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Biomedical subjects

G N Ege

Publications and source records attributed to G N Ege.

At least 19 recordsLinked to original sources
PubMed1988

Magnetic resonance imaging, computed tomography, and radionuclide scintigraphy in detection of liver metastases.

A series of 100 patients with suspected hepatic metastases was studied with magnetic resonance (MR), unenhanced computed tomography (CT), and radionuclide (RN) scintigraphy. Each set of images was read by three clinicians using a five-point scale to allow receiver operating characteristic (ROC) analysis using truth data derived from clinical review. Performance was measured by the areas under the ROC curves (0.940 +/- .018 for MR, 0.951 O +/- .013 for CT and 0.943 +/- .013 for RN) which were statistically not significantly different. We conclude that at their present level of development these three diagnostic examinations have equivalent performance and that MR is not superior in the detection of hepatic metastases.

Evaluation Studies as Topic↗
PubMed1986

Prognostic value of axillary lymphoscintigraphy in breast carcinoma patients.

Axillary lymphoscintigraphy (AxLS) with bilateral interdigital injection of [99mTc]antimony sulfide colloid carried out concurrently with internal mammary lymphoscintigraphy in 488 patients with breast carcinoma was evaluated. Patterns of radiocolloid distribution within the ipsilateral axilla and supraclavicular fossa were compared with similar features on the contralateral side to determine whether image characteristics are significantly disrupted by prior surgery, reflect the presence of metastases, and can predict treatment failure. Interpretive criteria for AxLS were refined after correlation of the identified image components with clinical parameters including axillary surgery, lymph node histology and relapse within a follow-up period of 2 years from the study. Results indicate that AxLS is at least as accurate as clinical assessment and provides data predictive of relapse to complement axillary lymph node status although the technique cannot presently replace lymph node sampling for patient staging.

Adolescent↗
PubMed1985

Determination of depth distribution of internal mammary lymph nodes on lateral lymphoscintigraphy.

A method using a calibrated ruler for measuring lymph node depth on lateral lymphoscintigrams is described. The accuracy of the method was confirmed with a plexiglass phantom. At the time of internal mammary lymphoscintigraphy, lateral images were obtained in 201 patients. A total of 545 lymph nodes were visualised and categorised into 13 depth intervals. The average lymph node depth was 3.0 +/- 1.1 cm with a range of 1.0-7.1 cm. Average lymph node depth was classified according to body weight with an average depth of 2.5, 3.1 and 3.7 cm for patients weighing less than 60, 60-75 and more than 75 kg, respectively. Lateral lymphoscintigrams demonstrated normal anatomical communication between internal mammary and anterior mediastinal lymph nodes in 3.5% of patients.

Breast↗
PubMed1985

Internal mammary lymphoscintigraphy in the conservative management of breast carcinoma: an update and recommendations for a new TNM staging.

The results of internal mammary lymphoscintigraphy (IML) in 524 patients with breast carcinoma who underwent partial mastectomy, with or without axillary dissection, demonstrate the predictive value of an abnormal lymphoscintigram. There was a significant difference (P less than 0.0005) in actuarial survival between patients with normal and abnormal IML. In view of the increased mortality associated with metastases to both internal mammary and axillary lymphatics compared with involvement of either site alone, and the most favourable outcome in patients with involvement of neither site, it is proposed that the current TNM staging for breast carcinoma should henceforth include the status of internal mammary lymph nodes determined by radiocolloid lymphoscintigraphy. Further refinement of the N status into NA (axilla) and N1 (internal mammary nodes) is suggested. Stages I, II, and III should designate, respectively, patients with no evidence of involvement of either lymphatic site, patients with involvement of one or the other site and patients with involvement of both sites. This would constitute a more rational approach to the staging and management of the patient with breast carcinoma and would also provide a more accurate means of evaluating the true efficacy of current strategies in comparable groups of patients. Unrecognised internal mammary lymphatic metastases have probably confounded the results of past prospective trials.

Actuarial Analysis↗
PubMed1985

Comparison as a lymphoscintigraphic agent between 99Tcm dextran and 99Tcm antimony sulphide colloid.

To determine its suitability as a lymph node imaging agent, 99Tcm dextran (99TcmDx) was compared with 99Tcm antimony sulphide colloid (99TcmSb2S3) in rabbits and dogs. In two groups of five rabbits each, absorption from the interstitial injection site, popliteal lymph node sequestration and total body uptake and distribution of both agents were determined. In three dogs, both agents were studied simultaneously, 99TcmDx and 99TcmSb2S3 being injected into the left and right hind feet respectively; therefore, only popliteal lymph node sequestration and image qualities were evaluated. Uptake curves in the rabbits indicated that total body uptake of 99TcmDx is faster and greater than that of 99TcmSb2S3. In spite of rapid lymph node uptake rates, total popliteal lymph node sequestration of 99TcmDx is significantly lower than that observed for 99TcmSb2S3. While lymph node uptake of 99TcmDx in dogs is higher than in rabbits, disparity between the two agents persists and is demonstrable in the image in both species. Reduced lymph node sequestration of 99TcmDx may result from its non-colloidal nature as well as its instability, both of which render this agent unsuitable for imaging pathological features of lymph nodes although its rapid absorption and distribution may be ideal characteristics for the study of lymphatic kinetics.

Animals↗
PubMed1984

The relevance of internal mammary lymphoscintigraphy in the management of breast carcinoma.

The incidence, implications, and significance of an abnormal internal mammary lymphoscintigram (IML) in 981 breast carcinoma patients without histologic or clinical evidence of axillary metastases is reported. A 13%-16% incidence of parasternal abnormality in patients with early, operable disease correlates well with clinical data. The statistically significant increase, with P consistently less than or equal to 0.005, in incidence of local or distant relapse associated with an abnormal IML when compared to the normal IML emphasizes the value of the procedure as a marker. These results indicate that patients with negative axillae but an abnormal IML should be considered to have stage II disease and should be offered adjuvant therapy. The significance of the IML in determining the true extent of disease in patients with apparent local relapse as well as the prognostic implications of an abnormal IML in 311 patients seen initially with recurrent breast carcinoma is also reported.

Actuarial Analysis↗
PubMed1983

Lymphoscintigraphy--techniques and applications in the management of breast carcinoma.

Radiocolloid lymphoscintigraphy is a versatile, simple technique which has been utilized extensively in the assessment of lymphatic function and structure in anatomic regions accessible to neither clinical examination nor radiocontrast lymphography, as well as in circumstances where radiocontrast lymphography is not feasible. The most important requirement for an effective study are: (a) Determination of the appropriate injection site for reproducibly visualizing the majority of the lymphatics under study and, (b) use of an agent with the optimum properties of a preformed small, uniform, well-dispersed particle colloid. Multiple applications of lymphoscintigraphy in the patient with breast carcinoma have demonstrated its value in distinguishing abnormalities of the internal mammary lymphatics shown to have significant prognostic implications, in providing accurate localization of the parasternal lymphatics for radiation therapy and its potential for determining the status of axillary lymphatics in lieu of surgical intervention. The following review is based on an experience of over 6500 studies in 5550 patients with breast carcinoma.

Antimony↗
PubMed1983

Predicting nodal metastases in breast cancer by lymphoscintigraphy.

In a prospective trial, 89 women with breast lumps underwent bilateral axillary and internal mammary lymphoscintigraphy preoperatively, using technetium-99m antimony sulfide colloid. All scans were interpreted blindly by three separate observers. Breast biopsy was then performed; if the biopsy specimen showed malignant tumour, definitive therapy was performed with axillary dissection. The interpretation of the axillary and internal mammary lymphoscintigrams was subsequently compared with the histologic assessment of the axillary nodes. Of the 89 women, 54 had benign disease and 35 had cancer. The internal mammary lymphoscintigram was considered to show abnormality in only 1 of the 54 patients with benign disease. One patient with cancer was eliminated from the review. Sixteen of the remaining 34 patients had axillary node metastases. Of these, 8 had an abnormal internal mammary lymphoscintigram. Only 2 of the 18 patients with cancer but no axillary metastases had an abnormal internal mammary lymphoscintigram. One bilateral axillary lymphoscintigram in the 54 patients with benign disease was discarded for technical reasons. The axillary lymphoscintigram was accurate in 52 of the remaining 53 patients. Two such scintigrams in the 35 patients with breast cancer were discarded for technical reasons. The axillary lymphoscintigram indicated abnormalities in 12 of 16 patients with axillary nodal metastases but appeared normal in 13 of 17 patients without axillary metastases. Lymphoscintigraphy may play a valuable role in the staging of breast cancer in the future.

Antimony↗
PubMed1983

Effects of a metastatic (13762) and nonmetastatic (R3230AC) mammary adenocarcinoma on radiocolloid localization in regional lymph nodes in Fischer 344 rats.

Effects of a metastatic and nonmetastatic tumor on radiocolloid localization in regional lymph nodes in the rat were studied in order to examine further the hypothesis that suppression of radiocolloid uptake results from inhibition of macrophage phagocytic function by tumor products. On the basis of data obtained in the present model using homogenates of autologous spleen and two weakly immunogenic tumors introduced into the foot pad of rats, it is proposed that decreased radiocolloid uptake induced by a regional neoplasm may result from proliferation of nonphagocytic cellular elements within the regional lymph nodes and alterations in the cell population at the site of radiocolloid injection, which impede the transport of interstitially administered radiocolloid and its access to phagocytic macrophages, within primary and secondary regional lymph nodes. In its inception, therefore, suppression of radiocolloid uptake is not unique to neoplasia and may not directly reflect altered phagocytosis.

Adenocarcinoma↗
PubMed1982

Internal mammary lymphoscintigraphy in the assessment of patients with ovarian carcinoma.

Radiocolloid internal mammary lymphoscintigraphy (IML) was evaluated in 364 patients with ovarian carcinoma to determine the frequency of abnormalities in post-operative patients, the association between the results of the lymphoscintigram and known clinical prognostic variables, and to establish whether IML yielded predictive information independent of these variables. Results of IML showed a correlation with established clinical prognostic features and yielded independent prognostic information. The sensitivity and specificity of IML in predicting relapse are 51% and 71% respectively, indicating that a single post-operative IML does not predict relapse or freedom from relapse with sufficient accuracy to make it a clinically useful test even though it provides an independent prediction of relapse.

Adenocarcinoma, Mucinous↗