Advantage of delayed whole-body FDG-PET imaging for tumour detection.

Delayed imaging that coincides with the highest uptake of fluorine-18 fluorodeoxyglucose (FDG) by tumour may be advantageous in oncological positron emission tomography (PET), where delineation of metastasis from normal tissue background is important. In order to identify the better imaging protocol for tumour detection, whole-body FDG-PET images acquired at 1 h and 2 h after injection were evaluated in 22 subjects, with a post-injection transmission scan at 90 min for attenuation correction. After visual interpretation, tumour uptake [tumour standardised uptake ratio (SUR)], normal tissue uptake (normal SUR) and tumour to background contrast (tumour SUR/normal tissue SUR) were evaluated in the images acquired at 1 h and at 2 h. Most malignant lesions, including primary lung cancer, metastatic mediastinal lymph nodes and lymphoma lesions, showed higher FDG uptake at 2 h than at 1 h. By contrast, benign lesions, with the exception of sarcoidosis, showed lower uptake of FDG at 2 h than at 1 h. Among normal tissues, the kidney, liver, mediastinum, lung, upper abdomen and left abdomen showed significant falls in FDG uptake from 1 h to 2 h. The lower abdomen, right abdomen and muscles (shoulder and thigh) showed no significant changes. Consequently, malignant lesions of the lung, mediastinum and upper abdomen showed significant increases in tumour to background contrast from 1 to 2 h. Three lesions (two lung cancers and a malignant lymphoma) that were equivocal on 1-h images became evident on 2-h images, changing the results of interpretation. All other malignant lesions were detected on 1-h images, but were clearer, with higher contrast, on 2-h images. Lesion-based sensitivity was improved from 92% (49/53) to 98% (52/53), and patient-based sensitivity from 78% (14/18) to 94% (17/18). It is concluded that delayed whole-body FDG-PET imaging is a better and more reliable imaging protocol for tumour detection.

In vivo evaluation of carborane gadolinium-DTPA complex as an MR imaging boron carrier.

The evaluation of the Gd-carborane complex 2 as an MR imaging and boron carrier agent was carried out in vivo using tumor-bearing Donryu rats, MRI, ICP-AES, and alpha-autoradiography. The MR imaging revealed that the carborane Gd-DTPA 2 was metabolized slower in the body than Gd-DTPA 1. The results of the ICP-AES method indicated that compound 2 was incorporated into normal tissues and metabolized quickly, whereas it was not accumulated into tumor or brain tissue. The alpha-autoradiography showed that a high level of boron was obtained in the internal organs and in the necrosis of tumor tissue.

Intact alveolar epithelial permeability and transalveolar fluid absorption after thoracic irradiation in rats.

We have addressed the question of how the alveolar space stays relatively free of fluid when thoracic irradiation injures the pulmonary capillary endothelium and plasma fluid leaks into the interstitium. A single dose of 15 Gy to the thorax of rats significantly increased the pulmonary capillary filtration coefficient and the lung wet/dry weight ratio 2 h after irradiation. However, there was no significant increase in the release of lactose dehydrogenase or leaking of Evans blue dye into the alveolar space, indicating that alveolar epithelial permeability remained intact. We found no significant difference in the basal alveolar fluid clearance between control and irradiated animals. There was also no significant difference in blockage of alveolar fluid clearance by amiloride. This indicates that the function of the alveolar epithelial Na(+) channels is not impaired and that alveolar epithelium absorbs fluid normally. Examination of lung tissue by light microscopy demonstrated accumulation of fluid in the perivascular region but not in the alveolar space. Our data appear to indicate that the alveolar epithelial barrier function is more resistant to radiation than that of the pulmonary capillary endothelium. We conclude that intact alveolar epithelial permeability and normal transalveolar epithelial fluid absorption ability are of critical importance in keeping the alveolar space relatively free of fluid during acute radiation lung injury.

Analysis of time-density curves of contrast media for improvement of chest dynamic incremental CT.

PURPOSE: The goal of this work was to analyze time-density curves (TDCs) of contrast media (CM) in the mediastinal vasculature to optimize chest dynamic incremental CT. METHOD: Forty-three patients were injected with nonionic CM into the forearm veins with injection rates (ml/s), durations (s), and total amounts (ml) of 2.0, 20, and 40 (protocol 1); 4.0, 20, and 80 (protocol 2); and 2.0, 40, and 80 (protocol 3). TDCs were obtained for the pulmonary trunk (PA) and ascending (AA) and descending (DA) aorta from dynamic scans. Areas under the curves (AUCs) of TDCs for imaginary 30 s scans were evaluated. RESULTS: AUC peaks were obtained after 10, 17, and 19 s (PA, AA and DA; protocol 1; 9, 16, and 18 s (protocol 2); and 18, 25, and 28 s (protocol 3) delay time. CONCLUSION: Better chest dynamic incremental CT would be expected with scan midpoints a little after the end of injection of CM.

Pharmacokinetics of 10B-p-boronophenylalanine in tumours, skin and blood of melanoma patients: a study of boron neutron capture therapy for malignant melanoma.

To optimize the neutron dose for boron neutron capture therapy (BNCT), the boron-10 (10B) concentration kinetics of 10B-p-boronophenylalanine (BPA) were analysed in 22 melanoma patients with primary or metastatic melanomas who received BPA and subsequently underwent BNCT or surgery. The blood concentration in nine patients receiving 179.7+/-14.9 mg/kg BPA increased with time during intravenous infusion, peaked at the end of administration and decreased thereafter. The peak values at the end of administration were 9.4 2.6 microg 10B/g blood, and half-lives for the initial and second components of the blood clearance were 2.8 and 9.2 h, respectively. Skin concentrations in the 10 patients varied from case to case; however, skin-to-blood ratios were relatively constant at 1.31+/-0.22 during the 6 h after the end of administration. Boron concentrations in the tumours resected from the seven patients who were operated on decreased in parallel to the blood values, the tumour-to-blood ratio being relatively constant at 3.40+/-0.83. The present analytical data of BPA pharmacokinetics support our previous approach for optimizing the timing of irradiation and setting the neutron flux large enough for tumour eradication but still tolerable for normal skin.

Influence of chemotherapy on FDG uptake by human cancer xenografts in nude mice.

UNLABELLED: This study evaluated the use of PET with 18F-2-deoxy-2-fluoro-D-glucose (18F-FDG) for monitoring chemotherapy effects, using a human cancer xenograft (poorly differentiated human gastric cancer) in vivo model. METHODS: Tumor 18F-FDG uptakes and sizes were measured after administrating mitomycin (MMC), cisplatin (CDDP) and adriamycin (ADR) to xenograft-bearing nude mice and compared with 18F-FDG tumor uptake and tumor size in a non-therapy group. The correlation between the uptake and size was also assessed. RESULTS: The largest reduction in tumor size after chemotherapy occurred in the MMC administered group, followed by the CDDP case, with no reduction in the ADR group as compared to the controls. Fluorine-18-FDG tumor uptake after chemotherapy was also decreased in the MMC and CDDP groups, in that order, but not in the ADR case. With MMC and CDDP, size reduction became significant on Days 8 or 11, whereas 18F-FDG tumor uptake had already been decreased on Days 3 or 7. CONCLUSION: Fluorine-18-FDG uptake decreases in parallel to the efficacy of anticancer agents and correlates with subsequent morphologic changes. We conclude that 18F-FDG PET tumor images are indeed useful for monitoring the effects of cancer chemotherapy.

[Normal cerebral perfusion of 99mTc-HMPAO brain SPECT--evaluation by ananatomical standardization technique].

Single photon labeled tracer 99mTc-hexamethylpropylene amine oxime (HMPAO) has been used for rCBF studies by SPECT. However, normal perfusion pattern of this agent still remains unclear. The purpose of this study was to investigate normal 99mTc-HMPAO SPECT image voxel by voxel. Eighteen male subjects without any prior or present history of medical illness participated in this study. All SPECT images were globally normalized to 100 count/voxel. Each subject had an X-ray CT scan at the same day of SPECT measurement. All subjects had normal X-ray CT scans. The standard anatomical structures of the computerized brain atlas of Roland et al. were fitted to X-ray CT images of a subject by linear and non-linear parameters. These parameters were subsequently used to transform SPECT images of the subject. After the anatomical standardization, mean and SD images of eight standardized images were calculated voxel-by-voxel basis. In the mean image, following structures showed relatively higher radioactivity; the putamen, the cerebellum, and the frontal lobe. In addition, the occipital lobe, parietal lobe, frontal lobe, and the putamen showed large degree of SD. Anatomical standardization of SPECT images may be useful as a reference to diagnose and evaluate various brain disorders.

[A new 3-dimensional head fixation device for brain imaging].

We have developed a new head fixation device for studies of brain function. This device was designed to immobilize subject's heads during image scanning and to precisely reproduce the head position for two different imaging modalities such as MRI and PET. The device consists of a plastic frame, a pillow filled with beads of styrene foam, and a face mask of thermoplastic resin which was originally intended for application in radiotherapy. A bridge for biting was incorporated into the mask for stable fixation. The device enables immobilization of subject's heads with good reproducibility of position at the practical level. Our results indicate that this head fixation system is useful for fixation of head during activation studies using PET.

[A simple method for measurement of cerebral blood flow using 123I-IMP SPECT with calibrated standard input function by one point blood sampling; validation of calibration by one point venous blood sampling as a substitute for arterial blood sampling].

In a simplified method for measurement of cerebral blood flow using one 123I-IMP SPECT scan and one point arterial blood sampling (Autoradiography method), input function is obtained by calibrating a standard input function by one point arterial blood sampling. A purpose of this study is validation of calibration by one point venous blood sampling as a substitute for one point arterial blood sampling. After intravenous infusion of 123I-IMP, frequent arterial and venous blood sampling were simultaneously performed on 12 patients of CNS disease without any heart and lung disease and 5 normal volunteers. The radioactivity ratio of venous whole blood which obtained from cutaneous cubital vein to arterial whole blood were 0.76 +/- 0.08, 0.80 +/- 0.05, 0.81 +/- 0.06, 0.83 +/- 0.11 at 10, 20, 30, 50 min after 123I-IMP infusion, respectively. The venous blood radioactivities were always 20% lower than those of arterial blood radioactivity during 50 min. However, the ratio which obtained from cutaneous dorsal hand vein to artery were 0.93 +/- 0.02, 0.94 +/- 0.05, 0.98 +/- 0.04, 0.98 +/- 0.03, at 10, 20, 30, 50 min after 123I-IMP infusion, respectively. The venous blood radioactivity was consistent with artery. These indicate that arterio-venous difference of radioactivity in a peripheral cutaneous vein like a dorsal hand vein is minimal due to arteriovenous shunt in palm. Therefore, a substitution by blood sampling from cutaneous dorsal hand vein for artery will be possible. Optimized time for venous blood sampling evaluated by error analysis was 20 min after 123I-IMP infusion, which is 10 min later than that of arterial blood sampling.