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Biomedical subjects

K Kanegae

Publications and source records attributed to K Kanegae.

At least 19 recordsLinked to original sources
PubMed1998

Accumulation of iodine-131-iodocholesterol in renal cell carcinoma adrenal metastases.

Adrenocortical scintigraphy is a useful technique for differentiating between types of nonhyperfunctioning adrenal masses. Metastatic tumors do not normally accumulate radioiodocholesterol and show discordant uptake on scintigrams. We present two patients who showed accumulation of 131I-6beta-iodomethyl-19-norcholesterol (NP59) in the adrenal metastases from renal cell carcinoma. In one patient with bilateral adrenal metastases, accumulation in the primary tumor as well as adrenal metastases was demonstrated. The adrenal metastases in both patients were resected and were histologically proven to be metastases from clear-cell renal carcinoma. Accumulation of NP59 in metastatic adrenal tumors, although a very rare finding, suggests a pitfall in the differential diagnosis of adrenal cortical tumors.

19-Iodocholesterol↗
PubMed1998

Thallium-201 scintigraphy to predict therapeutic outcome of iodine-131 therapy of metastatic thyroid carcinoma.

UNLABELLED: We studied the relationship between 201Tl uptake and the efficacy of radioiodine therapy in thyroid carcinoma. METHODS: Forty-four patients with metastases of well-differentiated thyroid carcinoma received 201Tl scintigraphy within the 2 mo before their initial 131I therapy. Patients were classified into two groups according to the tumor-to-background (T/B) ratio on the late 201Tl scan: high 201Tl uptake (T/B > or = 2.1) and low 201Tl uptake (T/B < 2.1). The therapeutic outcome was judged by the percent reduction in the tumor diameter at 6 mo after the treatment. The treatment was defined as effective when the tumor showed more than 50% reduction in the tumor diameter. The patients in whom radioiodine was ineffective were followed up to determine if the tumor showed further growth. RESULTS: Of the 44 patients, 25 had high 201Tl uptake and 19 had low 201Tl uptake. The therapy was effective in 15 patients and was ineffective in 29. All the patients in whom radioiodine was effective had low 201Tl uptake. On the other hand, 25 of 29 patients in whom radioiodine was ineffective had high 201Tl uptake. Eight patients, in whom radioiodine was ineffective despite good 131I uptake, had high 201Tl uptake. There were no significant differences in the positive predictive value and the negative predictive value for effective treatment between 201Tl scintigraphy and therapeutic dose 131I scintigraphy. Among the 25 patients in whom radioiodine was ineffective and who had high 201Tl uptake, the tumor diameter increased in 7 (28%). However, none of the tumors with low 201Tl uptake increased in size during the follow-up period. CONCLUSION: Thallium-201 scintigraphy has a high predictive value for the efficacy of radioiodine therapy in metastatic thyroid carcinoma. Thus, it is helpful in determining the indication for radioiodine therapy and it seems to be an adjunct to tracer dose 131I scintigraphy.

Adenocarcinoma, Follicular↗
PubMed1997

Thallium-201 single photon emission computed tomography as an indicator of prognosis for patients with lung carcinoma.

BACKGROUND: The uptake of thallium-201 (T1-201) in malignant tumors is associated with malignant potential (metastatic potential and proliferative activity). The grade of accumulation of T1-201 in malignant tumors may provide information regarding prognosis. METHODS: A T1-201 single photon emission computed tomography was conducted 120 minutes after intravenous injection of 111 megabecquerel of T1-201 chloride. The authors calculated the uptake ratio to evaluate the degree of T1-201 uptake in the primary tumor. This ratio was compared with survival time and other prognostic factors. RESULTS: The authors studied 152 patients (125 men and 27 women). The group of patients with the low T1-201 uptake ratio survived longer than the group of patients with the high T1-201 uptake ratio (median survival, 58 weeks vs. 33 weeks; P = 0.0138 by the log rank test). The multivariate analysis confirmed that the T1-201 uptake ratio was an independent prognostic factor for survival. CONCLUSIONS: These results suggest that the T1-201 uptake ratio provides independent and objective prognostic information for patients with lung carcinoma.

Adult↗
PubMed1997

Sequential change of BMIPP uptake with age in spontaneously hypertensive rat model.

UNLABELLED: Changes in myocardial perfusion and metabolism are often associated with myocardial hypertrophy, but there are few reports describing the serial assessment of fatty acid metabolism in hypertrophic myocardium. The aim of this study is to assess fatty acid metabolism serially in hypertrophic myocardium in spontaneously hypertensive rats (SHR) with 125I-BMIPP, a branched fatty acid analog. METHODS: SHR and Wistar-Kyoto rats (WKY) as the control were divided into 4 groups (12, 15, 18 and 51 weeks after birth). The heart was extracted 10 minutes after intravenous injection of 125I-BMIPP and 201Tl at the same time. The accumulation of each radiotracer in the myocardium was counted with a well gamma counter. In addition, 125I-BMIPP uptake was corrected by 201Tl uptake (B/T). RESULTS: The heart weight/body weight ratio was significantly higher in SHR than that in WKY (p < 0.001). In SHR, this ratio increased up to 18 weeks (12 weeks; 0.266 +/- 0.005, 18 weeks; 0.281 +/- 0.006: mean +/- SE, p < 0.05). The 125I-BMIPP uptake tended to be significantly reduced in SHR (12 weeks; 2.373 +/- 0.212, 18 weeks; 1.380 +/- 0.047; mean +/- SE, p < 0.05). Such a difference in BMIPP uptake was more evident when BMIPP uptake was corrected by Tl uptake (B/T), but no regional difference or heterogeneity of BMIPP distribution was observed in the hypertrophic myocardium in SHR. CONCLUSION: A change in fatty acid metabolism with age was observed in association with myocardial hypetrophy in this hypertensive rat model, which was well demonstrated with 125I-BMIPP and 201Tl.

Aging↗
PubMed1997

Incidence and clinical significance of linear defects ascribed to interrenuncular septa on 99Tcm-DMSA SPET.

99Tcm-dimercaptosuccinic acid (99Tcm-DMSA) planar and single photon emission tomographic images from 100 children were reviewed to analyse whether linear defects corresponding to anatomical characteristics of interrenuncular septum (IRS) could be seen. Thirty sites in 30 kidneys (20 right, 10 left) from 27 patients were determined as showing IRS. They were seen less frequently in patients less than 7 years of age. The prevalence of IRS in the patients with vesico-ureteric reflux (VUR) was not significantly different from that in the patients without VUR. The interrenuncular septum was never seen on planar images and was most clearly demonstrated on conventional coronal tomographic images. The linear defects ascribed to IRS on 99Tcm-DMSA scintigrams were of a similar incidence to that reported previously. However, IRS is still an unestablished structure, and there is no evidence that these linear defects actually correspond to the structure described as the interrenuncular septum.

Child↗
PubMed1997

Visualization of lung cancer with 99Tcm-tetrofosmin imaging: a comparison with 201T1.

We evaluated the usefulness of 99Tcm-tetrofosmin imaging in lung cancer. The study sample comprised 46 patients with lung cancer. Single photon emission tomography was conducted after the intravenous injection of 740 MBq 99Tcm-tetrofosmin and 111 MBq 201T1-chloride. We obtained an uptake ratio (counts per pixel in the lesion/counts per pixel in contralateral normal lung) for each scan to evaluate the degree of uptake in the tumour. Our results demonstrate that 89.1% of the primary lung cancers were visualized by 99Tcm-tetrofosmin and 95.7% by 201T1. The difference between the 201T1 uptake ratio and the 99Tcm-tetrofosmin uptake ratio was significantly greater in squamous cell carcinomas than small cell carcinomas (P < 0.01) and tended to be greater in squamous cell carcinomas than adenocarcinomas (P = 0.093). This study has indicated that 99Tcm-tetrofosmin, like 201T1, is a highly effective agent in the delineation of lung cancer. The difference between the 99Tcm-tetrofosmin and 201T1 uptake ratios might provide further information regarding the histological type of lung cancer.

Adenocarcinoma↗
PubMed1996

Early massive accumulation of In-111 pentetreotide in a metastatic liver tumor of islet cell carcinoma.

A 62-year-old woman was examined with In-111 pentetreotide and Ga-67 citrate. She had undergone an operation to resect a neuroendocrine tumor of the pancreas and still had masses in the liver. One of her hepatic lesions had been biopsied and acinar cell carcinoma was suspected. Fluid in the cyst of the tumor, however, contained a high concentration of gastrin and the tumor was strongly suspected of being a metastasis from the neuroendocrine tumor of the pancreas. The hepatic tumors quickly accumulated In-111 pentetreotide immediately after the injection, but there was no Ga-67 citrate uptake in the tumor. Five months after pentetreotide scintigraphy, her hepatic tumors were resected and histologically proven to be metastasis of islet cell carcinoma. In-111 pentetreotide provides information of the somatostatin-receptor status on the tumor and supports the diagnosis made by hormonal survey.

Biopsy↗
PubMed1996

Treatment of radioiodine-negative bone metastasis from papillary thyroid carcinoma with percutaneous ethanol injection therapy.

A 62-year-old woman with metastatic papillary thyroid carcinoma in the sternum was successfully treated with percutaneous ethanol injection therapy (PET) when previous radioiodine therapy and external irradiation were ineffective. The patient tolerated the treatment well and the refractory pain in the anterior chest wall that was alleviated with morphine prior to PEIT completely disappeared. No severe complications were observed. PEIT was performed 4 times (2 times with ultrasound guidance and 2 times with CT guidance). The posttreatment CT scan and 201Tl scintigraphy demonstrated significant decrease in the tumor volume. The serum thyroglobulin level fell to less than one-twentieth of the pretreatment value. It is suggested that PEIT has a value in treating bone metastasis from thyroid carcinoma which do not respond to radioiodine.

Bone Neoplasms↗
PubMed1996

The role of 201Tl scintigraphy in evaluating proliferative activity in thyroid neoplasms.

To identify the relationship between the uptake of 201Tl and the proliferative activity in thyroid neoplasms, 201Tl scintigraphy was performed in 57 patients with thyroid neoplasms. 201Tl uptake ratio was calculated in both the early and the delayed images and then compared with factors representing cellular or practical proliferative activity of the lesions. The labeling index (LI) for proliferating cell nuclear antigen (PCNA) was determined quantitatively by flow cytometry. There was a significant correlation between the uptake ratio and LI for PCNA. The correlation coefficient for the delayed ratio (DR) vs. LI was better than that for the early ratio (ER) vs. LI. As parameters for practical proliferation, the surgical stage in primary thyroid carcinoma or 131I uptake in recurrent thyroid carcinoma was focused on. DR was strongly related to these parameters, regardless of the histopathological features or size of the lesions. Our results suggest that 201Tl uptake in delayed thyroid scan is useful in assessing proliferative activity in thyroid neoplasms.

Adolescent↗
PubMed1996

Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule.

Four patients with solitary autonomously functioning thyroid nodule (AFTN; 2 toxic and 2 subclinically toxic) received ultrasonography (US)-guided percutaneous ethanol injection therapy (PEIT). The pretreatment scintigraphic appearance of the nodule was hot, and radioactivity in the extranodular tissue was completely suppressed throughout. Ninety-nine percent ethanol was slowly injected under US guidance. As a rule, the injection was performed in fractionated sessions and the treatment was repeated until the total amount of ethanol exceeded the baseline nodular volume. The therapy was successful. Complete remission of hyperthyroidism was observed among the patients with toxic nodule. The basal level of TSH and its response to TRH injection was normalized in the patients with subclinically toxic nodule. Posttreatment scintigrams revealed that the extranodular tissue recovered and radioactivity in the hot nodule had noticeably decreased. The rate of reduction in the nodular volume was more than 80% in all. There was no recurrence or development of hypothyroidism during a follow up of 10 to 23 months. The main side effect was mild and transient pain and/or a burning sensation at injection. No severe or permanent complications occurred. Although the number of our cases was small, the results suggest that PEIT is a useful program in treating AFTN.

Adult↗
PubMed1996

Quantification of renal function with a count-based gamma camera method using technetium-99m-MAG3 in children.

UNLABELLED: To evaluate renal function quantitatively without blood sampling in children, renal uptake by gamma camera renography using 99mTc-MAG3 was compared with plasma clearance by a single blood sample method as the reference. METHODS: Twenty children (15 boys, 5 girls; aged 2-14 yr) with nephrourological diseases were examined prospectively in this study. The patient received an intravenous administration of 5 MBq/kg 99mTc-MAG3 which was prepared using a commercially available kit. Gamma camera renography was performed and the renal uptake per injected dose (%RU) of the 1-min period of postinjection was calculated from a background-corrected renogram curve by computer. The plasma clearance (Clmag) of 99mTc-MAG3 was calculated by the single blood sample method at 35 min postinjection. RESULTS: The %RU of the 1-min period in the 1-3 min postinjection correlated well with Clmag. The best correlation was observed 1-2 min postinjection. The regression equation between total %RU (X) and Clmag (Y) (ml/min/1.73 m2) was Y = -98.509 + 20.373X (r = 0.910, s = 84.19) with standardization by BSA. The best fit regression equation between individual %RU (X) and Clmag (Y) (ml/min/1.73m2) was Y = -43.799 + 19.917X (p = 0.932, s = 43.27). CONCLUSION: The renal uptake method based on separate counts by gamma camera renography using 99mTc-MAG3 does not require a blood sample for quantification of renal function and may be potentially more practical in children.

Adolescent↗
PubMed1995

[Imaging of infectious and inflammatory foci using 111In-DTPA-IgG].

We performed radionuclide scanning after intravenous administration of 80 MBq of 111In-labeled non-specific polyclonal human immunoglobulin G (111In-DTPA-IgG). Serial scintigrams were acquired at 6, 24, 48, and 72 hr after injection in 10 patients suspected of having inflammation and/or infection. In 5 patients, the results of scintigraphy were verified with intraoperative cultures or biopsy. The values were as follow: sensitivity: 100% (4/4); specificity 50% (3/6); accuracy: 70% (7/10); positive predictive value: 57.1% (4/7); and negative predictive value: 100% (3/3). The results indicate that 111In-DTPA-IgG scintigraphy is certainly a promising method for the detection of inflammation and/or infection.

Adult↗
PubMed1994

[Detection and localization of parathyroid adenomas and hyperplasias in patients with hyperparathyroidism using thallium-201/technetium-99m parathyroid subtraction scintigraphy].

201Tl/99mTc subtraction scintigraphy (TTS) has been recognized as a useful procedure in the preoperative localization of hyperfunctioning parathyroid glands. Ninety-one patients suspected of hyperparathyroidism (HPT) were studied with TTS for the localization of lesions and 59 patients out of those had a neck exploration and parathyroidectomy which allowed for clinical correlation of pathologic findings with the imaging results. The weight of 30 glands of adenoma ranged 0.100 to 11.700 g (1.840 +/- 0.446 g (mean +/- SE)). The weight of 88 glands of hyperplasia ranged 0.025 to 7.000 g (0.623 +/- 0.100 g). Overall sensitivity and specificity were 47% and 54%, respectively. The sensitivity for the adenoma and the hyperplasia was 87% and 33%, respectively. The specificity for them was 57% and 52%. There was significant difference for the detection between adenomas and hyperplasias. TTS is more useful for the localizing diagnosis of parathyroid adenomas than parathyroid hyperplasia in a patient with hyperfunctioning parathyroid state.

Adenoma↗
PubMed1993

Captopril renoscintigraphy with Tc-99m DTPA in patients with suspected renovascular hypertension. Prospective and retrospective evaluation.

Sensitivity and specificity of captopril renoscintigraphy (CRS) with Tc-99m DTPA has been analyzed in 41 cases, 16 with renovascular hypertension (RVH) and 25 with non-RVH. The sensitivity and specificity of the baseline study were 63% (10/16) and 63% (12/19), respectively, based on the split renal function study in which the lower limit of normal was assumed to be 42% of the total renal uptake. Captopril renoscintigraphy yielded 67% (12/18) sensitivity and 76% (19/25) specificity. The low specificity of CRS was due to the application of a prospective criterion of the captopril-induced reduction rate (CRR) of less than -20%, which was calculated from the renal uptake before and after captopril. When criteria of CRR less than -25% were used, the specificity of CRS was improved to 96%, but the sensitivity declined to 61%. Changes in the configuration of the renogram induced by captopril also had high specificity but low sensitivity. Renovascular hypertension was most likely when criteria for both CRR and the renogram were fulfilled. These criteria often were diagnostic in patients with bilateral renal artery stenosis that showed variable scintigraphic responses to captopril challenge. Captopril renoscintigraphy is a very specific means to evaluate RVH, but may have limitations in certain clinical situations such as poorly preserved function of the affected kidney, prior long-term administration of captopril, prior surgical manipulation of stenotic renal artery, and chronic renal parenchymal damage.

Adult↗
PubMed1993

[Role of 99mTc-labeled RBC SPECT in the diagnosis of hepatic hemangioma--comparison with US, CT and angiography].

The roles of planar imaging and SPECT with 99mTc-labeled RBC, US, Dynamic CT and angiography in the diagnosis of hepatic hemangioma were evaluated. The study group consisted of 18 patients with a total of 40 hemangiomas and 13 patients with a total of 21 non-hemangiomas. Among these patients, 5 patients with a total of 8 hemangiomas and 10 patients with a total of 14 non-hemangiomas were diagnosed by operation and biopsy. In all 40 hemangiomas, sensitivity for planar imaging was 35%, SPECT 50%, US 53%, Dynamic CT 82% and angiography 81%, respectively. When the tumor size was greater than 2.2 cm by SPECT and 2.8 cm by planar imaging, their sensitivity for both methods was 100%. Specificity for planar imaging was 100%, SPECT 95%, US 81%, Dynamic CT 100% and angiography 83%, respectively. One patient with hepatocellular carcinoma diagnosed by angiography showed increased uptake on SPECT. Because of the highest accuracy for SPECT in hemangioma greater than 2.0 cm, SPECT should be considered to be the method of choice for noninvasive diagnosis of hemangioma.

Adult↗