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At least 19 recordsLinked to original sources

Synthesis, characterization, and in vitro evaluation of nitroimidazole--BATO complexes: new technetium compounds designed for imaging hypoxic tissue.

Several technetium-99 BATO (boronic acid adduct of technetium dioximes) complexes TcX(dioxime)3BR (X = Cl) that contain a boron cap R which bears a 2- or 4-nitroimidazole moiety have been prepared from either TcCl(dioxime)3 or from Tc(dioxime)3(mu-OH)SnCl3 [dioxime = dimethyl glyoxime (DMG) or cyclohexanedione dioxime (CDO)]. Two hydroxy analogs (X = OH) were isolated by treatment of the corresponding chloro complexes with aqueous NaOH. The complexes have been characterized by elemental analysis, mass spectrometry, NMR, UV/vis spectroscopy, and high-performance liquid chromatography. These complexes have the potential for selective retention in hypoxic tissue, by a mechanism believed to be the result of nitro reduction. The electrochemistry and enzymatic reduction of these complexes was studied to assess the potential for reduction in vivo. The nitroreductase enzyme xanthine oxidase was shown to reduce the nitroimidazole group on the complexes 99TcOH(DMG)3BBNO2 and 99TcOH(DMG)3BprenNO2 under anaerobic conditions in the presence of hypoxanthine. However, the results indicated that the rate of reduction might be slow in vivo, limiting the suitability of these compounds for imaging of regions of hypoxia.

Anaerobiosis↗

Single image pericardial effusion evaluation with technetium compounds.

Three cases of suspected pericardial effusion were evaluated with rapid, noninvasive procedure, combined use of macroaggregated albumin technetium 99m and human serum albumin technetium 99m to produce a single radiography showing the heart, liver, and lung perfusion simultaneously. This technic confirmed the diagnosis of pericardial effusion in two cases and ruled out this possibility in the third case.

Adult↗

On the nature of technetium compounds. 1. A semiquantitative biological model system to assay 99mTc-complexes/radiopharmaceuticals.

Eleven different 99mTc compounds having some relevance in clinical nuclear medicine have been classified according to their localizing properties. The following classes of 99mTc compounds have been compared in a semiquantitative manner, using a Wistar strain rat model: liver and hepatobiliary agents such as Tc-phytate, Tc-sulfur colloid, reduced (SnII) TcO-4, and 99mTc-LIDA (dimethyl-IDA); bone agents like Tc-pyrophosphate, Tc-HEDP, Tc-EDTMP; kidney and bladder agents comprising Tc-DTPA, Tc-glucoheptonate, Tc-citrate, and TcO-4. The in vivo pharmacokinetic behavior lends itself to unified approach with respect to nature of 99mTc compounds. Most of the 99mTc complexes display an excretory type of pathway. These compounds were found to be relatively stable in aqueous solutions at room temperature (25 degrees-28 degrees C) for at least 2 h without any additives. Both paper chromatographic and biologic (tissue distribution) criteria, commonly used for quality assurance and control of 99mTc compounds, were employed to study these compounds.

Animals↗

Clinical evaluation of lymphoscintigraphy with a new technetium compound for metastatic cervical lymphadenopathy.

OBJECTIVES: To evaluate the potential usefulness of lymphoscintigraphy for the detection of metastatic cervical lymphadenopathy. METHODS: Dynamic and static lymphoscintigraphy with 99Tcm-HSA-D was performed in 23 patients with malignant oropharyngeal tumors. The internal jugular nodes were excised and examined pathologically. The results of the lymphoscintigraphy were compared with the pathological examination and clinical palpation for accuracy. RESULTS: All cases showed abnormal findings on lymphoscintigraphy. The accuracy on dynamic scintigraphy was 69% for asymmetric drainage, 69% for delayed drainage and 100% for inverse drainage. The overall accuracy for each side was 71%. With static scintigraphy, the accuracy was 69% for asymmetry, 86% for fitting defect, 67% for mottled-patchy appearance, 70% in swelling and 100% for collateral pathway. The overall accuracy for each side was 74%. The agreement between lymphoscintigraphy and palpation was 44%. CONCLUSIONS: Lymphoscintigraphy with 99Tcm-HSA-D was superior to palpation. The method is useful as a supplementary modality for the evaluation of metastatic cervical lymphadenopathy because of its relatively high accuracy and a low false-negative rate.

Adult↗

Imaging of acute myocardial infarction using technetium 99m labelled phosphate compounds.

Technetium 99m pyrophosphate or polyphosphate administered intravenously soon after acute myocardial infarction produces positive images of the area and extent of myocardial necrosis. Forty-four patients have been studied of whom 39 had myocardial infarction. There was good correlation of the site and extent of infarction as indicated by the scintigram with electrocardiogram and cardiac enzyme criteria.

Acute Disease↗

Extraosseous tumor uptake of 99m technetium phosphate compounds in children with abdominal neuroblastoma.

Sixteen patients with abdominal neuroblastoma had 99m Technetium Phosphate Compounds (99m TC-PC) bone scans as a preoperative evaluation for metastatic disease. Ten patients (62%) had extraosseous tumor uptake while six patients (38%) did not. There was no difference in the incidence of tumor calcification, tumor necrosis or hydronephrosis in the two groups. However, VMA levels were significantly higher in the group with extraosseous tumor uptake. Various bone seeking radionuclides are compared to 99m TC-PC and possible mechanism for extraosseous uptake of such radionuclides are postulated. Awareness of the frequency of such uptake should reduce the possibility of errors in the interpretation of bone scans in patients with neuroblastoma.

Abdominal Neoplasms↗

Reproducibility of the brain perfusion index for measuring cerebral blood flow using technetium-99m compounds.

We previously developed an alternative method for estimating the brain perfusion index (BPI) using technetium-99m compounds and spectral analysis (SA) for quantification of cerebral blood flow (CBF). In this study, we investigated the reproducibility of the BPI values obtained by SA (BPIS) using a double injection of technetium-99m ethyl cysteinate dimer without any intervention, and compared it with that of the BPI values obtained by graphical analysis (BPIG). The BPIS values in the first (x) and second sessions (y) correlated closely (y=0.921x+0.036; r=0.962; n=64; s.e.e.=0.058 min-1). Although the BPIG values in the first (x) and second sessions (y) also correlated (y=0.942x+0.040; r=0.916; n=64; s.e.e.=0.061 min-1), the correlation coefficient for BPIS was significantly higher than that for BPIG. The reproducibility was dependent on the injection dose ratio of the second session to the first (R). The difference in BPI between the first and second sessions tended to be smaller when 1.5<R<2.5 than when 0<R<1.5 or 2.5<R. These results suggest that the reproducibility of BPIS is satisfactory and that it can be applied to two sequential measurements of CBF using a double injection of 99mTc compounds. When applying our method to such measurements, it is recommended that R is taken as approximately 2.0.

Aged↗

99m-Technetium phosphate compound joint scintigraphy in the management of juvenile osteochondritis dissecans of the femoral condyles.

The known sensitivity of joint scintigraphy in following the course of fracture healing caused the authors to believe that this radiologic technique might be valuable in the management of osteochondritis dissecans (OCD). Accordingly, 99mTc-diphosphonate joint scintigraphy was used on 18 patients with OCD of the knee. The average age was 13 1/2 years. The scintigrams were repeated at 6-week intervals until healing had occurred. When the diagnosis of OCD was established by standard roentgenograms and joint scintigraphy, the patients were placed on an activity restriction program, attempting to reach a symptom-free level. The patients were followed for an average of 18 months. Ninety-five scans were categorized according to their level of scintigraphic activity. This led to a discrete four-part scintigraphic classification that is indicative of the extent of healing or progression of this condition, and precedes changes seen on standard x-rays by months. Joint scintigraphy also rules out anomalies of ossification in the diagnosis of OCD since an anomaly should have a normal scintigraphic appearance. We have concluded that joint scintigraphy is valuable in the management of OCD because of its superior sensitivity to changes in the activity of the lesion. As experience is gained with this technique, those cases that should be prophylactically surgically stabilized may be indicated.

Adolescent↗

An alternative approach to estimation of the brain perfusion index for measurement of cerebral blood flow using technetium-99m compounds.

Cerebral blood flow (CBF) has been quantified non-invasively using the brain perfusion index (BPI) determined from radionuclide angiographic data generated by technetium-99m hexamethylpropylene amine oxime( )((99m)Tc-HMPAO) or technetium-99m ethyl cysteinate dimer( )((99m)Tc-ECD). The BPI is generally calculated using graphical analysis (GA). In the present study, BPI was measured using spectral analysis (SA), and its usefulness evaluated in comparison with GA. The BPI was calculated from the sum of spectral data obtained by SA. We applied this method to radionuclide angiographic data collected from the bilateral brain hemispheres of 20 patients with various brain diseases using (99m)Tc-HMPAO and from those of 20 patients using (99m)Tc-ECD. We also measured BPI using GA. The BPI values obtained by SA (BPI(S)) (x) and by GA (BPI(G)) (y) correlated closely (y=0.708x+0.038, r=0.945 for (99m)Tc-HMPAO and y=0.559x+0.093, r=0.931 for (99m)Tc-ECD). However, the BPI(G) values were underestimated by 22.9%+/-6.6% (mean+/-SD) for (99m)Tc-HMPAO and by 27.9%+/-7.5% for (99m)Tc-ECD as compared with the BPI(S) values. The extent of underestimation tended to increase with increasing BPI(S) values. These findings were considered to be a result of the BPI(G) values being affected by the first-pass extraction fraction of the tracer. We also compared the BPI(S) and BPI(G) values with those of CBF measured using N-isopropyl-p-[(123)I]iodoamphetamine (CBF(IMP)) in 16 patients (six for (99m)Tc-HMPAO and ten for (99m)Tc-ECD). Although both BPI(S) and BPI(G) values correlated significantly with the CBF(IMP) values, the correlation coefficient in BPI(S) was always better than that in BPI(G) (r=0.869 for (99m)Tc-HMPAO and r=0.929 for (99m)Tc-ECD in BPI(S), r=0.629 for (99m)Tc-HMPAO and r=0.856 for (99m)Tc-ECD in BPI(G)). These results suggest that SA can provide a more reliable BPI for quantifying CBF using (99m)Tc-HMPAO or (99m)Tc-ECD than the conventional method using GA. Our method will be useful especially when using a tracer with a low first-pass extraction fraction and/or when performing activation studies using pharmacological intervention.

Aged↗

Is image subtraction necessary in the clinical interpretation of single-day split-dose stress cerebral perfusion single-photon emission tomography using technetium-99m compounds?

The aim of this study was to validate a simplified semiquantitative method of evaluating a single-day stress cerebral perfusion test to obtain cerebrovascular reserve capacity (CVRC) for routine clinical uses. A split-dose protocol was tested in 36 pairs of technetium-99m hexamethylpropylene amino oxime baseline (low dose) and acetazolamide (high dose) stress brain single-photon emission tomographic (SPET) studies from 16 patients with cerebrovascular disease. The images were displayed on a semiquantitative color scale with (corrected) and without (uncorrected) image subtraction, dose adjustment, and decay correction. The representative CVRC was determined by placing 3x3 pixel regions of interest on midthalamic and midcerebellar slices. The corrected and uncorrected relative changes in CVRC were correlated using linear regression. The relative changes of corrected (x) and uncorrected (y) CVRC by quantitative analysis were highly correlated in a linear fashion (y=0.67x+0.002, r=0.998, P<0.0005). As predicted by theory, the slope was related to the ratio of split dose and independent of ROI sampling. Single-day split-dose stress brain SPET can be accurately performed without image subtraction and complicated dose adjustment or decay correction for clinical studies.

Acetazolamide↗

Standard provocative manoeuvres in patients with and without left bundle branch block studied with myocardial SPECT.

BACKGROUND: The objective of this study was to determine the prevalence of anterior and septal defects in patients with left bundle branch block (LBBB), and to assess the diagnostic accuracy of myocardial single photon emission computed tomography (SPECT) with technetium compounds in patients with and without LBBB using standard provocative manoeuvres. METHODS: Five hundred and nine consecutive patients (456 without LBBB and 53 with LBBB) without previous infarction who had a coronary angiography performed within <3 months of the scintigraphic study were retrospectively evaluated. The same stress procedures were followed in all patients. (1) Only exercise when it was sufficient; and (2) exercise + simultaneous administration of dypiridamole if exercise was insufficient. Only reversible defects were considered positive and > or =50% of coronary stenosis was considered significant. RESULTS: Prevalence of reversible anterior and septal defects was low (33% and 12%, respectively) in patients with LBBB. Although lower values of global sensitivity (81%) and specificity (73%) were obtained in these patients, there were no significant differences with respect to the patients without LBBB (89% and 86%, respectively). Specificity values for the diagnosis of stenosis of left anterior descending (78%), left circumflex (96%) and right coronary artery (74%) in patients with LBBB were lower, but without significant statistical differences with respect patients without LBBB (90%, 96% and 82%, respectively). CONCLUSIONS: Myocardial SPECT with technetium compounds, using standard provocation manoeuvres, can be used in patients with LBBB with only a mild decrease in diagnostic accuracy as compared to patients without LBBB.

Aged↗

Biological studies of a new class of technetium complexes: the hexakis(alkylisonitrile)technetium(I) cations.

This study describes the preparation and synthesis of a new class of cationic technetium compounds, the hexakis(alkylisonitrile)technetium(+ 1) complexes, at both carrier added and no carrier added concentrations in aqueous media from pertechnetate. Biological distribution and imaging data in animals indicate that certain members of this class may be effective for cardiac imaging in man. The usefulness of these lipophilic water-soluble species for labeling mammalian cells is also reported.

Animals↗

Acute intrahepatic biliary obstruction caused by hydatid cysts. Correlation between various imaging techniques.

An 18-year-old male was evaluated for recurrent attacks of right abdominal pain and intermittent jaundice caused by hydatid cysts of the liver. The case illustrates the value of dynamic functional information provided by Tc-99m-HIDA imaging over noninvasive modalities that demonstrate structural changes, such as ultrasound, computed tomography, and tin colloid liver imaging.

Adolescent↗