Question of the month. 81Krm; ventilation imaging.
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Biomedical subjects
Publications and source records attributed to D J Silvester.
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Practical methods are described for the quality assurance of three labelled agents (L-6-[18F]fluoro-DOPA, S-[N-methyl-11C]nomifensine and [O-methyl-11C]raclopride) now produced regularly for PET studies of the dopaminergic system in man. These include indirect methods for the initial determination of label position (e.g. 13C-NMR spectroscopy) and also direct methods for the assessment of chiral purity (TLC and HPLC) and the routine determination of radiochemical purity, chemical purity and specific activity (HPLC). Mass spectrometry has been used to identify some impurities. L-6-hydroxy-DOPA (a precursor in vivo of the neurotoxin, L-6-hydroxydopamine) has been detected by HPLC in some preparations of L-6-[18F]fluoro-DOPA. Formulated S-[N-methyl-11C]nomifensine has been found to decrease in radiochemical purity with storage, whereas formulated [O-methyl-11C]raclopride has been found to be stable. Some quality assurance issues are discussed in relation to experience in the application of the described methods and the obtained results.
A new 99mTc-phosphine-isocyanide complex with the general structure [99mTc (DEPE)2(CNR)2]+ has been synthesised and tested in animals and one human. In three animal species (rat, rabbit, dog), the complex is an efficient myocardial imaging agent, while in humans it remains in the blood pool. The complex is 100% protein bound in animals and humans, but whereas in humans it is attached to a 51.5 kdalton protein (probably prealbumin), in rabbits it appears to be bound to a larger macromolecule (M.W. greater than 100 kdalton). The efficiency of the complex for blood pool labelling was tested in a human volunteer and compared with the standard in vivo red cell labelling technique with stannous pyrophosphate. A satisfactory radionuclide angiogram could be performed with less than 370 MBq of the complex. The count rate for the complex (cps/MBq) was 15% higher than that obtained with the labelled red cells and the absence of splenic activity was notable. In humans this complex appears to be an efficient blood pool labelling agent which might be useful for radionuclide ventriculography.
Time integral and time-differential PAC measurements have been made over a wide temperature range in aqueous solutions of [111In]tropolonate and [111In]acetylacetonate. The quadrupole frequency in the latter is approximately 30% higher than that in the former and the molecular volumes derived from rotational correlation times show the expected differences. Apo-transferrin was separately added to the two 111In-chelates and the transfer of activity from chelate to transferrin followed as a function of relative molar concentrations. Very much larger molar ratios of transferrin to tropolone than of transferrin to acetylacetone were required before substantial transfer of 111In from chelate to transferrin took place. This difference in affinity for transferrin could be one significant factor in explaining the enhanced ability of [111In]tropolonate to label blood cells in the presence of plasma. The determination of PAC parameters in [111In]transferrin over a range of temperatures showed that the values of quadrupole frequency obtained depended on the number of binding sites assumed. For only one 111In site per molecule, the quadrupole frequency increases by over 50% as the temperature is reduced below the freezing point of the solution. If two 111In sites are assumed there appears to be a change in the percentage occupancy of the two sites on either side of the transition.
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The concentration achieved in the infected tissue is of fundamental importance in the use of antibiotics. Erythromycin labelled with the positron-emitting nuclide carbon-11 and positron tomography were used to compare local concentrations of this antibiotic in the pneumonic and unaffected lungs of five patients with lobar pneumonia. The time course of uptake of erythromycin into the extravascular compartment (i.e., the intracellular, interstitial, and alveolar compartments) of the pneumonic lung was measured. The mean extravascular concentrations obtained during the first hour after an intravenous injection of 270 mg erythromycin lactobionate were similar in the pneumonic lung and the unaffected lung (5.5 +/- 2.2 and 6.6 +/- 2.2 micrograms/g, respectively). An effective concentration of erythromycin was reached in the pneumonic lung within 10 min of the injection and was maintained throughout the period of measurement (60 min).
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Autologous leukocytes have been isolated, labeled with indium-111, and administered to 15 patients suspected of inflammatory disease. The stability of the label has been demonstrated and the in vivo kinetics and distribution of the labeled cells studied. The distribution is influenced by the type and viability of the cells separated by three different techniques. Generally, there was initial accumulation of radioactivity in the lungs; approximately half of this cleared in 15 min and the remainder slowly. Twenty-five to 50 percent of the radioactivity subsequently distributed in the spleen, liver, and bone marrow, and these did not show significant change with time up to 48 hr post injection. The In-111 radioactivity administered as labeled leukocytes free from erythrocytes cleared from the circulating blood with a half-time of 7.5 hr. In three of 15 patients, the suspicion of inflammatory disease could not be confirmed, and in these a normal distribution of radioactivity was observed. In the remaining 12 patients, focal accumulation of radioactivity was detectable within 4 to 24 hr after administration, and subsequent confirmation of sepsis was obtained. From three such patients, samples of abscesses were recovered which showed markedly higher radioactivity than that in the same weight of blood.
Human serum albumin has been conjugated to 1-(p-bnezenediazonium)-(ethylenedinitrilo)tetraacetic acid, a powerful chelating agent, and radioactive 111indium ions have been added specifically to the chelating groups. The product, with a specific radioactivity of about 1 mCi/mg of protein, was employed as a radiotracer in scintillation scanning studies with human volunteers. Results show that 48 hr after injection, practically all of the label remains attached to albumin. This is confirmed by electrophoresis of serum proteins; 7 days after injection, 85% of the radioactivity in the serum is still in the albumin fraction. These observations agree with in vitro studies of the labeled albumin in human serum, where loss of the metal ion from the chelating group to the protein transferrin amounts to less than 3% after 1 week and less than 5% after 2 weeks. Measurements of the distribution of label in mice up to 23 days after injection suggest that metabolism of the labeled protein does not lead to binding of indium ions by transferrin. The binding of indium and other metal ions by transferrin has previously posed a major impediment to the use of metal chelates for in vivo diagnostic procedures. Demonstration of the kinetic inertness of the chelate in these experiments suggests the use of related chelates as physical probes of biological systems.
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