performed in all of the patients. If there was any MDP accumulation in the articular and/or peri-articular region, 67Ga and 201Tl whole-body and SPET images were then acquired. If any 67Ga and/or 201Tl uptake was observed, a CT-guided biopsy was done. In those patients who had articular and/or peri-articular uptake of 99mTc MDP, 67Ga and/or 201Tl and who were pathologically proven to have beta 2-MA, 99mTc MDP, 67Ga and 201Tl whole-body scans and SPET were carried out again, both 3 months and 1 year after initiation of treatment. This served to evaluate the therapeutic effect and allowed comparison with the clinical findings. Of the 23 patients, eight had abnormal 99mTc MDP uptake. Among these eight, six had intense 99mTc MDP, 67Ga and 201Tl uptake in the articular and peri-articular regions before medication. Three months after the start of treatment, there were very marked decreases in uptake on both the 67Ga and 201Tl scans but less obvious changes in uptake of 99mTc-MDP. In comparison with the other clinical manifestations such as limitation in range of motion, the more the painful disability improved, the less was the uptake on both 67Ga and 201Tl scans. There were virtually no differences in uptake pattern between the three scans of each radiopharmaceutical obtained for each patient in both 3 months and 1 year after initial of treatment. It is concluded that 99mTc-MDP whole-body bone scan can both detect active and pre-existing inactive deposits of beta 2-MA. 67Ga and 201Tl scans are helpful to differentiate active from inactive deposits of beta 2-MA and to evaluate the therapeutic effect on these patients. SPET images are usually needed to distinguish articular and periarticular lesions from bone lesions.

Amyloid↗
PubMed2002

Detection and chemoradiotherapeutic evaluation of advanced esophageal squamous cell carcinoma using gallium-67 SPET: a preliminary study.

About 20 years ago, gallium-67 planar scintigraphy was introduced for the evaluation of advanced esophageal squamous cell carcinoma (AESCC). Although single-photon emission tomography (SPET) is now available in many institutions, there have been no reports regarding the evaluation of AESCC using (67)Ga SPET. The aims of this preliminary study were to assess the potential of (67)Ga SPET for the detection of AESCC and to further evaluate whether (67)Ga SPET can predict the effect of preoperative chemoradiotherapy on AESCC. Thirty-eight patients with histologically proven AESCC (35 men and 3 women, mean age 62+/-6.9 years) underwent (67)Ga SPET before and after preoperative chemoradiotherapy. The histological response to the chemoradiotherapy was determined from a surgical specimen of the esophagus: grade 0, 100% viable tumor cells; grade 1a, 99%-67%; grade 1b, 66%-34%; grade 2, 33%-1%; grade 3, no viable cells. Thirty-seven out of 38 AESCCs (97.4%) were detected on pre-chemoradiotherapy SPET. In these 37 cancers, the tumor-to-lung ratio (TLRpre) was 3.5+/-2 (range 1.5-9.6). Post-chemoradiotherapy SPET exhibited positive results in 22 cancers, with a TLRpost of 1.8+/-0.4 (range 1.1-2.6). No patient exhibiting a pathologically complete response had a positive post-chemoradiotherapy SPET result, whereas 80% of patients with negative post-chemoradiotherapy SPET (12/15) results had residual tumor. The percent reduction rate was defined as (TLRpre-TLRpost)/TLRpre x100 and did not correlate with histological response grade ( P=0.5169 for Kruskal-Wallis test). These results suggest that (67)Ga SPET is a powerful tool for the detection of AESCC. However, (67)Ga SPET seems to be of little use in predicting the effects of preoperative chemoradiotherapy on AESCC. Further studies are warranted in order to further clarify the clinical usefulness of (67)Ga SPET in patients with AESCC.

Aged↗
PubMed2003

Gallium-67 activated charcoal: a new method for preparation of radioactive capsules for colonic transit study.

Indium-111 is currently the radionuclide of choice for colonic transit study. However, it is expensive and not available in many hospitals. Technetium-99m has been proposed for colonic transit study but the short half-life has limited its use. Gallium-67 citrate is inexpensive and available in most countries. Most importantly, it has a suitable half-life for colonic transit study. Attempts have been made in some studies to use (67)Ga citrate to label activated charcoal, but the results have not been good because of poor stability. In this study, we successfully labelled activated charcoal()with (67)Ga citrate by adding alcohol and 5% glucose solution. To evaluate the in vitro stability, the (67)Ga-activated charcoal was incubated in a milieu mimicking the intestinal content, containing lipase, trypsin and glycochenodeoxycholate at different pH values (6.0, 7.0, 7.4 and 8.0) and for different durations (0 h, 24 h, 48 h, 72 h and 96 h). For the in vivo study, the (67)Ga-activated charcoal was loaded into a commercial empty enteric capsule. Colonic transit scintigraphy was performed in five volunteers, including three healthy people and two constipated patients, after intake of the radioactive capsule. Images were obtained at 2 h, 4 h, 6 h, 8 h, 24h, 48 h, 72 h etc. until no radioactivity was detected in the bowel. Our data show that the in vitro stability of (67)Ga-activated charcoal was good. The labelling efficiency still exceeded 91% at 96 h at pH values of 6.0, 7.0 and 7.4. In the group with a pH value of 8.0, the labelling efficiency gradually fell during the 4-day incubation but was still higher than 88% at the end of the fourth day. In the in vivo study, most capsules disintegrated in the caecum/colon region, and the (67)Ga-activated charcoal mixed very well with bowel content. In addition, the radioactive charcoal could be detected clearly on the 72-h image, which is very important for the evaluation of colonic transit time in patients with constipation. In conclusion, activated charcoal labelled with (67)Ga citrate is a potential radioactive marker for colonic transit study.

Capsules↗
PubMed2003

Gallium-67 scintigraphy: a cornerstone in functional imaging of lymphoma.

Until recently, gallium-67 scintigraphy (GS) has been the best available functional imaging modality for evaluating patients with non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD). The diagnostic accuracy of GS in detecting lymphoma is based on optimisation of the imaging protocol, knowledge of potential physiological and benign sites of (67)Ga uptake, and the Ga avidity characteristics of the individual lymphoma. As (67)Ga is a tumour viability agent, the role of GS is primarily at follow-up. A residual mass persisting on CT after treatment poses a common clinical dilemma: it may indicate the presence of viable lymphoma, which requires further treatment, or it can be benign, consisting of only fibrotic and necrotic tissues. GS can successfully differentiate between these conditions. Routine follow-up with GS may allow early diagnosis of recurrence and early institution of treatment. Reversion of a positive GS to a negative test, and the rapidity with which this occurs has a high predictive value for the outcome of the individual patient. Lymphoma showing a normal GS early during treatment has a better prognosis than lymphoma with persistence of pathological findings. Other tumour-seeking single-photon emitting agents, such as thallium-201, technetium-99m methoxyisobutylisonitrile and indium-111 octreotide, have been investigated in lymphoma, primarily as an alternative to GS in specific clinical settings, but are of limited value. The role of radioimmunoscintigraphy is gaining importance in conjunction with radioimmunotherapy. Fluorine-18 fluorodeoxyglucose (FDG) imaging of lymphoma using either dedicated or camera-based PET systems is gradually replacing GS for assessment of lymphoma. FDG overcomes some of the limitations of GS while sharing its tumour viability characteristics. The extensive clinical knowledge and experience accumulated over three decades with GS in lymphoma provides a solid background as well as a model for the assessment of new functional imaging techniques.

Female↗