RESUMEN
Rhenium-186(tin) hydroxyethylidene diphosphonate (HEDP) is a new radiopharmaceutical that localizes in areas of osseous metastases in a manner similar to that of standard bone-scanning agents. It also emits beta particles with sufficient energy to be therapeutically useful. A single intravenous injection of about 33 mCi (1,221 MBq) was given to each of 20 elderly patients with advanced skeletal metastases from hormonally resistant prostate cancer. Prompt, significant relief of pain occurred 80% of the time with no significant side effects and only minimal, transient marrow toxicity. Re-186(Sn) HEDP appears to be a useful new agent for the palliation of painful osseous metastases in prostate cancer.
Asunto(s)
Adenocarcinoma/secundario , Neoplasias Óseas/secundario , Ácido Etidrónico/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Cuidados Paliativos , Neoplasias de la Próstata , Adenocarcinoma/radioterapia , Adenocarcinoma/terapia , Anciano , Neoplasias Óseas/radioterapia , Neoplasias Óseas/terapia , Estrógenos/uso terapéutico , Ácido Etidrónico/administración & dosificación , Ácido Etidrónico/efectos adversos , Humanos , Masculino , Compuestos Organometálicos/administración & dosificación , Compuestos Organometálicos/efectos adversos , Dolor/fisiopatología , Calidad de Vida , Radioisótopos , Dosificación Radioterapéutica , Renio , EstañoRESUMEN
Cardiac scintigraphy was performed in six patients with a documented previous myocardial infarction, in one patient with mitral regurgitation, and in four healthy volunteers following administration of 99mTc-tris-DMPE. An intense early blood pool phase permitted gated blood pool scintigraphy and left ventricular ejection fraction calculation. A myocardial phase 12-14 h later permitted myocardial perfusion imaging. The rest myocardial perfusion image quality with 99mTc-tris-DMPE appeared to be superior to the resting image quality obtained with 99mTc-dichloro-DMPE but was inferior to the resting image quality obtained with 201Tl.
Asunto(s)
Corazón/diagnóstico por imagen , Compuestos de Organotecnecio , Fosfinas , Tecnecio , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagen , Radioisótopos , Cintigrafía , Volumen Sistólico , TalioRESUMEN
Technetium-99m DMPE (99mTc-DMPE) is a newly synthesized myocardial perfusion imaging agent that shows intense myocardial accumulation in the dog. In the present study, dosimetry and potential clinical usefulness of this agent were assessed in four human subjects. Absorbed radiation doses were low, with the highest doses consisting of 200 mrad/mCi (54 microGy/MBq) to the gallbladder and 160 mrad/mCi (43 microGy/MBq) to the liver. No evidence of clinical toxicity was found. Technetium-99m DMPE did image the myocardium, but the ratio of target to nontarget activity was less favorable than that observed in the dog. Intense hepatic 99mTc-DMPE activity interfered with clinical imaging of the cardiac apex in two of the four subjects. We conclude that the prototype radiopharmaceutical, 99mTc-DMPE, is capable of myocardial perfusion imaging in man but the planar myocardial images produced are of inferior quality compared with 201Tl myocardial images. Further work is justified to develop related compounds to overcome the clinical limitations described.
