In-vivo tissue uptake and retention of Sn-117m(4+)DTPA in a human subject with metastatic bone pain and in normal mice.

Organ and tissue uptake and retention of Sn-117m(4+)DTPA were studied in a human subject treated for metastatic bone pain, and the results were compared with the biodistribution studies in five normal mice. The explanted organs from a patient who received a therapy dose of 18.6 mCi (688.2 MBq) Sn-117m(4+)DTPA and who died 47 days later were imaged with a gamma-camera, and tissue samples were counted and also autoradiographed. Bone, muscle, liver, fat, lungs, kidneys, spleen, heart and pancreas tissue samples were assayed in a well counter for radioactivity. Regions of interest were drawn over bone and major organs to calculate and quantify clearance times using three in vivo Sn-117m(4+)DTPA whole-body scintigrams acquired at 1, 24 and 168 h after injection. Five normal mice injected with the same batch of Sn-117m(4+)DTPA as used for the human subject were sacrificed at 24 h, and tissue samples were collected and assayed for radioactivity for comparison with the human data. For the human subject, whole-body retention at 47 days postinjection was 81% of the injected dose, and the rest (19%) was excreted in urine. Of the whole-body retained activity at 47 days, 82.4% was in bone, 7.8% in the muscle and 1.5% in the liver, and the rest was distributed among other tissues. Gamma-ray scintigrams and electron autoradiographs of coronal slices of the thoracolumbar vertebral body showed heterogeneous metastatic involvement with normal bone between metastatic lesions. There was nonuniform distribution of radioactivity even within a single vertebral body, indicating normal bone between metastatic lesions. Lesion-to-nonlesion ratios ranged from 3 to 5. However, the osteoid-to-marrow cavity deposition ratio, from the microautoradiographs, was 11:1. The peak uptake in the human bone was seen at 137 h with no biological clearance. Soft tissues showed peak uptake at 1 h and exhibited three compartmental clearance components. Whole-body retention in normal mice was 38.7% of the injected dose at 24 h and the rest was excreted. At 24 h postinjection, bone in mice showed 84.2% of the whole-body retention, muscle 1.7% and liver 1.4%, and the rest was distributed in other soft tissues. Percent distribution of the retained dose among bone, muscle, liver and other soft tissues is very similar between mice and a human subject. To calculate precise radiation absorbed doses from bone pain palliation radionuclides, it is necessary to take into account soft-tissue uptake and retention that may not be readily evident from routine external gamma-scintigraphy.

Tin-117m(4+)DTPA: pharmacokinetics and imaging characteristics in patients with metastatic bone pain.

UNLABELLED: Biokinetics and imaging characteristics of 117mSn(4+)DTPA have been studied in patients with metastatic bone pain. METHODS: Seventeen patients with bone pain due to metastasis were given three dose levels: 180 microCi/kg (6.66 MBq/kg), 229 microCi/kg (8.47 MBq/kg) and 285 microCi/kg (10.55 MBq/kg) body weight. Periodic blood and daily urine samples were collected for 14 days to measure percent injected activity retained in blood and that excreted in urine. Simultaneous anterior and posterior view whole-body images were obtained under identical scan settings at 1, 3.5 and 24 hr and on Days 3 and 7 and between 4-6 and 8-10 wk postinjection. The total body retention was calculated using the geometric mean counts. RESULTS: After intravenous injection, the total body clearance of 117mSn(4+)DTPA shows two components: a soft-tissue component and a bone component. The soft-tissue component accounts for 22.4% of the dose and consists of four subcomponents with an average biologic clearance half-time of 1.45 days (range 0.1-3.2 days). The bone component accounting for the remaining 77.6% of the dose shows no biologic clearance. A mean 22.4% of the dose is excreted in urine in 14 days; 11.4% within 24 hr. The uptake pattern appears similar to that of 99mTc-MDP. Peak uptake is observed in normal bone by 24 hr and metastatic lesions by 3-7 days. Pain palliation was observed with all three doses levels. CONCLUSION: Among the four potential bone pain palliation radionuclides, 117mSn(4+)DTPA demonstrates the highest bone uptake and retention. Some biokinetic and radionuclidic features of 117mSn(4+)DTPA are similar to other agents, but many features are different and unique and may make it an ideal bone pain palliation agent. Double-blind comparative studies are needed to determine its exact role in bone pain palliation.

Dead time of an anger camera in dual-energy-window-acquisition mode.

Two side-by-side energy windows are sometimes employed in quantitative single photon emission computed tomography (SPECT) studies. The count-rate losses at high activities for a GE400AT camera were measured in such a dual-window-acquisition mode by imaging a decaying source composed of a hot sphere within a warm cylinder. The data in each window was either kept separate or combined for purposes of dead-time correction and the paralyzable model was assumed. In addition, correction factors were derived from a "monitor" source at the edge of the camera. Finally, energy spectra for only the monitor-source region of interest and for the entire camera were obtained under both low- and high-count conditions and compared. With 99mTc (1) the spectral measurements show no peak shift but reveal pulse-pile-up spectral degradation. (2) The monitor-source corrections do not agree well with those from the model, presumably because of the differential effects of such degradation. For this camera the preferred correction method for patients is one using the model and two, effective, phantom-derived dead times for the separate data from the two windows. The two effective dead times are needed to compensate for pulse pile-up adding more counts to the lower-energy window than to the higher-energy one at high rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Count-based monitoring of Anger-camera spectra--local energy shifts due to rotation.

This study reports on a spectral monitoring method in which (1) a small source fixed to the camera is used, (2) a narrow, offset window is set on the side of the photopeak, and (3) variations in count rate are measured to assess energy shifts in the vicinity of the source. For one camera model, the count rate drops from 100% to 76% over a rotation of 180 degrees, implying a local energy shift of 1.4 keV. Also looked for are local count-rate variations with rotation for (1) wide-symmetric, (2) 20%-symmetric, and (3) 10%-asymmetric windows. The last is in limited use to partially compensate for Compton scattering. The effects of background and time stability are assessed.

Importance of intra-therapy single-photon emission tomographic imaging in calculating tumour dosimetry for a lymphoma patient.

The dosimetry for two, similarly sized tumours in a lymphoma patient being treated with non-bone marrow ablative, monoclonal antibody therapy is reported. The 45-year-old man was infused with 2.48 GBq (67 mCi) of 131I-labelled MB-1. Prior to therapy, a time series of diagnostic conjugate-view images and a radionuclide transmission scan were obtained and processed to obtain time-activity curves. Starting 2 days after the therapeutic infusion of radioactivity, a second conjugate-view time series was obtained. At that time, a quantitative single-photon emission tomography (SPET) acquisition was also carried out. Pre- and post-therapy X-ray computed tomography scans demonstrated a percentage reduction in volume for the right tumour which was 3.8 times that for the left tumour. In contrast, diagnostic conjugate views by themselves estimated the absorbed dose to be the same for the two tumours. Addition of therapy conjugate-view data increased the right-over-left ratio but only to 1.22. Normalizing either time-activity series by the intra-therapy SPET results increased the ratio to greater than 1.5. We assume here that a differential dose is correct according to the differential tumour shirnkage. One can further assume that the largest ratio corresponds most certainly to the most accurate dosimetric method. Other assumptions are possible. While additional study is essential, data from this patient suggest that the preferred dosimetric method is intra-therapy SPET normalization of either time series.

SPECT dual-energy-window Compton correction: scatter multiplier required for quantification.

The dual-energy window Compton-scattering correction technique is defined here especially for accurate quantification of focal regions having higher than average uptake. The quantification is relative to a known-activity reference source. The scatter multiplier ("k" value) is determined for a radioactive 99mTc sphere on or off the axis of a cylinder containing water with or without background. Both maximum likelihood and filtered-backprojection reconstruction are employed. Either projections or tomograms are corrected. With tight regions of interest, there is a tendency for the requisite "k" value to be slightly lower as the diameter of the cylinder is increased. Neither sphere location nor background perturbs "k", however, so a constant value is a good, first approximation. Then a two-sphere validation test yields an accuracy of 8% with subtracted-tomograms ("k" = 1.30) and 2% with subtracted-projections ("k" = 1.20). With a reference-source region of interest which is four times larger, "k" is reduced and also now depends on background. Although equivalent quantitatively, maximum likelihood is preferable to filtered backprojection with Chang attenuation correction since it produces a less-noisy image.