[Possibilities of radionuclide methods of investigation in the diagnosis of intracardiac foci of infection].
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Biomedical subjects
Publications and source records attributed to N P Fadeev.
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The radionuclide investigation was performed 1-3 and 24 hours after injection of a radiopharm preparation and included the single photon emission computed tomography of the heart and scintigraphy of the whole body. Inflammation foci were found on the scans as hyperfixation foci of autoleukocytes labeled with 99mTc-HMPAO (hexamethylpropilene aminooxime). Four patients had abscesses with 0.8-1.5 cm diameter in projection of the aortal and mitral valves of the heart, and in 10 patients there were foci of inflammation and suppuration of extracardiac localization (in the area of the operation wound, anterior mediastinum, frontal sinuses, transverse colon, parietal pleura). The data obtained convincingly speak of high sensitivity and specificity of radionuclide diagnostic methods with the help of labeled elements of the whole blood in recognizing latent inflammatory and suppurative processes in cardiosurgical patients at the pre- and postoperative periods.
The level of accumulation of sphingomyelin liposomes with 67-Ga-labelled aqueous phase in tumor tissue proved higher than that of the vesicles with labelled lipid phase. Presence of cholesterol in sphingomyelin liposome membranes failed to influence liposome accumulation in tumor tissue. Neutral sphingomyelin vesicles with 67-Ga-labelled aqueous phase offer promise in scintigraphic imaging of tumors.
The paper is concerned with the results of experimental investigations to develop methods for obtaining 99mTc and 67Ga-labeled liposomes, possessing tumor-tropic properties. Sphingomyelin vesiculae, labeled with 67Ga with the help of bifunctional chelates, were shown to possess a high level of hyperfixation. A study of biodistribution of these liposomes in rats with Plis lymphosarcoma showed that the level of accumulation of 67Ga-liposomes was enough to obtain a clear scintigraphic tumor image.
A study was made of the distribution of 125I (a chloramine method of labeling) monoclonal antibodies to the surface antigen Ly 2.1 of T-lymphocytes during action of immunomodulators (tactivin, hydrocortisone, tactivin administered after hydrocortisone) on ACR mice. These antibodies were shown to retain antigen binding capacity, permitting monitoring of the redistribution of the antigen in the body exposed to immunomodulators.
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A study was made of the biodistribution of 125I-labeled (chloramine, lactoperoxidase and iodogen tracer methods) monoclonal antibodies to free lambda and kappa chains of human immunoglobulins (Bence Jones proteins) using experimental models: ACR mice with a depot of antigen in the muscular tissue. Labeled MAB were shown to preserve their immunological properties. The results of investigation into biodistribution helped to reveal selective accumulation of radioactivity in the antigen depot (Bence Jones protein).
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The data on a complex radionuclide examination of veins of lower extremities carried out in the course of diagnosis of phlebothrombosis in cases of cancer of cervix uteri are presented. Radionuclide measurements with 125I-fibrinogen were carried out for diagnosis of venous thrombosis in lower extremities in 38 surgical patients and the signs of thrombosis were identified in 8 cases (21.1%). Phleboscintigraphy using 99mTc-labeled MAA was performed in 18 patients in order to preoperatively evaluate the status of deep veins of the lower extremities. In cases of symptoms of venous disease, phleboscintigrams showed such pathological features as construction or dilation of veins, foci of accumulated 99mTc-labeled MAA and collateral blood flow.
A study of 115 lung cancer patients has shown that indications to the use of multi-modality gammascintigraphy or its separate variants are as follows: the presence of the clinical manifestations of distant metastases, data on a considerable local dissemination of a primary tumor to the lungs, poor differentiation by the histological structure.
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Clinical estimation is given of indirect isotope lymphoscanning, performed by intrapulmonary administration of Au-198, for diagnosing lung cancer metastases. The method enables obtaining scannographs of intrathoracic lymphnodes and also, based on the changes in scannograms, judging the presence of lymphogenic metastases. Lymphoscanning is a technically feasible and safe method, it provides comparatively large information for diagnostic purposes and may occupy an important place among other diagnostic technics for ascertaining the extent of lung cancer proliferation.
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Scannograms of the thyroid in 138 patients were analysed. Scanning of the thyroid is a valuable diagnostic adjunct, but it should be performed on definite indications. The scannogram pattern in malignant neoplasms of the thyroid is dependent on morphological features of a tumor, size and localization of a tumor node in the gland thickness. But scanning is found to be of no decisive value in establishing the differential diagnosis between benign and malignant neoplasms of the thyroid. Isotope scanning of the thyroid proves to be a largely informative method of examination in patients previously subjected to thyroid surgery, since it suggests an idea of the extent of the operation performed and of the remaining gland tissue bulk. Scanning technic seems to be of importance in recognizing the ectopic thyroid tissue and neoplasms arising from it.
The potentialities of pneumoscintigraphy (its perfusion and inhalation variants) were estimated to assess the state of the broncho-vascular system in 35 patients, subjected to radiotherapy for lung cancer. It was found that nearly all patients with bronchial cancer showed an impairment of the perfusion and ventilation which was dependent on tumor localization and the degree of its local-regional proliferation. Studies on the pulmonary blood flow and ventilation in these patients during radiation treatment have demonstrated in most of them restoration of the involved bronchus drainage function, while in a half of the patients, in whom some regression of the tumor process was revealed roentgenologically, no improvement of the perfusion was noted. Also, it is stated that perfusion scanning is of great importance in estimating the efficacy of radiotherapy for regional metastases.