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Biomedical subjects

E C Glass

Publications and source records attributed to E C Glass.

14 recordsLinked to original sources
PubMed1998

Positron emission tomography plus serum TA90 immune complex assay for detection of occult metastatic melanoma.

BACKGROUND: Whole-body positron emission tomography (PET) using 18F-fluorodeoxyglucose is very sensitive for detection of metastatic melanoma. We previously reported the accuracy of a serum TA90 enzyme-linked immunosorbent assay (ELISA) in predicting the recurrence of early-stage melanoma. This serum ELISA measures a circulating immune complex composed of TA90 a tumor-associated 90-kD glycoprotein antigen, and its IgG antibody. We hypothesized that using PET examination in conjunction with our serum TA90 ELISA would increase the detection of occult melanoma lesions. STUDY DESIGN: From November 1, 1993 to December 31, 1995, 87 patients underwent PET examination followed within 6 weeks by serum TA90 ELISA. All patients had undergone complete resection of local, regional, or distant metastatic melanoma and had no clinical evidence of disease at the time of PET examination. Each patient had complete followup for 12 months after PET examination. The clinical course was determined by chart review of clinical and radiographic findings. RESULTS: Of the 25 patients who experienced recurrence of disease within 6 months of followup, 22 (88%) had a positive result on one or both tests. Of the 52 patients with a negative result on both tests, 49 (94%) remained disease-free at 6 months of followup. Of the 14 patients who developed distant metastases within 6 months after PET examination, 13 (93%) had a positive PET examination and/or a positive TA90 ELISA. CONCLUSIONS: The TA90 ELISA correlated well with PET examination for detection of metastatic melanoma. The high sensitivity of PET examination plus TA90 ELISA suggests that this combination may have a role in the surveillance of patients at high risk of developing metastatic melanoma.

Adolescent↗
PubMed1998

Kinetics of three lymphoscintigraphic agents in patients with cutaneous melanoma.

UNLABELLED: Although lymphoscintigraphy is commonly used for the preoperative evaluation of patients with cutaneous melanoma and for intraoperative identification of sentinel lymph nodes, there is no consensus regarding the most useful radiopharmaceuticals or imaging times. METHODS: Fifty-one consecutive patients with clinical American Joint Committee on Cancer Stage I or II melanoma were assigned to one of three groups of 17 for lymphoscintigraphy with one of three radiopharmaceuticals: 99mTc-albumin colloid (AC), 99mTc-human serum albumin (HSA) or 99mTc-sulfur colloid (SC). Colloidal agents were filtered through 0.2 microm filters. After injecting 18.5-30 MBq (500-800 microCi) of the radiopharmaceutical, dynamic monitoring over injection sites and node basins was performed to identify draining lymphatic channels and sentinel nodes. In addition, static digital and analog images were acquired from the injection site and draining node basins immediately after injection and at 30 min (early) and 2 to 4 hr (delayed) after injection. Dynamic and static images were analyzed to determine transit times to the sentinel node, the number of nodes visualized in early and delayed images, the quality of lymph node and lymph channel visualization, the sentinel-to-nonsentinel uptake ratios and the washout rates from injection sites. RESULTS: Early images with all three agents provided reliable identification of sentinel lymph nodes. Technetium-99m-HSA demonstrated faster washout rates from injection sites and better definition of lymph channels than either particulate agent, whereas particulate agents were retained longer in nodes and demonstrated more nodes in delayed images than in early images. All agents demonstrated lymph channels better in early images than in delayed images. In general, variations between patients exceeded differences between agents. Sentinel nodes could not be distinguished reliably from nonsentinel nodes in delayed images alone. CONCLUSION: All three agents are acceptable for cutaneous lymphoscintigraphy, but reliable identification of sentinel nodes and their afferent lymph channels requires early imaging. Delayed imaging or localization alone is unreliable and may lead to incorrect identification of the sentinel node.

Female↗
PubMed1996

PET scans of abdominal malignancy.

Positron emission tomography (PET) with fluorine-18-2-d-deoxyglucose (FDG) currently is being integrated into clinical oncology because it provides unique functional information that can be applied to the management of cancer. In particular, it is useful for assessing tumor activity and growth, evaluating efficacy of therapy, and detecting tumor recurrence. Studies have demonstrated the value of whole-body PET-FDG imaging when staging and managing abdominal malignancy.

Abdominal Neoplasms↗
PubMed1986

The lung as a metabolic organ.

Recently, the lung has received increasing attention as a metabolic organ. In this role, the lung modulates the composition of the arterial blood by several mechanisms: removing active substances from the plasma, releasing substances into the plasma, temporarily holding substances from circulation, and activating or inactivating substances that pass through the lungs. In this report, the procedures proposed by different investigators for in vivo noninvasive assessment of the lung metabolic functions are reviewed. Most procedures are based on an estimation of the clearance of plasma amines by the lung endothelial cells. This clearance is assessed by measuring the lung uptake or the extraction fraction of an intravenously (IV) injected radiolabeled amine. Our own procedure, which assesses the number of free pulmonary endothelial amine receptors, is discussed in detail. In our procedure, the number of receptors was computed using the number of injected molecules of amine and determining the lung extraction fraction of the amine during its first pass through the lungs. In goats, using N-isopropyl-p-iodoamphetamine labeled with 123I as the radiopharmaceutical, the total number of endothelial lung amine receptors was found to be 1.589 X 10(20). The methods for studying the lung metabolic functions, which are discussed in this report can be applied in humans to evaluate either physiological or pathological conditions.

Amines↗
PubMed1986

Effect of region of interest selection on first-pass radionuclide cardiac output determination.

In principle, region of interest (ROI) selection should not affect the measurement of cardiac output by the first-pass technique with a radioactive intravascular indicator. Clinical application of the method requires that this theoretical hypothesis be tested. Sixty-eight left anterior oblique first-pass studies were acquired with a scintillation camera and computer using red blood cells labeled in vitro with 99mTc. Calculated mean cardiac output varied in the following order with respect to ROI: lung greater than right heart greater than left ventricle greater than whole heart (both ventricles) greater than aorta. Similar variations were observed in patients both with and without valvular regurgitation. Regions of interest over left ventricle or whole heart yielded the best correlations with cardiac output by thermodilution (r = 0.96, 0.95, respectively, n = 28) as well as the smallest interobserver variations (r = 0.994, 0.995, respectively, n = 33). First-pass studies with [99mTc]red blood cells labeled in vitro can yield accurate, reproducible determinations of cardiac output provided that the effect of ROI selection is recognized and that regions are properly selected.

Adolescent↗
PubMed1984

Measurement of metabolic extraction of tracers in the lung using a multiple indicator dilution technique.

Selective pulmonary uptake of many natural and synthetic substances has been demonstrated by physiologists and pharmacologists using isolated perfused lung preparations or invasive techniques. It is difficult, however, to relate these laboratory studies to disease processes and to the study of problems encountered in a clinical environment. Our goal was to develop a noninvasive method for studying the pulmonary uptake of tracer substances using available radiotracers, gamma cameras, and computers that would give information similar, if not identical, to that from the invasive laboratory methods, and that could be applied in a clinical setting. The multiple-indicator dilution technique, modified for external counting, is well suited for such studies of pulmonary uptake of tracer substances. In this study, Tc-99m micro sulfur colloid (Tc-99m micro SC) was used as an intravascular reference tracer, N-isopropyl-p-[123I]iodoamphetamine (I-123 IMP) as a cellular test tracer amine, and In-111 DTPA as an extracellular tracer. Calculated first-pass lung uptakes of I-123 IMP and In-111 DTPA were 0.92 +/- 0.04 and 0.17 +/- 0.04, respectively, relative to the reference tracer. Using this approach, the first-pass pulmonary extraction of a variety of radiolabeled test tracers can be measured in a clinical environment in a variety of physiologic settings.

Amphetamines↗
PubMed1980

Immediate renal imaging and renography with 99mTc methylene diphosphonate to assess renal blood flow, excretory function, and anatomy.

99mTc methylene diphosphonate (99mTc MDP) was evaluated as a clinical renal imaging agent in 20 patients referred for bone scintigraphy. Sequential scintigraphy, which was started immediately after injection, yielded blood flow studies of high quality, and subsequent images accurately delineated renal anatomy and excretion in nonazotemic patients. In comparison with delayed images, early images were vastly superior in quality and demonstrated improved target-to-nontarget activity ratios(p less than 0.001) and improved lesion detectability (p less than 0.01). Renal imaging performed incidental to bone scintigraphy with MDP can be greatly enhanced by initiating sequential scintigraphy immediately after injection.

Adolescent↗
PubMed1978

Ventricular visualization on brain scan with intracranial hemorrhage in disseminated phycomycosis.

Infections with fungi of the class Phycomycetes result in distinctive tissue changes characterized by growth of hyphae in and around blood vessels, causing necrosis and hemorrhagic infarction of tissue. A brain scan on a patient with a phycomycotic intracranial aneurysm demonstrated ventricular visualization at a time when there was clinical and autopsy evidence of rupture of the aneurysm.

Brain↗