Biomedical subjects

F Crippa

Publications and source records attributed to F Crippa.

60 records · Page 4Linked to original sources

PubMedDate not supplied

Single determination of CA 15.3 and bone scintigraphy in the diagnosis of skeletal metastases of breast cancer.

Single determination of CA 15.3 and bone scintigraphy were performed on the same day as follow-up procedures in 864 patients with breast cancer. The sensitivity and specificity of bone scintigraphy for skeletal metastases were 99% and 88.8%, respectively. The overall sensitivity and specificity of CA 15.3 (cut-off for pathological values greater than 30 U/mL) for cancer recurrence or distant metastases were 69.2% and 92.1%, respectively. The sensitivity of CA 15.3 for bone metastases was lower (69.4%) than that of bone scintigraphy. This was mainly due to the relatively high proportion of false-negative CA 15.3 levels in patients with 1-2 bone metastases (sensitivity = 33.3%). According to this result, the circulating levels of CA 15.3 showed a good correlation with tumor extension and, in patients with bone metastases, with the number of skeletal lesions. As regards the contribution of CA 15.3 to the diagnosis of bone metastases, the demonstration of elevated CA 15.3 values in patients with positive bone scintigraphy could support the diagnosis of skeletal metastases. In fact, the positive predictive value of CA 15.3 in patients with positive bone scintigraphy was significantly higher than with only bone scintigraphy (53.8%) or CA 15.3 (50.4%). Finally, very high values of CA 15.3 in patients with known bone metastases could indicate the presence of visceral metastases (mean CA 15.3 in patients with bone metastases = 125.8 U/mL; mean CA 15.3 in patients with bone and visceral metastases = 420.5 U/mL).

Adult↗

PubMedDate not supplied

[131I]metaiodobenzylguanidine therapy in paraganglioma.

Our experience with [131I]metaiodobenzylguanidine (131I-MIBG) therapy in a 10 year old boy is reported. At disease onset, in May 1988, this boy presented a large mass in the upper left abdominal quadrant, which was resected with a histopathological diagnosis of extra-adrenal malignant pheochromocytoma (paraganglioma). He subsequently underwent two further surgical resections and chemotherapy. When 131I-MIBG therapy was started, in June 1990, skeletal and abdominal metastases were present. These localizations were revealed by 131I-MIBG scans and confirmed by x-ray examination. At present 6 courses of therapy have been performed with a cumulative activity of 29.6 GBq. Side-effects have been limited to vomiting and mild thrombocytopenia, lasting 2 weeks during the second course of therapy. After 15 months of therapy, a progressive reduction of MIBG uptake, coupled with a stabilization of the lythic lesions, has been observed.

3-Iodobenzylguanidine↗

PubMedDate not supplied

Clinical value of radioimmunoscintigraphy in the follow-up of ovarian carcinoma: a prospective study.

Twenty-five patients treated with debulking surgery and chemotherapy for ovarian cancer were prospectively studied to evaluate the efficacy of radioimmunoscintigraphy (RIS) in detecting residual tumor before second-look surgery. RIS was performed with the monoclonal antibody OC125 F(ab')2 labelled with I-131 without knowledge of clinical data and compared with subsequent surgical results. Second look showed tumor persistence in 12 patients, mostly characterized by small lesions. The overall diagnostic sensitivity of RIS was 50% and the specificity was 85%. In particular, RIS showed better sensitivity for pelvic tumor localizations than for abdominal sites (73% vs 33%); this was due to the inability of RIS to detect upper abdominal lesions. Therefore, our conclusion is that, at present, RIS cannot substitute surgical second-look in the management of ovarian cancer, however, considering that also ultrasonography, computer tomography and magnetic resonance are not always able to give definite diagnostic evidence in the follow-up of ovarian carcinoma, RIS could be added to these procedures to balance the limitations of each method. In this regard, the best application of RIS could be in the follow-up of patients with marker elevation without clinical evidence of disease, especially in the case of pelvic fibrosis or adhesions due to previous therapy, where the other non-invasive tools can give doubtful diagnostic results.

Adult↗

PubMedDate not supplied

Thymidine kinase (TK) activity as a prognostic parameter of survival in lymphoma patients.

ATP-thymidine 5'-phosphotransferase (TK) is a cellular enzyme involved in DNA synthesis, activated during the G1/S phase of the cell cycle. Elevated TK serum levels can be found in cancer patients due to the active proliferation of tumor cells. TK serum activity was tested by a radioenzymatic technique (Prolifigen TK REA, Sangtec Medical, Sweden) based on the conversion of 125 I deoxyuridine to 125 I deoxyuridine monophosphate. A total of 181 patients were enrolled in this study: 133 lymphomas (Hodgkin, HL and Non-Hodgkin, NHL) 48 benign diseases including acute (n = 17) and chronic inflammatory diseases (n = 13), myocardial infarction (n = 11), liver cirrhosis (n = 2), renal failures (n = 2), and diabetes (n = 3). Lymphoma patients were classified according to the Ann Arbor staging system, and 103 NHL patients were classified according to the Working Formulation histologic grade (21 low, 72 intermediate, and 10 high grade lymphomas). The patients were treated with standard chemo-radiotherapeutic protocols according to the stage and the histologic grade; the evaluation of the response to the treatments and the follow-up were performed according to the serial examinations currently used in our Institute. Given a TK cut-off of 5 U/L, the diagnostic sensitivity of TK test at lymphoma presentation was 81.8% and 75.7% in HL and NHL patients, respectively. Values exceeding 50 U/L were found only in NHL patients. The overall sensitivity of TK resulted higher than that of LDH (16.7%), copper (42.6%), IgG (23.5%), IgM (26.8%) and IgA (9.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMedDate not supplied

Prone scintimammography in patients with non-palpable breast lesions.

Non-palpable breast lesions are a clinical problem due to the low specificity of mammography and the resulting difficulty in choosing the type and extent of surgery. Twenty-four patients with non-palpable mammographic lesions underwent prone scintimammography after the i.v. injection of 740 MBq of 99m Tc-SestaMIBI (MIBI). For this purpose, we designed a special bed which allows the widest exposure of the breast to the detector and better visualisation of deep mammary tissue without interference from intra-thoracic activity. The day after the scintigraphy, all patients underwent quadrantectomy or a more limited excision. The specimens were X-rayed to check the presence of mammographic microcalcifications or opacities. All surgical specimens were histologically evaluated. The mammographic and scintigraphic findings were compared with the histological ones. Under these conditions, we observed that the MIBI scan has a good specificity (90%) but low sensitivity (50%) for this selected population. When the MIBI scan was positive, the probability of breast cancer was very high (positive predictive value of the test = 88%) as a consequence, a wider excision would be the most accurate surgical choice. On the other hand, if the MIBI scan is normal, the high number of false negative results does not allow any final diagnosis (negative predictive value of the test = 56%). The preliminary results of this work suggest that radionuclide imaging can help the surgeon in surgical planning.

Adult↗

PubMedDate not supplied

A simple and semi-automated system for increasing the recovery of aqueous [18F] fluoride from target.

A simple semi-automated apparatus is described for rinsing the transport line from the [18F] fluoride. target to the hot-cell after recovery of aqueous [18F] fluoride. The additional activity thus recovered can then be added to that previously trapped on Dowex 1X8 (CO3=) or, alternatively, diverted to a second vial for other uses such as research, PET-camera calibration or bone investigations by PET. Inclusion of the target chamber in the rinsing procedure increased the additional recovery of activity up to ca. 15%, without a noticeable effect on the isotopic integrity of the recovered [18O]H2O.

Anion Exchange Resins↗