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PubMed1985

The effect of methylene diphosphonate on the tissue distribution of gallium-67.

Nonradiolabeled methylene diphosphonate (MDP) was administered intravenously to CFW Swiss outbred female mice 2 hr prior to i.v. injection of [67Ga]citrate. The dose of MDP ranged from that usually administered for bone scanning (17.9 micrograms/kg) to 1,000 times the usual bone scan dose (17.9 mg/kg). The animals were killed 24 hr after administration of [67Ga]citrate and organ distribution determined as compared to control animals who received no MDP. At MDP doses one to ten times usual bone scan dose, the only organ showing significantly different 67Ga uptake was the lung and this difference in pulmonary uptake was accounted for by incidental pulmonary infection. At MDP doses 100 to 1,000 times usual bone scan dose, significantly altered 67Ga uptake was noted in lung, spleen, kidney, and gastrointestinal tract. The only consistent pattern of association of MDP administered dose and alteration in 67Ga uptake, however, was noted in the spleen where uptake was augmented with increased dose, and the bone where increased MDP dose depressed 67Ga uptake. Even this effect, however, was modest. It is concluded that at usual MDP dose levels used in bone imaging, no significant alterations occur in 67Ga distribution in normal mouse tissue. It is inferred that 67Ga scans performed following bone scans can be interpreted as if both radiopharmaceuticals had been administered separately.

Animals↗
PubMed1993

Gallium-67 and technetium-99m-methylene diphosphonate skeletal scintigraphy in determining prognosis for children with stage IV neuroblastoma.

Thirty-five children (aged 0-9 yr) who had presented with Stage IV neuroblastoma were studied to see if avidity for 67Ga or 99mTc-methylene diphosphonate (MDP) uptake in both primary and secondary sites at diagnosis conferred any prognostic significance. Twenty-three percent of the patients were disease free and off treatment at the time of study. Crude survival did not differ between groups. Duration of survival and the likelihood of completing treatment were related to the scintigraphic appearance at the time of diagnosis, after adjustment for potential confounding effects, using Cox's proportional hazards regression and multiple logistic regression. After adjustment for confounding influences, neither 67Ga avidity nor uptake of 99mTc-MDP was associated with a significantly worse prognosis, both in terms of adjusted survival and likelihood of completing treatment. Patients with 67Ga-avid scans at diagnosis did not demonstrate significantly worse survival (HR 1.47, 95% CI 0.43-5.11) than those without 67Ga avidity. They were somewhat less likely to complete treatment (OR 0.23, 95% CI 0.03-1.63), but this did not reach statistical significance. Similarly, although patients with 99mTc-MDP positive scans demonstrated somewhat worse survival (HR 2.47, 95% CI 0.45-13.54), this result did not reach statistical significance, nor were they less likely to complete treatment (OR 0.69, 95% CI 0.07-6.67) than those with 99mTc-MDP negative scans. Uptake of 99mTc-MDP into extraosseous sites was also not associated with worse survival (HR 1.45, 95% CI 0.58-3.62) nor with decreased likelihood of completing treatment (OR 0.78, 95% CI 0.12-5.09). Other than indicating disease stage, these results do not support the hypothesis that the scintigraphic appearance at diagnosis confers prognostic information in children with advanced neuroblastoma.

Bone Neoplasms↗
PubMed1993

Demonstration of unilateral sialadenitis on postradiotherapy gallium-67-citrate imaging.

Intense, asymetric uptake of 67Ga-citrate in the right parotid and submandibular glands was observed in an asymptomatic patient who had undergone locoregional radiotherapy for Stage IA Hodgkin's disease 8 mo earlier. In view of the modified minimantle radiation field and adjunctive 99mTc salivary imaging, a unilateral radiation-induced sialadenitis best explained this unusual scintigraphic appearance.

Aged↗
PubMed1998

Pleomorphic adenoma of the salivary glands: correlation between gallium-67 uptake and histopathological components.

UNLABELLED: We correlated 67Ga uptake and histopathological findings in pleomorphic adenomas of the salivary glands. METHODS: Sixty-two pleomorphic adenomas of the salivary glands were visually graded by degree of 67Ga uptake as negative, weakly positive or strongly positive in comparison to uptake in the nasal cavity. These adenomas were re-examined pathologically and classified as epithelial, intermediate or mesenchymal type according to their dominant histological components. The pathological presence of marginal invasion or associated sialoadenitis was also re-examined. RESULTS: Eighteen adenomas were classified as strongly positive, eight as weakly positive and 36 as negative. Nine (50%) of the 18 strongly positive adenomas were of the epithelial type and the other nine (50%) strongly positive adenomas were of the intermediate type. While none of the strongly positive adenomas were of the mesenchymal type, 27 (75%) of the 36 negative adenomas were of the mesenchymal type. Six (75%) of the eight weakly positive adenomas were of the intermediate type. About half of the adenomas showed marginal invasion regardless of the grade of 67Ga uptake. None of the strongly positive adenomas were associated with sialoadenitis. CONCLUSION: The epithelial component of pleomorphic adenomas may be responsible for 67Ga uptake. The presence of marginal invasion or associated sialoadenitis has little relation to 67Ga uptake in pleomorphic adenomas.

Adenoma, Pleomorphic↗
PubMed1998

Gallium-67-citrate scanning of renal parenchymal malacoplakia.

UNLABELLED: The purpose of this article is to review the potential role of nuclear medicine scanning, especially with 67Ga, in the presumptive diagnosis and clinical management of patients with renal parenchymal malacoplakia (RPMP), a rare disease associated with coliform bacterial infection of the kidney and characterized by chronic unresolving inflammatory infiltrates containing von Hansemann macrophages in the renal parenchyma. METHODS: Published cases of RPMP were collected from the archival literature by searching the MEDLINE database and by reviewing bibliographic references contained in articles on malacoplakia. Data on the clinical features and radiographic evaluation of patients with RPMP were extracted from the clinical case reports. RESULTS: Forty-three cases of RPMP published over the past 20 yr were identified. Ten of the 43 patients (23%) had 67Ga scanning as a component of their diagnostic evaluation. In all 10 patients, renal uptake of 67Ga was classified as intense. Two of those 10 patients had serial 67Ga scanning performed to assess response to antibiotic treatment; both patients exhibited decreased uptake or complete resolution of abnormal renal uptake over time, a finding also exhibited by our patient. CONCLUSION: Intense renal uptake of 67Ga, typically in the clinical setting of fever, progressive renal failure and nephromegaly, strongly supports a diagnosis of RPMP. In those patients receiving prolonged antimicrobial therapy for RPMP, resolution of abnormal 67Ga uptake over time may provide an objective endpoint for treatment.

Anti-Infective Agents↗