Comparison of Technetium-99m sestamibi and indium-111 octreotide imaging in a patient with Ewing's sarcoma before and after stem cell transplantation.

BACKGROUND: We report the use of two novel nuclide agents, Technetium-99m (99Tc)sestamibi (MIBI) and indium-111 (In-111) octreotide, in comparison with conventional computed tomography (CT) imaging in a patient with metastatic Ewing's sarcoma (ES) before and after high dose chemotherapy with autologous peripheral stem cell transplantation (PSCT). MIBI is taken up actively by metabolically active tumor cells. Octreotide, a somatostatin analog, binds specifically to somatostatin receptors. METHODS: The patient was a 20-year-old male with recurrent metastatic ES to the lung. Before and sequentially after high dose chemotherapy and PSCT, the patient was imaged with MIBI. Whole body planar and single photon emission computed tomography (SPECT) images were obtained after the injection of 30 mCi of 99Tc MIBI. Prior to PSCT the patient was imaged with 6 mCi In-111 pentreotide. RESULTS: Conventional CT scans also were performed. Initial CT revealed pulmonary metastasis in the right lower lobe along with multiple left pleural-based lesions. These lesions were visualized clearly with MIBI. Octreotide detected only the left lung involvement. Sequential MIBI scans after PSCT correlated with tumor reduction in the right lung field and tumor progression in the left lung as well as the development of new pulmonary metastasis. These findings were confirmed on CT. CONCLUSIONS: MIBI imaging was highly concordant with CT scanning in the detection of metastatic ES. MIBI scanning holds promise for the direct detection of a variety of human malignancies, and may prove useful as a rapid whole body imaging modality.

Comparison of gallium-67-citrate and thallium-201 scintigraphy in peripheral and intrathoracic lymphoma.

UNLABELLED: We performed this study in an attempt to reconcile the differences with respect to 67Ga uptake as a function of tumor grade and type in the literature, as well as to determine the sensitivity of 201Tl uptake in both Hodgkin's and non-Hodgkin's lymphoma. METHODS: Thirty-six (9 with low-grade lymphoma, 11 with intermediate-grade lymphoma, 4 with high-grade lymphoma and 12 with Hodgkin's lymphoma) patients underwent both 67Ga and 201Tl scintigraphy. Biopsies were done on all patients. A semiquantitative rating system was used to make statistical comparisons for thallium versus gallium in all lymphoma subgroups, as well as comparisons of thallium and gallium to themselves in all subgroups. RESULTS: Patient sensitivity was only 56% and site sensitivity was 32% in patients with low-grade lymphoma. Conversely, 201Tl sensitivity was 100%, respectively, for patients and sites. The difference between 201Tl and 67Ga sensitivity in patients with low-grade lymphoma on a site basis was statistically significant. When compared to itself in lymphoma subgroups, 201Tl was found to be statistically more avid for low-grade lymphoma than for intermediate, high or Hodgkin's lymphoma. Gallium-67 sensitivity for low-grade lymphoma was significantly less than for Hodgkin's and intermediate grade lymphomas. No significant differences were found when 201Tl and 67Ga were compared in the intermediate, high or Hodgkin's lymphoma groups. CONCLUSION: Thallium-201 demonstrates significantly greater tumor avidity in the low-grade lymphoma group compared to 67Ga citrate. Gallium-67-citrate appears relatively nonavid for low-grade lymphoma compared to 201Tl and is statistically inferior in detecting low-grade lymphoma in comparison to its ability to detect intermediate or high-grade lymphomas. Gallium-67-citrate should not be considered dependable in evaluating patients with low-grade lymphoma. Neither 201Tl or 67Ga is dependable in the evaluation of low-grade lymphoma within the abdomen, since gallium avidity for low-grade lymphoma is low and gastrointestinal excretion of 201Tl is poorly controlled.

Digital dermatoglyphics in mammary cancer.

Fingerprints from 200 women with histologically proven breast cancer (case group) were compared to fingerprints from 138 women with no history of any malignant disease (control group). Of the patterns analyzed, four were significantly associated with breast cancer: accidentals, transitionals, angled ulnar loops, and horizontal ulnar loops. A fifth print, the angled radial loop, was found to be of borderline importance as an independent predictor of breast cancer. Of 200 patients in the case group, 27 had one or more accidental prints, 58 had one or more transitionals, 34 had one or more horizontal ulnar loops, and 93 had one or more angled ulnar loop patterns. In 138 control subjects there were 2 with accidental patterns, 21 with one or more transitionals, 6 with horizontal ulnar loops, and 16 with one or more angled ulnar loops. In addition, there appeared to be a gradient of risk; a woman with one type of suspicious print is at higher risk of breast cancer than a woman with none, and two suspicious prints indicate a higher risk than does one. If these findings are confirmed, the prints described will represent a noninvasive anatomical marker of breast cancer risk.

In vivo study of lactoferrin and murine rebound myelopoiesis.

Lactoferrin has been reported to inhibit the production of colony-stimulating factor (CSF); thus we sought to study its possible effects on myelopoiesis in vivo. The characteristics of rebound myelopoiesis in C57BL mice injected with a sublethal dose of cyclophosphamide (CY) were used to test lactoferrin for any granulopoietic activity. An experimental group received daily injections of 50 micrograms of human lactoferrin beginning 24 hr after CY injections. By measuring the total nucleated cellularity of the femoral marrow, the peripheral blood count, and the incorporation of tritiated thymidine by the marrow in six replicate experiments, no statistically significant difference was noted between the lactoferrin injected groups and the control groups. Neither the route of lactoferrin administration (i.v. or i.p.) nor the sex of the animal altered the myelopoietic recovery. Lactoferrin had no stimulatory or inhibitory effect on murine rebound myelopoiesis in vivo contrary to the reported in vitro results.