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PubMed1986

[Diagnostic bronchoalveolar lavage in comparison with gallium-67 scintigraphy in the diagnosis and treatment of lung sarcoidosis].

The value of bronchoalveolar lavage (BAL) and Gallium-67-scintigraphy in the diagnosis of sarcoidosis is discussed. Both methods complete themselves and do not compete. Both are good indices for the activity of the disease and for corticoid treatment surveillance. There is not a direct correlation of SACE and Ga-67-scan in active disease. Ga-67-scan is the method preferred to establish the spread of granulomas. This radiological method allows the detection of invisible dissemination in the lungs and other organs. BAL allows a cell differentiation. With this method it is possible to survey the course of the disease and give further informations of the pathogenesis of sarcoidosis.

Follow-Up Studies↗
PubMed1987

Salvage chemotherapy of advanced lymphoma with investigational drugs: mitoguazone, gallium nitrate, and etoposide.

Patients with advanced lymphoma who relapse from intensive first-line combination chemotherapy generally have a very poor prognosis. The use of investigational drugs which lack cross-resistance to agents commonly used for initial therapy represents an important approach to the management of such patients. Based upon our prior experience, we developed a protocol which employed a combination of three new agents. Mitoguazone (600 mg/m2) was administered on Days 1 and 10; etoposide (100-125 mg/m2) was administered on Days 2, 3, and 4; and gallium nitrate (300 mg/m2/day) was administered as a continuous iv infusion over 24 hours on Days 1-7. Treatment cycles were repeated every 3-4 weeks pending tolerance to toxic reactions. Forty-two patients are evaluable for response (35 with non-Hodgkin's lymphoma and seven with Hodgkin's disease). All patients had received extensive prior treatment (median of two previous chemotherapy regimens). Less than one-half of patients had achieved complete remission (CR) with previous therapy. Twenty-two patients (52%) showed major antitumor responses (five CR, 17 partial). All patients who achieved CR had diffuse large cell lymphoma. Two patients in CR relapsed in the CNS. The median duration of response for patients who achieved partial response was 4 months (range, 1-11+). Major toxic reactions included myelosuppression, optic neuritis, mucositis, and corneal keratitis or conjunctivitis. This combination of experimental agents has major therapeutic activity in patients with advanced, resistant lymphoma. Optimal application of these drugs may be obtained by use as one arm of an intensive program of alternating non-cross-resistant regimens.

Adult↗
PubMed1985

Stability, targeting, and biodistribution of scandium-46- and gallium-67-labeled monoclonal antibody in erythroleukemic mice.

Using a monoclonal antibody specific for the Mr 70,000 glycoprotein of Rauscher erythroleukemia virus, we have determined the optimal conditions for conjugation with the cyclic anhydride of diethylene triamine pentaacetic acid and subsequent labeling with 46Sc. The conjugates were shown to retain their specificity and activity in vitro and to target specifically to virus-infected spleen cells in vivo. The stability of the 46Sc:diethylene triamine pentaacetic acid-antibody conjugates in vivo was studied using immunoaffinity chromatography; 25% of the isotope bound to transferrin, and 75% remained bound to the antibody conjugates. These results are discussed with respect to the potential for labeling antibodies with 47Sc for use in imaging and therapy. Studies with 111In-labeled antibody were used for comparison. Labeling with 67Ga was also performed; these labeled conjugates showed adventitious binding of isotope to the antibody and lack of stability of diethylene triamine pentaacetic acid-chelated gallium. Free EDTA was shown to stably incorporate 67Ga.

Animals↗
PubMed1985

Gallium-68 1,1,1-tris (5-methoxysalicylaldiminomethyl) ethane: a potential tracer for evaluation of regional myocardial blood flow.

Reaction of tris(acetylacetonato)gallium(III) with 1,1,1-tris(5-methoxysalicladiminomethyl)ethane, H3[(5-MeOsal)3 TAME], affords a neutral six-coordinate complex, Ga[5-MeOsal)3 TAME], for which the x-ray crystal structure is reported. The 67Ga and 68Ga complexes of H3[(5-MeOsal)3 TAME] and the bis(salicylaldimine) of triethylenetetramine were prepared and characterized by paper chromatography and electrophoresis. The biodistribution of lipophilic 68Ga[(5-MeOsal)3 TAME] was determined following intravenous injection in rats. Myocardial images obtained by positron emission tomography from three dogs injected with 68Ga[(5-MeOsal)3 TAME] show a correlation between 68Ga uptake and regional myocardial blood flow. Single-pass coronary extraction studies in open-chest dogs indicate that 68Ga[(5-MeOsal)3 TAME] behaves neither as a freely diffusible tracer nor as a microsphere analog.

Animals↗
PubMed1985

Comparison of indium-labeled-leukocyte imaging with sequential technetium-gallium scanning in the diagnosis of low-grade musculoskeletal sepsis. A prospective study.

We prospectively compared sequential technetium-gallium imaging with indium-labeled-leukocyte imaging in fifty patients with suspected low-grade musculoskeletal sepsis. Adequate images and follow-up examinations were obtained for forty-two patients. The presence or absence of low-grade sepsis was confirmed by histological and bacteriological examinations of tissue specimens taken at surgery in thirty of the forty-two patients. In these thirty patients, the sensitivity of sequential Tc-Ga imaging was 48 per cent, the specificity was 86 per cent, and the accuracy was 57 per cent, whereas the sensitivity of the indium-labeled-leukocyte technique was 83 per cent, the specificity was 86 per cent, and the accuracy was 83 per cent. When the additional twelve patients for whom surgery was deemed unnecessary were considered, the sensitivity of sequential Tc-Ga imaging was 50 per cent, the specificity was 78 per cent, and the accuracy was 62 per cent, as compared with a sensitivity of 83 per cent, a specificity of 94 per cent, and an accuracy of 88 per cent with the indium-labeled-leukocyte method. In patients with a prosthesis the indium-labeled-leukocyte image was 94 per cent accurate, compared with 75 per cent accuracy for sequential Tc-Ga imaging. Statistical analysis of these data demonstrated that the indium-labeled-leukocyte technique was superior to sequential Tc-Ga imaging in detecting areas of low-grade musculoskeletal sepsis.

Adolescent↗
PubMed1985

Gallium-68 lipophilic complexes for labeling platelets.

Generator produced 68Ga-labeled platelets could be useful for positron emission tomographic (PET) studies of thrombosis or atherosclerosis. To label platelets with 68Ga, we have studied the effects of trace metals in elutions of 68Ga from 68Ge. Studies were conducted on the formation of lipophilic 68Ga complexes 8-hydroxyquinoline, tropolone, and mercaptopyridine-N-oxide (MPO). Parameters such as pH, buffers, concentration of ligand, and stability with time were investigated. High performance liquid chromatography and instant thin layer chromatography were used to quantitate formation of the 68Ga complex. Platelets from human, dog, and rabbit plasma were incubated with the 68Ga complexes and the percent labeling determined. Accumulation of platelets in the catheter scraped aorta of the rabbit was determined by PET imaging, tissue counting, and autoradiography. Gallium-68 MPO gave 40-60% labeling of rabbit platelets with higher accumulation in the scraped aorta compared to the normal.

Animals↗
PubMed1974

Gallium-67 scans in the diagnosis of pyelonephritis.

Gallium-67 ((67)Ga) citrate was administered intravenously (50 microcuries per kg of body weight) to patients in whom acute and chronic urinary tract infections were suspected. Scanning was done, using both the Anger-type scintillation camera and the rectilinear scanner, 24 to 78 hours after injection of the isotope. The preliminary results imply that (67)Ga renal uptake is present in patients with pyelonephritis whether overt or silent, as well as in patients with uretero-sigmoidostomies. However, (67)Ga renal uptake is not present in patients with radiographic evidence of chronic pyelonephritis without active infection and in patients without renal disease.

Acute Disease↗
PubMed1975

Gallium-67-citrate scanning in primary cancer of the liver: diagnostic value in the presence of cirrhosis and relation to alpha-fetoprotein.

Gallium-67-citrate and 99mTc-sulfur colloid scans were performed in 38 South African blacks with primary hepatocellular cancer. Selective uptake of the radinuclide by the tumor occurred in 27 patients (70%). In 12 out of 18 patients with associated cirrhosis, 67Ga was concentrated in the defect or defects visible on the 99mTc-sulfur colloid scan, but in the remaining 6 cases (33%), the 2 scans were identical and the defects may have been attributed wrongly to cirrhosis. Alpha-fetoprotein (AFP) was detected by immunodiffusion in the serum of 26 patients. Twenty-one of these showed selective uptake of 67Ga by the tumor as compared with 6 out of 12 patients in whom this protein could not be detected. We were therefore unable to confirm a previous finding of a greater uptake of the of the radionuclide in AFP-negative primary liver cancer.

Fetal Proteins↗
PubMed1979

Gallium-67 citrate scanning--a new adjunct in the detection and follow-up of extrapulmonary tuberculosis: concise communication.

Gallium-67 citrate scans were obtained in 11 patients considered at risk for extrapulmonary tuberculosis. Radiographic and bacteriologic studies were performed routinely and tissue biopsy selectively. Of five patients with proven extrapulmonary tuberculosis, there were three with renal tuberculosis, one with Pott's disease, and one with peritoneal tuberculosis. The Ga-67 scan correctly predicted presence or absence of active extrapulmonary foci in all 11 patients. Follow-up scans correlated well with clinical response to therapy. The diagnosis of extrapulmonary tuberculosis is often overlooked because of nonspecific symptoms and frequent lack of concurrent lung involvement. Scanning with Ga-67 citrate offers a reliable and simple means of screening patients at risk and of monitoring response to treatment.

Gallium Radioisotopes↗
PubMed1983

[Diagnosis in sarcoidosis. Sensitivity and specificity of 67-gallium scintigraphy, serum angiotensin converting enzyme levels, thoracic radiography and blood lymphocyte subpopulations].

In a prospective study in 73 patients (48 female, 25 male) with histologically proven sarcoidosis we examined the sensitivity and specificity of Gallium 67 scanning, S-ACE, chest X-ray and blood T-lymphocyte assays for assessment of activity in sarcoidosis. We found a positive correlation between 67Ga score and S-ACE (r = 0.54, p less than 0.001). S-ACE levels and 67Ga score were significantly higher (p less than 0.001) in active sarcoidosis compared to inactive sarcoidosis. However, patients characterized by bihilar active sarcoidosis proved to have higher mean S-ACE levels (p less than 0.025) and a higher 67Ga score (n. s.) compared to patients with other presentations of active sarcoidosis. 67Ga scanning had the highest sensitivity of all parameters (92%) to detect active sarcoidosis, followed by chest X-ray (79%) and S-ACE (70%). Blood T-lymphocyte assays without comparison to lavaged lung T-lymphocytes failed to give reliable results. In patients with inactive sarcoidosis S-ACE showed a higher specificity (85%) compared to 67 Ga scanning (77%). Among follow up assessments in 26 patients with recurrent sarcoidosis 67Ga scanning proved to be the most reliable means for all stages of sarcoidosis whereas in patients with interstitial pulmonary lesions chest X-ray as well as S-ACE sometimes failed to assess activity. For the clinical management of patients with pulmonary sarcoidosis we suggest the combined use of chest X-ray and S-ACE. In case of discrepant results, as well as interstitial pulmonary involvement or for difficult therapeutic decisions the use of 67Ga scanning or bronchoalveolar lavage should be considered.

Adolescent↗
PubMed1978

The complementary role of gallium citrate imaging and computed tomography in the evaluation of suspected abdominal infection.

Fifteen patients with a suspected abdominal abscess were examined by both gallium-67 and computed tomographic scanning. The Ga-67 scan was a useful screening examination, correctly identifying all eight cases of infection, whereas the CT scan missed one case of a pericecal phlegmon. Misdiagnosis of infection by Ga-67 scan occurred in 2/8 cases without infection but the CT scan correctly identified all noninfected patients. While this series is too small to decide whether there is significant difference in the ability of the two procedures to suggest the correct diagnosis, it is felt that Ga-67 and subsequent CT scans may be complementary in that a Ga-67 scan can initially locate the abnormality and thus direct the CT scan, which can confirm the diagnosis or avoid a misinterpretation of the Ga-67 scan. Computed tomography also provides more anatomical detail, better location of the lesion, and demonsrates lesions noninfectious in nature.

Abdomen↗
PubMedDate not supplied

Phase I-II trial of gallium nitrate for advanced hypernephroma.

Gallium nitrate in doses of 100-200 mg/m2/day was continuously infused for 7 consecutive days to 12 patients with advanced hypernephroma. Since nephrotoxicity was moderate and no objective tumor response was observed in ten adequately treated cases, further trials with this agent for hypernephroma are unwarrented.

Adult↗
PubMed1984

The use of gallium-67 liver imaging for the early diagnosis of Budd-Chiari syndrome.

A gallium-67 study, performed in a rare case of Budd-Chiari syndrome (BCS) in a 6-yr-old child, showed marked concentration of the tracer in the left and caudate lobes of the liver. Ten days later, a less specific and clear-cut appearance of left- and caudate-lobe concentration of Tc-99m phytate was obtained. The possible use of Ga-67 citrate imaging to diagnose BCS in its earliest stage is suggested, although no firm conclusion can be made from this single case.

Budd-Chiari Syndrome↗
PubMed1984

Pulmonary gallium-67 uptake in amiodarone pneumonitis.

Three patients are presented suffering from interstitial pneumonitis caused by amiodarone. Pulmonary Ga-67 uptake occurred in all three. There appeared to be a discrepancy between the scintigraphic and radiographic findings in two patients. Gallium-67 lung scintigraphy may offer an early, sensitive indicator for amiodarone pneumonitis.

Aged↗
PubMed1984

Gallium-67 imaging in muscular sarcoidosis.

A case is presented of sarcoid myopathy in which radiogallium was seen to accumulate in the sites of muscle involvement. Uptake of the radiotracer disappeared following institution of corticosteroid therapy. The exceptional nature of this case contrasts with the high frequency of biopsy evidence of sarcoid muscle disease but is consistent with the rarity of clinical evidence of sarcoid granulomas in muscle. Gallium-67 imaging can be used to determine the extent of muscle involvement and, through evaluation of uptake intensity, the degree of disease activity before and after treatment.

Adult↗
PubMed1978

Gallium-67 scintigraphy in untreated and treated non-hodgkin lymphomas.

One hundred and seventy-four gallium scans of patients with biopsy-proved non-Hodgkin lymphoma were reviewed. When the lymphomas were subdivided into histologic groups, there was a significant difference in detection rates, with 62% of the histiocytic lymphomas being identified, while only 39% of the poorly differentiated lymphocytic lymphomas were detected. There was a high detection rate for lesions in the mediastinum and in extranodal locations. When analyzed with regard to therapy, the detection rate was higher in all histologic subgroups after therapy than before.

Adult↗