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PubMed1992

Biodistribution studies of liposome encapsulated hemoglobin (LEH) studied with a newly developed 99m-technetium liposome label.

A new method has been developed to label preformed liposomes with 99m-Technetium (99mTc) using hexamethylpropylenamine oxime (HMPAO). 99mTc is an ideal isotope for performing non-invasive dynamic biodistribution studies. This labeling method results in a high labeling efficiency (greater than 95%) and is stable as determined by both in vitro and in vivo studies. In vitro studies indicated that glutathione encapsulated in the LEH is important in the labeling process with 99mTc-HMPAO. In vivo studies with LEH were performed on 7 rabbits with dynamic scintigraphic 1 minute images performed from 1-120 minutes. Delayed images were performed at 20 hours followed by sacrifice and organ counting. Dynamic images reveal a gradual deposition of the LEH in the liver and spleen. Twenty hour biodistributions revealed 50% of the LEH remaining in the blood, 15% in the liver, 14% in the spleen, 3% in lungs, 3% in muscle with trace amounts in the brain, kidneys, and heart. Doses per gram were highest in the spleen with 12.5% of the injected dose per gram of spleen vs. 0.2% per gram of liver. This labeling technique is an effective method for non-invasively monitoring dynamic changes in liposome biodistribution and can be used to study the effects of various liposome modifications on biodistribution.

Animals↗
PubMed1994

Circulation profile of technetium-99m labeled liposome encapsulated hemoglobin in a 10% or 50% rat hypovolemic shock model.

The circulation kinetics and organ biodistribution of liposome encapsulated hemoglobin (LEH) was determined non-invasively in hypovolemic rats using a technetium-99m (Tc-99m) liposome labeling procedure. Rats with an indwelling catheter had either 10% or 50% of their blood volume removed and replaced with an equal volume of LEH labeled with Tc-99m (Tc-99m LEH). Mean arterial pressures and heart rates were monitored throughout the experiment. Gamma camera images were acquired during the first 90 minutes following infusion of the Tc-99m LEH and at 20 hours post-infusion. Blood capillaries were drawn at various times to monitor Tc-99m activity and the amount of LEH remaining in circulation. There were significant differences in the kinetics and biodistribution for the two groups. In the 10% group, the LEH was removed quickly from circulation with only 0.9% remaining at 20 hours, while the 50% group had 51.2% at 20 hours. The liver and spleen were the major organs responsible for LEH clearance. The 20 hour biodistribution by tissue sampling showed that the 10% group had 37.6% in the liver and 34.3% in the spleen, while the 50% group had only 18.4% in the liver and 14.6% in the spleen.

Animals↗
PubMed1992

Technetium-99m HM-PAO SPECT in patients with delayed neurologic sequelae after carbon monoxide poisoning.

We used single photon emission computed tomography (SPECT) with technetium-99m hexamethylpropylene amine oxime (99mTc-HM-PAO) in 14 studies on 6 patients with delayed neurologic sequelae from carbon monoxide (CO) poisoning to determine whether any changes in cerebral blood flow could be correlated with clinical or computed tomographic evidence of delayed deficits. Among the six initial CT brain scans, two showed low density of both basal ganglia and two showed decreased density of the cerebral white matter. There was no correlation between the clinical outcome and the findings of the follow-up CT brain scans. Of the two SPECTS with 99mTc-HM-PAO performed during acute anoxic insult, one showed focal hypoperfusion which appeared 20 days prior to the onset of delayed neurologic sequelae after CO poisoning. Seven SPECTs in the six patients performing the delayed phase showed diffuse patched patterns of hypoperfusion which improved on follow-up images. There was good correlation between the clinical outcome and the findings of the 99mTc-HM-PAO SPECT. In preliminary conclusion, 9Tc-HM-PAO brain SPECT can be used for predicting or evaluating the outcome of delayed neurologic sequelae after CO poisoning. Cerebral vascular changes may be the possible cause of hypoperfusion in patients with CO poisoning.

Adult↗
PubMed2004

Antisense imaging of colon cancer-bearing nude mice with liposome-entrapped 99m-technetium-labeled antisense oligonucleotides of c-myc mRNA.

AIM: To investigate the feasibility for antisense imaging of the colon cancer with liposome-entrapped 99 m-technetium labeled antisense oligonucleotides as tracers. METHODS: Fifteen mer single-stranded aminolinked phosphorothioate antisense oligonucleotides of c-myc mRNA were labeled with 99mTc-pertechnetate, then purified and finally entrapped with liposomes to form the labeling compounds, liposome-entrapped 99mTc-labeled antisense oligonucleotides. The LS-174-T cells (colon of adenocarcinoma cell line) were incubated with the labeling compounds to test the uptake rates of LS-174-T cells. Later on, a model of 30 tumor bearing nude mice was constructed by inoculating with 5 x 10(6) of LS-174-T cells at right flank of each nude mouse. About 10 d later, the model were administered by intravenous injection of the liposome-entrapped 99mTc-labeled antisense oligonucleotides. Then some of the tumour bearing nude mice were sacrificed at 0.5, 1, 2, and 4 h after intravenous injection, and proper quantity of liver, spleen, tumor, etc. was obtained. The tissues were counted in a gamma counter, and after correction for decay and background activity, expressed as a percentage of the injected dose. The others whose anterior and posterior whole-body scans were obtained at 1, 1.5, 2, 4, 6 and 24 h with a dual-head bodyscan camera equipped with parallel-hole low-energy collimaters. The ratios of radioactive counts in tumor to that in contralateral equivalent region of abdomen were calculated. RESULTS: The uptake rates of LS-174-T cells for liposome-entrapped 99mTc-labeled antisense oligonucleotides increased as time prolonged and reach the peak (17.77 +/- 2.41%) at 7 h. The biodistributions showed that the radioactivity in the tumor (13.46 +/- 0.20%) of injected dose was the highest at 2 h of intravenous injection of liposome-entrapped 99mTc-labeled antisense oligonucleotides, and then decreased sharply to 4.58 +/- 0.45% at 4 h. The tumor was shown clearly in the whole-body scan at 2 h of intravenous injection. The ratios, radioactive counts in tumor to that in contralateral equivalent region of abdomen (1.7332 +/- 0.2537), was the highest one at 2 h after intravenous injection of liposome-entrapped 99mTc-labeled antisense oligonucleotides. CONCLUSION: The liposome-entrapped 99mTc-labeled antisense oligonucleotides deserve being developed into radiopharmaceutics for the colon cancer imaging.

Animals↗
PubMed2000

Technetium tin colloid test detecting symptomless dysphagia and ACE inhibitor prevented occurrence of aspiration pneumonia.

Symptomless dysphagia and swallowing disorders play a very important role in the pathogenesis of aspiration pneumonia. A videofluoroscopic examination and a simple two-step swallowing provocation test (STS-SPT) could be useful for detection of swallowing disorders in elderly patients with stroke, however, there is no report on such a test for detection of symptomless dysphagia. We administered 1 ml Technetium Tin Colloid (99mTC) to the patient during sleep via a nasal catheter placed in the mouth. At 09:00 h the next day, symptomless dysphagia was checked for by imaging. Improvement of the symptomless dysphagia was observed, and thus we could prevent the occurrence of aspiration pneumonia. The 99mTC test was particularly useful in detecting symptomless dysphagia in elderly patients with stroke.

Aged↗
PubMed1978

Dual radionuclide study of acute myocardial infarction: comparison of thallium-201 and technetium-99m stannous prophosphate imaging in man.

We evaluated dual imaging with thalium-201 (201TI) and technetium-99m (99mTc) pyrophosphate in 80 patients with documented acute myocardial infarction (55 transmural, 25 nontransmural infarction). Color-coded isocount display of 201TI images was essential for interpretation in 16 patients. Combined 201 TI and 99mTc-pyrophosphate imaging for infarct detection was 100% sensitive; however, either was falsely negative in 12 of 80 patients. False-negative individual 201TI or 99mTc-pyrophosphate infarct images were most common in patients with small infacts or left ventricular hypertrophy. Thallium-201 images correctly localized the site of acute transmural infarction in all 51 patients with a positive image, while 99mTc-pyrophosphate localized the site of infarction in 49 of 53 with an abnormal image. Comparison of the size of the imaged infarct region revealed size discordance in 25 of 49 patinets, with 99mTc-pyrophosphate larger in 21 of 49 and 201TI larger in only four of 49. Thus dual radionuclide imaging provides definition of the presence and location of acute myocardial infarction.

Acute Disease↗
PubMed2002

Cerebral hemodynamic patterns with technetium Tc 99m exametazime single photon emission computed tomography and transcranial Doppler sonography: a validation study using visual stimulation.

OBJECTIVE: To assess whether a correlation between perfusion changes to visual stimulus on the bilateral occipital areas and blood flow velocity changes to visual stimulus in both posterior cerebral arteries is present. METHODS: Nine right-handed healthy subjects (4 women and 5 men; mean +/- SD age, 58.0 +/- 5.6 years) were included in the study. Visual stimulation was performed in room light with the subject's eyes open and looking around versus eyes closed as the stimulus-off condition. The blood flow velocities were recorded using transcranial Doppler sonography, and the regional cerebral blood flow measurements were recorded with the use of technetium Tc 99m exametazime and a single photon emission computed tomographic gamma camera system. Individual reactivity was defined as a relative increase of blood flow velocity and perfusion, which were calculated as percentage changes of baseline values. RESULTS: Visual stimuli produced a marked increase of blood flow velocity in both posterior cerebral arteries (35.2 +/- 2.3 cm/s; P < .001) without a significant side-to-side difference in all subjects as well as a marked increase of perfusion on both occipital areas (24.9 +/- 4.8 cm/s; P < .01). Moreover, there was a positive correlation between blood flow velocity changes and perfusion changes on both sides (r = 0.833; P < .01). CONCLUSIONS: The use of bilateral simultaneous Doppler recordings by means of a flow velocity averaging algorithm to a specific stimulus allows quantitative assessment of blood flow responses, and simple visual stimuli can be applied for different disorders to assess the vasomotor regulation that may result in measurable abnormal cerebral flow regulation even when clinically stabilized.

Blood Flow Velocity↗
PubMed1976

[Diagnosis of cerebrovascular disorders using stannous technetium pyrophosphate].

A total of 122 cases of various neurological diagnoses (among which 72 cerebral infarcts, 7 intracerebral hematomas and 38 intracranial tumors) had two separate brain scans, performed within 48 hours of each other after the administration of pertechnetate and technetium stannous pyrophosphate. The comparison of the resulting seans indicates that, in addition of an osseous accumulation, the pyrophosphate localizes greatly in ischemic cerebral lesions, especially those observed during the second week of evolution. It seems that the uptake of pyrophosphate reflects the area of anaerobic changes whereas the accumulation of pertechnetate depends on the disruption of the blood brain barrier. The scintigraphic diagnostic of cerebral infarctions is greatly improved.

Brain Neoplasms↗
PubMed1999

Rapid diagnostic imaging of acute, nonclassic appendicitis by leukoscintigraphy with sulesomab, a technetium 99m-labeled antigranulocyte antibody Fab' fragment. LeukoScan Appendicitis Clinical Trial Group.

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of a technetium 99m-labeled antigranulocyte antibody Fab' fragment (sulesomab) as a diagnostic imaging agent in patients with suspected acute, nonclassic appendicitis. METHODS: This prospective multicenter trial involved 141 children and adults with suspected acute, nonclassic appendicitis. The investigators interpreted planar images acquired 15 to 30 minutes and 1, 2, and 4 hours after injection and also by single-photon emission computed tomography (SPECT). The imaging results were confirmed surgically, whereas nonsurgical patients were considered as not having appendicitis (intent to treat). RESULTS: Sulesomab had a sensitivity of 91% (29/32 patients) and a negative predictive rate of 97% for acute appendicitis. It detected additional abnormalities in 7 of 9 patients with other inflammatory abdominal disease and had a specificity of 92% (91/99 patients) and a positive predictive value of 80% for surgically confirmed right-lower-quadrant disease. In positive studies, 26% were identified by planar imaging at 15 to 30 minutes, 46% by 1 hour, 63% by 2 hours, and 71% by 4 hours; 29% required SPECT to detect the abnormality. Scanning time was 5 to 10 minutes per planar image and about 45 minutes for a SPECT study. Investigators found that sulesomab would have changed clinical management or reduced additional diagnostic studies in 64% of the patients. Adverse events were infrequent, minor, and self-limiting (9/141 patients, 6%). No human antimurine antibody response occurred in 48 evaluable patients. CONCLUSIONS: Sulesomab is safe, well-tolerated, and with no apparent immunogenicity. Focal inflammation or infection in the setting of suspected atypical appendicitis is rapidly and accurately detected. Management decisions incorporating sulesomab imaging potentially provide clear patient benefits, especially by correctly predicting surgery to be unnecessary in 97% of patients without acute appendicitis.

Abdominal Pain↗
PubMed1999

Myocardial perfusion imaging with technetium-99m sestamibi in patients with cocaine-associated chest pain.

STUDY OBJECTIVE: To describe the characteristics and outcome in patients presenting to the emergency department with chest pain associated with cocaine use, the majority of whom underwent early rest perfusion imaging. METHODS: From January 1994 to June 1996, 218 patients had 241 ED visits for evaluation of symptoms consistent with myocardial ischemia after cocaine use. High-risk patients (N=25) were admitted directly to the CCU for exclusion of myocardial infarction (MI). Moderate- to low-risk patients (N=216) were promptly injected with technetium-99m sestamibi in the ED and underwent gated myocardial perfusion imaging 60 to 90 minutes later. Moderate-risk patients were observed in the CCU, whereas low-risk patients with negative perfusion imaging results were discharged home directly from the ED. RESULTS: A diagnosis of MI was made in 6 patients, 4 of whom had ECG findings consistent with MI. Of the 216 patients who underwent perfusion imaging, 5 had positive study results, including 2 with MI. None of the 38 patients with negative results after perfusion imaging who were admitted to the CCU had a diagnosis of MI. Only 6 of the 67 patients undergoing stress perfusion imaging had reversible perfusion defects. At 30-day follow-up, there were no cardiac events in patients with negative results after rest perfusion imaging. CONCLUSION: Acute MI is infrequent in patients presenting with cocaine-associated chest pain. Positive results after rest perfusion imaging are uncommon, suggesting that myocardial ischemia is infrequently the cause of cocaine-associated chest pain. Early perfusion imaging may offer an effective alternative to routine CCU admission of patients with cocaine-related cardiac symptoms.

Adult↗
PubMed1999

Monitoring the response of patients with locally advanced breast carcinoma to neoadjuvant chemotherapy using [technetium 99m]-sestamibi scintimammography.

BACKGROUND: Mammographic and physical examination assessments of the response of locally advanced breast carcinoma (LABC) to neoadjuvant therapy have been shown to be inaccurate. The authors studied the feasibility and accuracy of [technetium 99m]-sestamibi (MIBI) for monitoring the response of patients with LABC to neoadjuvant chemotherapy. METHODS: Patients receiving neoadjuvant chemotherapy for LABC underwent prone lateral scintimammography before therapy, after 2 months of therapy, and close to the completion of chemotherapy (presurgery) if chemotherapy continued for >3 months. Images were analyzed both qualitatively and quantitatively using the lesion-to-normal breast MIBI uptake ratio (L:N). Imaging results were compared with the clinical response and the pathologic response as determined from the posttherapy surgical specimen. RESULTS: A total of 32 patients (29 who were assessable for primary tumor response and 28 who were assessable for lymph node response) were included in the study. The mean change in the primary tumor L:N MIBI uptake ratio after 2 months of chemotherapy was -35% for clinical responders and +17% for nonresponders (P<0.001). Patients achieving a pathologic primary tumor macroscopic complete response (CR) had a mean change in uptake on the presurgical scan of -58% versus -18% for patients with a partial response (P<0.005). A decrease of > or =40% in the MIBI uptake ratio identified CRs with 100% sensitivity and 89% specificity. Pretherapy imaging predicted axillary lymph node metastases in 85% of patients ultimately found to have > or =1 positive lymph nodes at surgery, but was less accurate in identifying residual lymph node disease after therapy (55% sensitivity and 75% specificity). CONCLUSIONS: MIBI imaging accurately assessed the response to neoadjuvant chemotherapy in patients with LABC. Further studies are needed to determine the role of MIBI in this group of patients.

Adult↗
PubMed1999

Pulmonary distribution of aerosolized technetium Tc 99m pentetate after administration of a single dose of aerosolized albuterol sulfate in horses with recurrent airway obstruction.

OBJECTIVE: To determine whether pulmonary distribution of aerosolized technetium Tc 99m pentetate is improved after inhalation of a single dose of albuterol sulfate in horses susceptible to recurrent airway obstruction (heaves). ANIMALS: 6 horses with heaves and 4 horses with normal respiratory tract function. PROCEDURE: Images were obtained during ventilation of horses at baseline (maximal change in pleural pressure during tidal breathing [deltaPpImax] >15 cm H2O) and after aerosolized albuterol sulfate (360 microg) administration, with a 24-hour washout period between experiments. The deltaPpImax was determined prior to the baseline scan, prior to albuterol sulfate administration, and 5 minutes after albuterol sulfate administration. Images were assessed by visual inspection (semi-quantitative scoring system) and histogram analysis. RESULTS: Images obtained from horses with heaves had nonuniform pulmonary distribution of radionuclide characterized by poor penetration in peripheral lung fields and excess deposition in large airways. Histogram analysis of images of the caudal portions of the lungs revealed nonuniform radionuclide deposition in horses with heaves and uniform radionuclide deposition in control horses. CONCLUSION: Administration of a single dose of aerosolized albuterol sulfate improved pulmonary distribution of aerosolized radiolabeled pentetate suspension in horses with heaves but did not alter pulmonary distribution in clinically normal horses. CLINICAL RELEVANCE: Precedent bronchodilator administration may improve pulmonary distribution of aerosolized, surface-active anti-inflammatory preparations.

Administration, Inhalation↗
PubMed1999

Diagnosis of blunt rupture of the right hemidiaphragm by technetium scan.

Traumatic rupture of the diaphragm, particularly of the right hemidiaphragm, may be occult and can be difficult to diagnose if laparotomy is not required for concomitant injury. Missed or delayed diagnosis of such injuries can produce life-threatening complications, such as intestinal herniation, ischemia, and necrosis. We present a case of traumatic rupture of the right hemidiaphragm that demonstrates the typically occult nature of this injury. The majority of right-sided injuries are diagnosed during laparotomy performed for other injuries. In those patients not requiring laparotomy, the diagnosis is usually delayed because this injury seldom produces clinical or radiographic findings that are either sensitive or specific. In this case, intraperitoneal injection of technetium sulfur colloid was used to establish the diagnosis of right diaphragm rupture, and an uncomplicated repair was undertaken.

Accidents, Traffic↗
PubMed1999

[Assessment of left ventricular contraction abnormalities with myocardial infarction using gated technetium-99m sestamibi SPECT: comparison of wall thickening and regional ejection fraction analysis for the detection of coronary artery stenosis].

ECG-gated myocardial Technetium-99m sestamibi SPECT is a useful technique to measure myocardial perfusion and function simultaneously. In this study, wall thickening (WT) and regional ejection fraction (rEF) using ECG-gated SPECT have been studied to determine which parameter would be more sensitive to detect coronary artery stenosis in patients with acute myocardial infarction (AMI). Forty-five patients (36 men, 9 women, mean age 63 +/- 9 years old) with AMI were examined. CAG was performed for all patients. ECG-gated SPECT was performed 60 min after the intravenous injection of 555 MBq 99mTc-sestamibi at rest. Commercially available software (QGS) was used to produce WT and rEF polar maps from acquired SPECT data. The WT and rEF polar maps were evaluated visually and quantitatively. WT indicated higher sensitivity (80.3% vs. 59.1%, p < 0.05) and accuracy (86.7% vs. 74.8%, p < 0.05) than rEF for detecting overall coronary artery stenosis on visual interpretation. On quantitative analysis, WT had higher specificity (91.3% vs. 75.4%, p < 0.05) and accuracy (85.9% vs. 72.6%, p < 0.05) than rEF for detecting overall coronary artery stenosis, and showed a higher specificity (93.8% vs. 59.4%, p < 0.01) and accuracy (88.9% vs. 62.2%, p < 0.01) for detecting LCX stenosis. Moreover, sensitivity of WT for detecting coronary artery stenosis without infarction was higher than that of rEF significantly in quantitative analysis (75.0% vs. 31.3%, p < 0.05). These results suggested that WT was superior to rEF for detecting the coronary artery stenosis in patients with and without myocardial infarction. We concluded that WT is more sensitive indicator to determine localization of regional left ventricular dysfunction in AMI than rEF.

Aged↗
PubMed1975

Fever of unknown origin and the value of gallium-67 and technetium-99M for defining abnormality of the spleen: a case report.

A three-year-old white female with acute promyelocytic leukemia developed persistent fever after successful induction-remission therapy; many large monilial abscesses were later found in the grossly enlarged spleen. Although the technetium-99M sulfur colloid scan prior to splenectomy suggested only a slight abnormality of the spleen, the gallium-67 citrate scintigraph showed a marked increase in gallium accumulation. The disparate results of the scanning techniques utilized in this patient suggest that it may be necessary to use more than one type of radiopharmaceutical to define an enlarged spleen, as well as the pathological process responsible for its enlargement.

Abscess↗
PubMed1999

Validation of a column method for technetium-99m exametazime quality control.

OBJECTIVE: The purpose of this study was to investigate if an octadecyl (18C) minicolumn could be applied successfully for quality control of 99mTc exametazime (HMPAO). METHODS: The 18C column system using saline eluent was validated against the Whatman 17 method in calculating the percent radiochemical purity of 99mTc-HMPAO. The behavior of 99mTc-pertechnetate (99mTc04-) and hydrolyzed-reduced 99mTc (99mTc02) on the column was examined, as well as method reproducibility. RESULTS: The column method is reproducible and yields results that are highly comparable to the Whatman 17 method. Technetium-99m-pertechnetate is associated with the eluent, and some 99mTc02 is retained by the column but this level is insignificant to the final patient dose. CONCLUSION: The minicolumn system is safe, simple, rapid and reliable for the quality control analysis of routine 99mTCHMPAO preparations.

Quality Control↗
PubMed1976

Peripheral joint scanning with technetium pertechnetate. Application in clinical practice.

Results of a prospective study to evaluate the clinical usefulness of radioisotope joint scanning in the practice of rheumatology are reported. The radiopharmaceutical used was technetium pertechnetate, increased synovial blood flow being the main contributory factor to abnormal joint images. Strict adherence to a procedural protocol was necessary to assure reproducible images. Joint scintigraphy was performed on 56 control subjects without joint disease and 51 patients with different rheumatic disorders. There was excellent agreement between clinical examination and joint scintigraphy in all groups studied. In cases of disagreement, the joint scintigram generally was more sensitive. This high sensitivity for the detection of synovitis was accompanied by a lack of specificity, because it failed to diagnose the nature of the joint involvement. The joint scan was helpful for diagnosing early or steroid-suppressed synovitis and also for suspected nonarticular rheumatism. It aided in delineating the pattern of joint involvement. Joint scintigraphy is the only objective nontraumatic permanent record documenting joint inflammation.

Adult↗
PubMed2000

Quickly predicting chemotherapy response to paclitaxel-based therapy in non-small cell lung cancer by early technetium-99m methoxyisobutylisonitrile chest single-photon-emission computed tomography.

The purpose of this study was to retrospectively predict the chemotherapy response to paclitaxel in non-small cell lung cancer (NSCLC) using technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) chest single-photon-emission computed tomography (SPECT) to detect the expression of multidrug-resistance-mediated Mr 170,000 P-glycoprotein. Before chemotherapy with Paclitaxel (Taxol), 30 patients with stage IIIb or IV NSCLC were enrolled in this study. Early chest SPECT 10 min after i.v. injection of Tc-99m MIBI was performed to qualitatively interpret Tc-99m MIBI chest SPECT visually and quantitatively calculate early tumor:normal lung ratios (T:NL) for quick assessment of multidrug-resistant P-glycoprotein expression in NSCLC. On the basis of qualitatively visual interpretation of early Tc-99m MIBI chest SPECT, all of 15 (100%) cases with good response to chemotherapy with Taxol could be detected but 10 (67%) of 15 cases with poor response could not be detected. Early Tc-99m MIBI chest SPECT could correctly predict chemotherapy response in 25 (83%) of 30 of cases. The early T:NL were 3.30 +/- 0.82 for 15 patients with good response and 2.02 +/- 0.19 for 5 patients with poor response. The differences were significant (P < 0.05) by independent Student t tests. However, no significant differences were found for other prognostic factors (age, sex, tumor size, tumor location, stage, and cell type) between good-response and poor-response patients. Early Tc-99m MIBI chest SPECT has the potential to predict chemotherapy response to Paclitaxel.

ATP Binding Cassette Transporter, Subfamily B, Mem↗