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1.
Neurotoxicology ; 76: 162-173, 2020 01.
Article in English | MEDLINE | ID: mdl-31738976

ABSTRACT

Epidemiological data have linked cadmium exposure to neurotoxicity and to neurodegenerative diseases (e.g., Alzheimer's and Parkinson's disease), and to increased risk of developing ALS. Even though the brain is not a primary target organ, this metal can bypass the blood brain barrier, thus exerting its toxic effects. The coordination chemistry of cadmium is of strong biological relevance, as it resembles to zinc(II) and calcium(II), two ions crucial for neuronal signaling. A toxicogenomics approach applied to a neuronal human model (SH-SY5Y cells) exposed to cadmium (10 and 20 µM) allowed the identification of early deregulated genes and altered processes, and the discrimination between neuronal-specific and unspecific responses as possible triggers of neurodegeneration. Cadmium confirmed its recognized carcinogenicity even on neuronal cells by activating the p53 signaling pathway and genes involved in tumor initiation and cancer cell proliferation, and by down-regulating genes coding for tumor suppressors and for DNA repair enzymes. Two cadmium-induced stress responses were observed: the activation of different members of the heat shock family, as a mechanism to restore protein folding in response to proteotoxicity, and the activation of metallothioneins (MTs), involved in zinc and copper homeostasis, protection against metal toxicity and oxidative damage. Perturbed function of essential metals is suggested by the mineral absorption pathway, with MTs, HMOX1, ZnT-1, and Ferritin genes highly up-regulated. Cadmium interferes also with Ca2+ regulation as S100A2 is one of the top up-regulated genes, coding for a highly specialized family of regulatory Ca2+-binding proteins. Other neuronal-related functions altered in SH-SY5Y cells by cadmium are microtubules dynamics, microtubules motor-based proteins and neuroprotection by down-regulation of NEK3, KIF15, and GREM2 genes, respectively.


Subject(s)
Cadmium/toxicity , Gene Expression/drug effects , Neurons/drug effects , Neurons/metabolism , Cell Line, Tumor , Humans , Metallothionein/metabolism , Signal Transduction/drug effects , Toxicogenetics
2.
J Exp Clin Cancer Res ; 38(1): 326, 2019 Jul 23.
Article in English | MEDLINE | ID: mdl-31337429

ABSTRACT

BACKGROUND: Prostate cancer (PCa) is the second leading cause of cancer-related death in the Western population. The use in oncology of positron emission tomography/computed tomography (PET/CT) with emerging radiopharmaceuticals promises accurate staging of primary disease, restaging of recurrent disease and detection of metastatic lesions. Prostate-specific membrane antigen (PSMA) expression, directly related to androgen-independence, metastasis and progression, renders this tumour associate antigen a good target for the development of new radiopharmaceuticals for PET. Aim of this study was to demonstrate in a preclinical in vivo model (PSMA-positive versus PSMA-negative tumours) the targeting specificity and sensitivity of the anti-PSMA single-chain variable fragment (scFv) labelled with 124I. METHODS: The 124I-labeling conditions of the antibody fragment scFvD2B were optimized and assessed for purity and immunoreactivity. The specificity of 124I-scFvD2B was tested in mice bearing PSMA-positive and PSMA-negative tumours to assess both ex-vivo biodistribution and immune-PET. RESULTS: The uptake fraction of 124I-scFvD2B was very high on PSMA positive cells (range 75-91%) and highly specific and immuno-PET at the optimal time point, defined between 15 h and 24 h, provides a specific localization of lesions bearing the target antigen of interest (PSMA positive vs PSMA negative tumors %ID/g: p = 0.0198 and p = 0.0176 respectively) yielding a median target/background ratio around 30-40. CONCLUSIONS: Preclinical in vivo results of our immuno-PET reagent are highly promising. The target to background ratio is improved notably using PET compared to SPECT previously performed. These data suggest that, upon clinical confirmation of sensitivity and specificity, our anti-PSMA 124I-scFvD2B may be superior to other diagnostic modalities for PCa. The possibility to combine in patients our 124I-scFvD2B in multi-modal systems, such as PET/CT, PET/MR and PET/SPECT/CT, will provide quantitative 3D tomographic images improving the knowledge of cancer biology and treatment.


Subject(s)
Antigens, Surface/immunology , Glutamate Carboxypeptidase II/immunology , Prostatic Neoplasms/diagnosis , Radiopharmaceuticals/pharmacology , Single-Chain Antibodies/immunology , Animals , Antigens, Surface/pharmacology , Cell Line, Tumor , Glutamate Carboxypeptidase II/pharmacology , Humans , Immunoconjugates/immunology , Immunoconjugates/pharmacology , Iodine Radioisotopes/pharmacology , Male , Mice , Neoplasm Metastasis , Positron Emission Tomography Computed Tomography , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/immunology , Prostatic Neoplasms/pathology , Radiopharmaceuticals/immunology , Single-Chain Antibodies/pharmacology , Tissue Distribution
3.
Nucl Med Biol ; 72-73: 11-19, 2019.
Article in English | MEDLINE | ID: mdl-31255875

ABSTRACT

INTRODUCTION: O-(2-[18F]Fluoroethyl)-L-tyrosine ([18F]FET) is an established radiotracer used for oncology investigations by Positron Emission Tomography (PET). Main limitations to its widespread use are the synthesis itself (time; cost; radiochemical yield; complexity) and a troublesome and time-consuming HPLC purification. Aim of this work was to improve the preparation overall efficiency and, most important, to achieve an efficient and reliable purification by means of disposable cartridges. METHODS: [18F]FET was synthesized by direct nucleophilic radiofluorination of O-(2-tosyloxy-ethyl)-N-trityl-L-tyrosine t-butylester (TET) followed by acid hydrolysis with HCl. Several conditions and materials were tested for the synthesis and purification step. For the latter, a number of different commercial cartridges, varying in amount, particulate size and adsorbent, were examined. Best results were obtained by a combination of STRATA-X, tC18 and QMA cartridges. RESULTS: Starting from only 5 mg of TET, up to 11 GBq of injectable solutions of [18F]FET were produced within 36 min with 54-65% radiochemical yields and radiochemical purities >99%. No D-form was observed by chiral HPLC. Chemical purity was 1-2 order of magnitude below the limits imposed by the European Pharmacopoeia's monograph on [18F]FET. A radiochemical purity decrease by radiolysis, observed only on relatively large batches of [18F]FET, was efficiently suppressed by preloading in the receiving final vial a small amount of ethanol (<2% v/v). CONCLUSIONS: By combining improvements to a known synthetic route with a novel cartridge-based purification, [18F]FET was obtained in a very efficient and reproducible way. The whole process was easily implemented on a commercial automated module presently used for [18F]FDG production. ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE: A few drawbacks regarding the HPLC conditions recommended in the European Pharmacopoeia were highlighted. An alternative method able to cope with them is herein proposed The simplified preparation herein described is expected to encourage a more widespread clinical use of [18F]FET.


Subject(s)
Radiopharmaceuticals/chemical synthesis , Solid Phase Extraction/methods , Tyrosine/analogs & derivatives , Chromatography, High Pressure Liquid , Humans , Radiochemistry , Radiopharmaceuticals/isolation & purification , Tyrosine/chemical synthesis , Tyrosine/isolation & purification
4.
Int J Pharm ; 511(2): 969-82, 2016 Sep 25.
Article in English | MEDLINE | ID: mdl-27498282

ABSTRACT

The majority of active agents do not readily permeate into brain due to the presence of the blood-brain barrier and blood-cerebrospinal fluid barrier. Currently, the most innovative and promising non-invasive strategy in brain delivery is the design and preparation of nanocarriers, which can move through the brain endothelium. Niosomes can perform brain delivery, in fact polysorbates, can act as an anchor for apolipoprotein E from blood plasma. The particles mimic LDL and interact with the LDL receptor leading to the endothelial cells uptake. The efficacy of niosomes for anticancer therapeutic applications was correlated to their physicochemical and drug delivery properties. Dimensions and ζ-potential were characterized using dynamic light scattering and asymmetric flow-field fractionation system. Lipid bilayer was characterized measuring the fluidity, polarity and microviscosity by fluorescent probe spectra evaluation. Morphology and homogeneity were characterized using atomic force microscopy. Physicochemical stability and serum stability (45% v/v fetal bovine and human serum) were evaluated as a function of time using dynamic light scattering. U87-MG human glioblastoma cells were used to evaluate vesicle cytotoxicity and internalisation efficiency. From the obtained data, the systems appear useful to perform a prolonged (modified) release of biological active substances to the central nervous system.


Subject(s)
Blood-Brain Barrier/drug effects , Brain/drug effects , Drug Delivery Systems/methods , Liposomes/administration & dosage , Liposomes/toxicity , Animals , Blood-Brain Barrier/metabolism , Brain/metabolism , Cattle , Cell Line, Tumor , Humans , Liposomes/chemistry , Serum Albumin/administration & dosage , Serum Albumin/chemistry , Serum Albumin/toxicity
5.
Eur J Nucl Med Mol Imaging ; 41(2): 223-30, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24233003

ABSTRACT

PURPOSE: Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues has been demonstrated to be an effective therapeutic option in patients with disseminated neuroendocrine tumours (NET). Treatment with tandem [(90)Y]DOTA-TATE and [(177)Lu]DOTA-TATE may improve the efficacy of PRRT without increasing the toxicity. In a phase II study we evaluated the feasibility of combined PPRT with a high-energy beta emitter ((90)Y) and a medium-energy beta/gamma emitter ([(177)Lu) in patients with metastatic NET refractory to conventional therapy. METHODS: A group of 26 patients with metastatic NET were treated with four therapeutic cycles of alternating [[(177)Lu]DOTA-TATE (5.55 GBq) and [(90)Y]DOTA-TATE (2.6 GBq). A dosimetric evaluation was carried out after administration of [[(177)Lu]DOTA-TATE to calculate the absorbed doses in healthy organs. The acute and long-term toxicities of repeated treatment were analysed. PRRT efficacy was evaluated according to RECIST. RESULTS: Administration of tandem [(90)Y]DOTA-TATE and [[(177)Lu]DOTA-TATE induced objective responses in 42.3 % of patients with metastatic NET with a median progression-free survival longer than 24 months. Of patients with pretreatment carcinoid syndrome, 90 % showed a symptomatic response or a reduction in tumour-associated pain. The cumulative biologically effective doses (BED) were below the toxicity limit in the majority of patients, in the absence of renal function impairment. CONCLUSION: The results of our study indicates that combined [(90)Y]DOTA-TATE and [(177)Lu]DOTA-TATE therapy is a feasible and effective therapeutic option in NET refractory to conventional therapy. Furthermore, the absence of kidney damage and the evaluated cumulative BEDs suggest that increasing the number of tandem administrations is an interesting approach.


Subject(s)
Neuroendocrine Tumors/radiotherapy , Octreotide/analogs & derivatives , Organometallic Compounds/therapeutic use , Radiopharmaceuticals/therapeutic use , Adult , Aged , Drug Resistance, Neoplasm , Female , Humans , Male , Middle Aged , Neuroendocrine Tumors/drug therapy , Octreotide/adverse effects , Octreotide/therapeutic use , Organometallic Compounds/adverse effects , Radiometry , Radiopharmaceuticals/adverse effects , Treatment Outcome
6.
Q J Nucl Med Mol Imaging ; 54(1): 84-91, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20168290

ABSTRACT

AIM: Neuroendocrine tumors over-express somatostatin receptors and literature data have demonstrated the efficacy of the peptide receptor radionuclide therapy with somatostatin analogues labelled with high activities of b-emitting radioisotopes, such as (90)Y and (177)Lu. Yttrium-90 is a pure high energy b-emitter while (177)Lu is a b/g emitter of medium energy. We decided to evaluate an original tandem treatment based on administration of radiolabeled [DOTA(0),Tyr(3)]octreotate (DOTA-TATE) alternating (177)Lu and 90Y. Aim of this study was to evaluate the feasibility, the efficacy and the toxicity of this treatment in neuroendocrine tumors expressing somatostatin receptors relapsed or refractory to conventional therapies. METHODS: Patients were treated with four therapeutic cycles alternating [(177)Lu]DOTA-TATE (5.55 GBq) and [(90)Y]DOTA-TATE (2.6 GBq). Dosimetric evaluation after administration of [(177)Lu]DOTA-TATE allows to calculate the absorbed doses in healthy organs. Blood samples were collected at 5 min, 1, 6, 24, 48, 72, 96 h and scintigraphy was performed once a day for four days after administration. Toxicity was evaluated considering hematological parameters and renal toxicity was evaluated also by the glomerular filtration rate (GFR). Efficacy related with RECIST criteria. RESULTS: Up to now 26 patients entered the study and 16 patients completed all cycles. Treatment was well tolerated with no adverse event registered. No damage to healthy organs was revealed in accordance with the calculated absorbed doses. We had a partial response in 10/15 patients evaluated three months after the fourth treatment. CONCLUSIONS: Up to now only a few patients participated in and concluded this study; preliminary results are encouraging and indicate the feasibility of the study.


Subject(s)
Neuroendocrine Tumors/pathology , Neuroendocrine Tumors/radiotherapy , Octreotide/analogs & derivatives , Organometallic Compounds/administration & dosage , Organometallic Compounds/therapeutic use , Adult , Aged , Drug Therapy, Combination , Humans , Male , Middle Aged , Neuroendocrine Tumors/therapy , Octreotide/administration & dosage , Octreotide/adverse effects , Octreotide/therapeutic use , Organometallic Compounds/adverse effects , Radiometry , Treatment Outcome
7.
Clin Pharmacol Ther ; 84(6): 691-7, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18509329

ABSTRACT

Therapy-related acute myeloid leukemia (t-AML) caused by MLL rearrangements (rMLL) can arise from topoisomerase II agents. However, whether rMLL-related leukemogenesis is inextricably linked to drug cytotoxicity remains controversial. We therefore compared (i) rMLL in children with acute lymphoblastic leukemia (ALL) who developed t-AML and those who did not, (ii) epipodophyllotoxin toxicity in patients with t-AML and in controls, and (iii) rMLL in cells sensitive to etoposide and in those resistant to etoposide. In children with ALL, rMLL appeared to be more frequent in children who developed t-AML than in those who did not (seven pairs, P = 0.04), although independent of the cumulative etoposide dose (P = 0.5). Similarly, the frequency of epipodophyllotoxin-related toxicities did not differ between patients with t-AML and controls (26 pairs, P > 0.17). Moreover, in 25 cell lines, etoposide-induced MLL fusions did not differ in sensitive vs. resistant lines at equitoxic concentrations (P = 0.65). Together, these results indicate that epipodophyllotoxin-mediated leukemogenesis is not directly linked to drug cytotoxicity.


Subject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Etoposide/adverse effects , Leukemia, Myeloid, Acute/chemically induced , Myeloid-Lymphoid Leukemia Protein/drug effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Antineoplastic Agents, Phytogenic/administration & dosage , Case-Control Studies , Child , Child, Preschool , Drug Hypersensitivity , Etoposide/therapeutic use , Female , Humans , Leukemia, Myeloid, Acute/physiopathology , Male , Myeloid-Lymphoid Leukemia Protein/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Predictive Value of Tests , Reference Values , Risk Assessment
8.
Leukemia ; 21(10): 2128-36, 2007 Oct.
Article in English | MEDLINE | ID: mdl-17673902

ABSTRACT

The genetic risk factors for etoposide-induced leukemia with MLL translocations remain largely unknown. To identify genetic risk factors for and novel characteristics of secondary leukemia, we profiled 116,204 single nucleotide polymorphisms (SNPs) in germline and paired leukemic cell DNA from 13 secondary leukemia/myelodysplasia cases and germline DNA from 13 matched and 156 unmatched controls, all with acute lymphoblastic leukemia treated with etoposide. We analyzed global gene expression from a partially overlapping cohort. No single locus was altered in most cases. We discovered 81 regions of loss of heterozygosity (LOH) in leukemic blasts and 309 SNPs whose allele frequencies differed in cases vs controls. Candidate genes were prioritized on the basis of genes whose SNPs or expression differentiated cases from controls or showed LOH or copy number change in germline vs paired blast DNA from the 13 cases. Three biological pathways were altered: adhesion, Wnt signaling and regulation of actin. Validation experiments using a genome scan for etoposide-induced leukemogenic MLL chimeric fusions in 15 HapMap cell lines also implicated genes involved in adhesion, a process linked to de novo leukemogenesis. Independent clinical epidemiologic and in vitro genome-wide approaches converged to identify novel pathways that may contribute to therapy-induced leukemia.


Subject(s)
Genome, Human , Leukemia/chemically induced , Leukemia/genetics , Leukemia/pathology , Adolescent , Case-Control Studies , Cell Adhesion , Child , Child, Preschool , Cohort Studies , Etoposide/adverse effects , Etoposide/pharmacology , Female , Gene Frequency , Humans , Infant , Loss of Heterozygosity , Male , Polymorphism, Single Nucleotide , Translocation, Genetic
9.
Leukemia ; 20(2): 239-46, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16341039

ABSTRACT

Using a target gene approach, only a few host genetic risk factors for treatment-related myeloid leukemia (t-ML) have been defined. Gene expression microarrays allow for a more genome-wide approach to assess possible genetic risk factors for t-ML. We assessed gene expression profiles (n=12 625 probe sets) in diagnostic acute lymphoblastic leukemic cells from 228 children treated on protocols that included leukemogenic agents such as etoposide, 13 of whom developed t-ML. Expression of 68 probes, corresponding to 63 genes, was significantly related to risk of t-ML. Hierarchical clustering of these probe sets clustered patients into three groups with 94, 122 and 12 patients, respectively; 12 of the 13 patients who went on to develop t-ML were overrepresented in the latter group (P<0.0001). A permutation test indicated a low likelihood that these probe sets and clusters were obtained by chance (P<0.001). Distinguishing genes included transcription-related oncogenes (v-Myb, Pax-5), cyclins (CCNG1, CCNG2 and CCND1) and histone HIST1H4C. Common transcription factor recognition elements among similarly up- or downregulated genes included several involved in hematopoietic differentiation or leukemogenesis (Maz, PU.1, ARNT). This approach has identified several genes whose expression distinguishes patients at risk of t-ML, and suggests targets for assessing germline predisposition to leukemogenesis.


Subject(s)
Gene Expression Profiling , Leukemia, Myeloid/genetics , Neoplasms, Second Primary/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Child , Cluster Analysis , Cohort Studies , Follow-Up Studies , Genotype , Humans , Leukemia, Myeloid/etiology , Neoplasms, Second Primary/etiology , Oligonucleotide Array Sequence Analysis/methods , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , RNA, Neoplasm/genetics , Regression Analysis , Risk Factors
11.
Toxicol In Vitro ; 15(4-5): 553-6, 2001.
Article in English | MEDLINE | ID: mdl-11566590

ABSTRACT

As an example of advanced testing in the field of metabolism in an industrial environment, the introduction of some novel approaches, including the use of genetically engineered cell lines for assessing CYP 2D6-related polymorphic effects is illustrated. In this paper, it is demonstrated that novel in vitro test systems can be developed by using these genetically engineered cell lines for evaluating the potential risks associated with proprietary drugs (especially if their metabolism depends to a high extent on CYP 2D6). Moreover, it is demonstrated that, by the use of these in vitro methods, issues such as polymorphism, for which no animal models are available, can be assessed in such a way that predictions can be made on adverse effects which, up to now, could only be detected during clinical trials. Through the use of these new biotechnological in vitro metabolism models, clinically relevant data can be obtained for a scientifically-based human risk assessment, and animal use can be reduced.


Subject(s)
Cell Line/enzymology , Cytochrome P-450 CYP2D6/genetics , Genetic Engineering , Polymorphism, Genetic/genetics , Animal Testing Alternatives , Animals , Cell Line/drug effects , Chromatography, High Pressure Liquid , Cricetinae , Cricetulus , Cytochrome P-450 CYP2D6/classification , Cytochrome P-450 CYP2D6/metabolism , Dextromethorphan/metabolism , Dextromethorphan/pharmacology , Ethanolamines/metabolism , Ethanolamines/pharmacology , Humans , Lung/cytology , Mass Spectrometry , Polymorphism, Genetic/drug effects
12.
Appl Radiat Isot ; 55(1): 17-22, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11339532

ABSTRACT

A simple automated preparation of [11C]raclopride by reaction of [11C]methyl triflate with demethylraclopride triflate is described. The conventional bubbling of [11C]methyl triflate into the precursor solution was compared with two alternative methods which used a commercially available C18 cartridge (on-column method) or an empty PTFE tube (loop method) as support for the precursor solution. The influence of several solvents was assessed for all three methods. The on-column method showed excellent trapping efficiencies of [11C]methyl triflate but gave the lowest radiochemical yields. The loop method proved to be a simplified alternative to the bubbling method, giving comparable radiochemical yields with less precursor and offering an easy way to transfer the reaction mixture into an HPLC column. By the simple-loop method [11C]raclopride could be prepared in over 40% radiochemical yields (decay-corrected and based on [11C]methyl triflate).


Subject(s)
Raclopride/chemical synthesis , Radiopharmaceuticals/chemical synthesis , Carbon Radioisotopes , Chromatography, High Pressure Liquid , Isotope Labeling/instrumentation , Isotope Labeling/methods , Mesylates/chemistry , Molecular Structure , Radiometry/instrumentation , Radiometry/methods
13.
Appl Radiat Isot ; 52(1): 87-92, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10670927

ABSTRACT

A convenient method suitable for automated preparation of 4-[18F]fluorobenzyl halides from no-carrier-added [18F]fluoride has been developed. 4-[18F]Fluorobenzaldehyde, synthesized from [18F]fluoride by aromatic nucleophilic substitution on 4-trimethylammoniumbenzaldehyde triflate, was first retained on a C18 cartridge and there efficiently reduced to 4-[18F]fluorobenzyl alcohol simply by flowing an aqueous solution of NaBH4. The conversion of 4-[18F]fluorobenzyl alcohol to 4-[18F]fluorobenzyl halide was investigated using PBr3, PI3, P2I4, Ph3PBr2 and Ph3PI2 in CH2Cl2. 4-[18F]Fluorobenzyl halides were purified by passing through a disposable silica cartridge. The conversion rapidly proceeded in radiochemical yields of nearly 90% at 40 degrees C with P2I4 and almost quantitatively at room temperature with Ph3PBr2. With this last reagent 4-[18F]fluorobenzyl bromide was obtained in overall radiochemical yields of 50-60% within 30 min from EOB.

14.
Eur J Nucl Med ; 25(10): 1429-34, 1998 Oct.
Article in English | MEDLINE | ID: mdl-9818284

ABSTRACT

To investigate the possible role of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) in the prognostic evaluation of primary breast cancer, we studied 86 patients with T1-3 (TNM classification) breast tumours before surgery and compared the tumour FDG uptake, calculated as a standardized uptake value (SUV), with postoperative histopathological findings, steroid hormone receptor status of the tumour, thymidine labelling index (LI) and tissular expression of p53. SUV was significantly higher in infiltrating ductal carcinomas (n = 68; median SUV = 5.6) than in lobular ones (n = 18; median SUV = 3.8), and in grade 3 carcinomas (n = 26; median SUV = 6.2) than in grade 1-2 ones (n = 60; median SUV = 4.9). Moreover, SUV was significantly higher in carcinomas with high levels of p53 (n = 12; median SUV = 9.5) than in those with low levels (n = 48; median SUV = 4.25). By contrast, there was no significant correlation between SUV and the steroid hormone receptor status or LI of tumours. Our data demonstrate that FDG uptake, expressed as SUV, is associated with certain prognostic factors in breast cancer, such as histopathological grading and p53 expression, which can be assessed only by means of postoperative in vitro examinations. Hence, the information provided by FDG-PET is to some extent related to relevant information on tumour biology. The clinical value of these data will have to be confirmed by analysis of the independence of SUV from other prognostic factors by means of a multivariate analysis performed on a larger series of patients with adequate follow-up. If SUV is confirmed as an independent variable, FDG-PET could assume an important role in the determination of appropriate therapeutic strategies for primary breast cancer.


Subject(s)
Breast Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Radiopharmaceuticals , Receptors, Cell Surface/drug effects , Thymidine/metabolism , Tumor Suppressor Protein p53/metabolism , Adult , Aged , Aged, 80 and over , Breast Neoplasms/metabolism , Breast Neoplasms/surgery , Female , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Middle Aged , Multivariate Analysis , Radiopharmaceuticals/pharmacokinetics , Tomography, Emission-Computed
15.
Anticancer Res ; 18(3A): 1563-7, 1998.
Article in English | MEDLINE | ID: mdl-9673371

ABSTRACT

A simple semi-automated apparatus is described for rinsing the transport line from the [18F] fluoride. target to the hot-cell after recovery of aqueous [18F] fluoride. The additional activity thus recovered can then be added to that previously trapped on Dowex 1X8 (CO3=) or, alternatively, diverted to a second vial for other uses such as research, PET-camera calibration or bone investigations by PET. Inclusion of the target chamber in the rinsing procedure increased the additional recovery of activity up to ca. 15%, without a noticeable effect on the isotopic integrity of the recovered [18O]H2O.


Subject(s)
Bone and Bones/diagnostic imaging , Fluorides/isolation & purification , Fluorine Radioisotopes/isolation & purification , Anion Exchange Resins , Automation/instrumentation , Automation/methods , Calibration , Chromatography, Ion Exchange/instrumentation , Chromatography, Ion Exchange/methods , Cyclotrons , Humans , Oxygen Isotopes , Resins, Synthetic , Tomography, Emission-Computed , Water
16.
J Nucl Med ; 39(1): 4-8, 1998 Jan.
Article in English | MEDLINE | ID: mdl-9443729

ABSTRACT

METHODS: The presurgical, noninvasive staging of axillary nodes for metastases was prospectively investigated in 68 patients who were diagnosed with primary breast cancer using PET with 18F-fluorodeoxyglucose (FDG). Four patients had bilateral nodules; therefore, the total number of evaluable cases was 72. Visual analyses of attenuation-corrected PET images and standardized uptake values (SUVs) of FDG uptake in carcinomas were compared with histopathological surgical findings. The SUV distribution differences between carcinomas with and without axillary metastases were evaluated by means of statistical and receiver operating characteristics analyses. RESULTS: PET correctly classified 64 of the 72 cases; four false-positive and four false-negative PET results were found. The overall sensitivity, specificity and accuracy of PET for axillary metastases were 85%, 91% and 89%, respectively. With respect to the clinical axillary stage of the patients (TNM, or tumor-node-metastasis, classification), we obtained the following results: N0 patients, sensitivity = 70%, specificity = 92%, accuracy = 86%; N1a patients, sensitivity = 85.5%, specificity = 100%, accuracy = 95%; and N1b-2 patients, sensitivity = 100%, specificity = 67%, accuracy = 87%. The median SUV in carcinomas with axillary metastases (4.6) was significantly higher than that in carcinomas without metastases (2.9), but there was a great SUV overlap between the two groups (interquartile ranges = 2.7-7.2 and 1.9-4.5, respectively). Analysis of the receiver operating characteristics curve showed that a high sensitivity of SUV in predicting axillary metastases was associated with a very low specificity and vice versa. With the best SUV cutoff value of 2.9, the sensitivity and specificity were 74% and 56%, respectively. CONCLUSION: PET showed good overall diagnostic accuracy in the detection of axillary metastases (86%). The very high accuracy (95%) in N1a patients is of particular importance. False-negative PET findings, however, can be encountered. SUVs of breast carcinoma cannot predict the spread of the disease to the axilla, even if higher values are often associated with axillary metastases. Any decision on the use of PET in the presurgical staging of breast cancer should be incorporated into a more general debate on axillary management. In selected patients with a very low probability of axillary metastases (T1a), in whom axillary surgery can already be avoided according to data from follow-up studies, 18F-FDG PET could be proposed as a noninvasive imaging modality to improve the diagnosis of axillary relapses.


Subject(s)
Breast Neoplasms/pathology , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Lymph Nodes/diagnostic imaging , Radiopharmaceuticals , Tomography, Emission-Computed , Axilla , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/surgery , Female , Humans , Lymph Node Excision , Lymph Nodes/pathology , Lymphatic Metastasis , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Preoperative Care , Prospective Studies , ROC Curve , Sensitivity and Specificity
17.
Tumori ; 83(4): 748-52, 1997.
Article in English | MEDLINE | ID: mdl-9349315

ABSTRACT

AIMS AND BACKGROUND: To study the influence of blood glucose levels on the clinical reliability of positron emission tomography (PET) with [18F]-2-fluoro-2-deoxy-D-glucose (FDG) in the detection of liver metastases from colorectal carcinomas and in the analysis of tumor uptake of FDG. METHODS: After having given their informed consent, 8 patients with 20 liver metastases (mean size, 31.5 mm; range, 10-75 mm) detected by means of CT were submitted to a first FDG-PET examination under fasting conditions and, 2 days later, to a second FDG-PET examination performed after i.v. infusion of a glucose solution (4 mg/kg/min for 2 hrs). The results of the two studies were compared in each patient, considering both the localization of the metastases and the FDG uptake in the lesions. A non-kinetic method was used, calculating the Standardized Uptake Value (SUV). RESULTS: All 20 metastases were clearly visible on FDG-PET under fasting conditions. Moreover, in 2 patients FDG-PET detected a number of unknown liver metastases. The blood glucose levels after glucose infusion were significantly higher than the levels under fasting conditions, 158 +/- 13.8 mg/100 ml (mean +/- sd) and 92.4 +/- 10.2, respectively (P < 0.001), and the quality of the FDG-PET images showed a marked deterioration. FDG-PET was unable to detect 6 of the 20 lesions and another 10 lesions were localized less clearly. Moreover, 80% of the unknown liver metastases were not detected after glucose loading. The SUVs of metastases decreased from 9.4 +/- 5.7 (mean +/- sd) under fasting conditions to 4.3 +/- 8.3 after glucose loading (P < 0.001). CONCLUSIONS: FDG-PET studies may be particularly unreliable under conditions of high levels of blood glucose. Therefore, patients entering FDG-PET studies should fast, and blood glucose concentration needs to be taken into account when evaluating FDG uptakes in follow-up studies.


Subject(s)
Blood Glucose/metabolism , Colorectal Neoplasms/pathology , Fluorodeoxyglucose F18/metabolism , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/metabolism , Liver/diagnostic imaging , Liver/metabolism , Tomography, Emission-Computed , Adult , Female , Humans , Liver Neoplasms/blood , Liver Neoplasms/secondary , Male , Middle Aged
18.
Tumori ; 83(3): 625-32, 1997.
Article in English | MEDLINE | ID: mdl-9267478

ABSTRACT

In this review the main characteristics, i.e., structure, function and gene expression, of the different mucins are discussed. Mucin-type molecules consist of a core protein moiety (apomucin) where a number of carbohydrate chains are attached to serines and threonines by glycosidic bonds. O-linked carbohydrates form up to 80% of the molecule and the length of the glucidic side chains varies from one to more than 20 residues. At least eight mucin-like genes have been isolated so far, and the main characteristic is the presence of a central domain composed of a variable number of "tandem repeats". The sequence homology of the central domain among the different members of the mucin-type family is limited, indicating that this internal domain is unique for each mucin. Thanks to the integrated results of genetic, immunological and biochemical studies, it is now possible to identify eight apomucin genes, namely MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC5B, MUC6 and MUC7. MUC1 is the best characterized mucin and it is expressed on the apical surface of most polarized epithelial cells. The MUC1 gene has been cloned and sequenced. The MUC2 gene encodes a typical secretory gel-forming mucin which represents the predominant form in human intestinal and colon tissues. Another intestinal mucin is MUC3. The MUC4, MUC5AC and MUC5B genes have been isolated from a bronchial tissue cDNA library. The MUC4 and MUC5AC genes are mainly expressed in the respiratory tract, in gastric and reproductive mucosa, while MUC5B is highly detectable only in the bronchial glands. The MUC6 gene is expressed by gastric tissue and, recently, MUC7 has been cloned and sequenced using a salivary cDNA library.


Subject(s)
Gene Expression Regulation , Mucins , Amino Acid Sequence , Animals , Epithelium/metabolism , Gene Expression Regulation, Neoplastic , Humans , Molecular Sequence Data , Mucins/biosynthesis , Mucins/chemistry , Mucins/genetics , Mucins/physiology , Neoplasms/metabolism
19.
Eur J Nucl Med ; 24(5): 497-504, 1997 May.
Article in English | MEDLINE | ID: mdl-9142729

ABSTRACT

One approach in the treatment of ovarian cancer patients involves the infusion of autologous T lymphocytes coupled with a bispecific monoclonal antibody MOv18/anti-CD3 (biMAb OC/TR), which recognizes a 38-kDa glycoprotein expressed on ovarian carcinomas and the CD3 T cell receptor. However, little is known about the in vivo biodistribution of injected activated lymphocytes, information that could be obtained by scintigraphic imaging of radiolabelled T cells in order to visualize the migratory pattern. We compared the efficiency, stability and toxicity of technetium-99m hexamethylpropylene amine oxime (HMPAO), indium-111 oxine and fluorine-18 2-fluoro-2-deoxy-d-glucose (FDG) in radiolabelling activated lymphocytes targeted with biMAb OC/TR. The mean labelling efficiencies of 111In-oxine and 18F-FDG using 2.5x10(8) lymphocytes (68% and 64%, respectively) were more than twice that of 99mTc-HMPAO (31%). Retention of the radionuclide in the cell was highest in the case of 111In-oxine labelling (less than 25% of the initial cell-bound activity released after 240 min, as compared with 44% of the 99mTc label in the same period and 45% of 18F radionuclide released after 150 min). None of the three radiolabelling reagents induced any significant alteration in cell viability or immunophenotype. However, both 111In-oxine and 18F-FDG induced a loss of cytotoxic activity of lymphocytes against the ovarian carcinoma cell line IGROV1, and all three radiolabelling reagents caused a significant reduction in the proliferative ability of labelled lymphocytes compared to controls, with cell death occurring after 8-9 days. Radiolabelling with the more stable 111In-oxine reagent using a higher number of lymphocytes (1.4x10(9)) but the same total activity (around 55.5 MBq) resulted in improved labelled T cell viability and proliferative ability, although the mean labelling efficiency decreased (35.8%). Together the data suggest that 111In-oxine at low activity per cell is the most appropriate reagent for radiolabelling activated retargeted T lymphocytes useful for in vivo biodistribution studies.


Subject(s)
Deoxyglucose/analogs & derivatives , Fluorine Radioisotopes , Indium Radioisotopes , Isotope Labeling/methods , Organometallic Compounds , Organotechnetium Compounds , Oximes , Oxyquinoline/analogs & derivatives , T-Lymphocytes/physiology , Cell Death , Cell Survival , Cells, Cultured , Female , Fluorodeoxyglucose F18 , Humans , Lymphocyte Activation , Ovarian Neoplasms/immunology , T-Lymphocytes/immunology , Technetium Tc 99m Exametazime , Tumor Cells, Cultured
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