99mTc-sestaMIBI breast scintigraphy.
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Breast Neoplasms↗
Biomedical subjects
R Danieli
Publications and source records attributed to R Danieli.
Immunoscintigraphy with a technetium-99m labelled anti-epithelial growth factor receptor antibody in patients with non-small cell lung cancer.
BACKGROUND: A variety of human tumours, including non-small cell lung cancer, overexpress epithelial growth factor (EGF) receptors. In this study we evaluated the feasibility of immunoscintigraphy with a technetium-99m-labelled monoclonal antibody directed towards the EGF receptor (MINT5). MATERIALS AND METHODS: The labelling with technetium-99m was performed using the glucoheptonate-iminothiolane method. Eight patients with non-small cell lung cancer were i.v. injected 740 MBq of MINT5. Neither side-effects, nor toxicity, nor HAMA response were observed. Each patient was submitted to total body planar images in anterior and posterior projections at 1-2 hours and at 4-6 hours after the injection. RESULTS: Uptake of MINT5 was mainly visible in liver, spleen and bone marrow; it proved stable in vivo. The primary lung cancer was imaged in 7 out of 8 patients and metastases were detected in 3 out of 3 cases. CONCLUSION: MINT5 is a safe and promising radiopharmaceutical for in vivo localization and biological characterization of non-small cell lung cancer.
Aged↗
[Suicide in adolescents: the possibilities of prevention].
The survey of the epidemiologic data points out that suicide among adolescents is, as a matter of fact, a social emergency all over the world. This phenomenon is dramatically topical in our country too. The authors sum up the present knowledge about both risk and precipitating factors relating the suicide dynamics with particular references to potential prevention strategies. With regard to this specific issue they underline the predominant role played by pediatricians in both social and medical field.
Adolescent↗
[Prediction of outcome in critically ill patients using haemodynamic and oxyphoretic parameters].
OBJECTIVE: To find a predictive model for short time mortality and survival of haemodinamically instable patients. DESIGN: Prospective study on two consecutive series of critically ill patients admitted to ICU. SUBJECTS: 115 critically ill patients, subdivided in two series of 83 (47 survivors and 36 non survivors after 20 days from admission) and 32 patients (19 survivors and 13 non survivors), respectively. INTERVENTIONTS: All the patients have been monitored with a Swan-Ganz catheter. MEASUREMENTS: Oxyphoretic parameters were measured at 7 different times (T): T0 (start), T1 (after 12 hours from T0, T2 (24 hrs), T3 (48 hrs), T4 (72 hrs), T5 (96 hrs) and T6 (120 hrs). A total number of 401 recorded values of the first patients' series were used to create the predictive model for outcome (0 non survivors, 1 survivors). Stepwise logistic regression was used to create the model. Model calibration and discrimination was assessed. The model was validated using data collected from the second series. RESULTS: The probability of survival after 20 days was Pr (survive) = e(logit)/1+e(logit), with "logit" = -5,106+(-6,58E-02 SVI)+(-2,76E-03 SVR)+(0,1379 LVSWI)+(0,8933 Hb)+(-3,25E-02 VO2I)+(9,09E-02 O2ER)+(-7,89E-02 SHUNT)+PAT. For medical patients PAT = -0.568; for surgical patients PAT = -1.0525 and for politrauma PAT = 1.593. Goodness-of-fit test showed a good calibration: chi 2 = 4.267, p = 0.832. The area under the ROC curve was 0.831. The model used in the validation data set, with 199 recorded values, also showed a good calibration and discrimination (Goodness-of-fit test: chi 2 = 15.65, p = 0.111; area under the curve 0.798). CONCLUSIONS: The mathematical model we found has been validated also in the second series and the discrimination capability increases with time. Using this model we can evaluate the probability of survival at every time. Its application at different times permits a better evaluation of haemodynamically instable patient trend.
APACHE↗
Technetium-99m sestamibi imaging in the detection of axillary lymph node involvement in patients with breast cancer.
BACKGROUND: The status of the axillary lymph nodes is the most important prognostic factor in breast cancer, and the findings of axillary node dissection remain the gold standard for the patients staging and prognosis. The aim of this study was to evaluate the usefulness of Tc-99m sestamibi scintigraphy in the detection of axillary node involvement. MATERIALS AND METHODS: Forty-nine patients (age range: 32-72 years) with breast cancer were studied. Dynamic images (1-20 minutes post-injection of the radiopharmaceutical) followed by multiple planar views and tomographic images were performed. Final diagnosis was achieved by histology after surgery. RESULTS: Metastatic axillary lymph node involvement was present in 21 patients: sensitivity was 81% (17/21) for tomographic and 61.9% (13/21) for planar images; specificity was 92.9% (26/28) and 96.4% (27/28), respectively. CONCLUSIONS: Tc-99m sestamibi imaging is a promising noninvasive method to detect axillary node metastases in patients with breast cancer, tomography appears more sensitive than planar views.
Adult↗
Scintimammography with technetium-99m tetrofosmin in suspected breast cancer.
BACKGROUND: Scintimammography with Tc-99m sestamibi has recently demonstrated a clinical usefulness in the evaluation of patients with breast lesions. The aim of this study was to assess the potential role of scintimammography using Tc-99m tetrofosmin in the detection of breast cancer. MATERIALS AND METHODS: Fifty-five patients (age range: 33-76 years) with suspicious breast abnormalities detected by mammography, and ten controls were examined. Dynamic images (1-20 min post-injection of the radiopharmaceutical) followed by three planar views were performed. Final diagnosis was achieved by hystology after surgery or excisional biopsy. RESULTS: A total of 59 breast lesions were considered. The sensitivity of Tc-99m tetrofosmin scintimammography for detection of primary breast cancer was 93.1% (27/29) and the specificity was 93.3% (28/30). No focal uptake was observed in both breasts of the control population. CONCLUSIONS: Tc-99m tetrofosmin scintimammography has high diagnostic accuracy in detecting breast cancer and may have a clinical role as complement to conventional mammography.
Adult↗
A three center study on the diagnostic accuracy of 99mTc-MIBI scintimammography.
In order to assess specificity and sensitivity of the prone scintimammography (PSM) in a large series with 99m-Tc MIBI, we performed a three-center study; 420 patients were studied; after mammography all the patients were submitted to PSM and biopsy and/or operation. PSM was considered positive if hot spot within the breast was observed. In palpable masses sensitivity was 0.98 and specificity 0.89, non palpable masses showed a sensitivity of 0.62 and a specificity of 0.91. When the cancers were stratified for T category the sensitivity was 0.28 in T1a 0.26 in the group of T1a carcinomas, 0.56 in T1b 0.95 in T1c and 0.97 T2 tumors. Physical factors such as attenuation. Compton scattering from chest, as well as biological factors have a role in breast tumor imaging. In the tumors smaller than 1 cm biological factors are probably involved too.
Adult↗
Single photon emission computerized tomography increases the sensitivity of indium-111-pentetreotide scintigraphy in detecting abdominal carcinoids.
Somatostatin (sms) receptors have been identified in carcinoids (c), so enabling their visualization with 111In-pentetreotide scintigraphy. The aim of this study was to evaluate if single photon emission computerized tomography (SPECT) can increase the sensitivity of sms receptor scintigraphy in the detection of abdominal c. 26 patients (pts) with a present, or previously operated, abdominal carcinoid were submitted to SPECT over the abdomen and multiple planar views after the injection of 111In-pentetreotide. Magnetic resonance imaging and computed tomography were also performed. In 19 pts abnormal sites of uptake were found by SPECT which localized 13 abdominal extrahepatic (in 11 pts) and 45 hepatic lesions (in 15 pts). No pathologic accumulation was seen in 7 pts in complete remission after surgery. Planar images visualized 7 abdominal extrahepatic (in 6 pts) and 26 liver tumor sites (in 10 pts), conventional procedures detected 5 abdominal extrahepatic (in 4 pts) and 36 hepatic lesions (in 10 pts). 111In-pentetreotide SPECT is more sensitive than planar scanning and conventional methods to detect abdominal c, and so may play a major role in the early and accurate mapping of tumour spread.
Abdominal Neoplasms↗
111In-pentetreotide detection of gastrinoma before and after surgery.
Eighteen patients with Zollinger-Ellison syndrome were studied with 111In-pentetreotide SPECT in order to localize gastrinoma, the tumour responsible for this pathology. NMR imaging was also carried out. Eight patients were operated. 111In-pentetreotide was reinjected 4 hours before operation and the radioactivity of the excised tumours counted. The nature of the withdrawn tissues was assessed by immunohistochemistry (chromogranina A). The scintigraphy was repeated 3-6 months after surgery. 111In pentetreotide SPECT was more sensitive than NMR. It was also absolutely specific because all the radioactive tumours excised showed positive chromogranin A staining. The radioactivity/gram counted in gastrinomas exceeded 10 fold the hepatic and biliary radioactivity and 20-100 folds the radioactivity of blood and omentum. In all the operated patients but three, the scintigraphy performed after surgery did not detect tumours. However complete eradication did not occur, because though 3-6 months after surgery the gastrinemia was significantly lower with respect to pre-surgery results it did not return to normal values in all patients but two.
Chromogranin A↗
In vivo study of a technetium labelled anti-EGFr MoAB.
Epithelial Growth Factor receptors (EGFr) are normally present in all the epithelial cells, but their overexpression is closely related to presence of cancer. We have raised EGF-competitive antibody against EGFr and have labelled it with 131I and technetium. The ability of this antibody to bind to A431 cells to be internalized has been tested on A431 cells cultures. Its ability to give scintigraphic images of epithelial tumors has been tested on nu/nu balb c mice xenografted with A431 cells. The labelled antibody is well internalized by cultured cells. Xenografted tumors are clearly imaged both by 131I and 99mTc anti EGFr Mo/Ab. 99mTc labelling is very interesting. The tumor/background ratio was 0.72 +/- 0.2 for 99mTc and 0.40 +/- 0.6 for 131I labelling. Moreover very high uptake of 99mTc MoAb was obtained 2 hours after injection whereas the 131I antibody required 24 hours.
Animals↗