A case of parathyroid carcinoma visualized by 67Ga citrate and 201Tl chloride scintigraphy

Both 67Ga citrate and 201Tl chloride accumulated in a parathyroid tumor of a 62 year-old woman with primary hyperparathyroidism. Histological studies disclosed that the tumor was a parathyroid carcinoma. The use of both tumor scanning agents, 67Ga citrate and 201Tl chloride to visualize parathyroid carcinoma in a patient with primary hyperparathyroidism has not been reported as far as we could determine.     

Preparation and evaluation of [<Superscript>201</Superscript>Tl](III)-DTPA complex for cell labeling

Due to interesting physical properties and wide availability of ²⁰¹Tl as a SPECT radionuclide, the incorporation of this nuclide into DTPA for cell labeling was targeted. Thallium-201 (T _1/2 = 3.04 d) in Tl⁺ form was converted to Tl³⁺ cation in the presence of O₃/6M HCl and di-isopropyl ether, controlled by RTLC/gel electrophoresis methods. The final evaporated activity reacted with cDTPA in normal saline to yield [²⁰¹Tl](III)DTPA at room temperature after 0.5 hour, followed by solid phase extraction purification using C₁₈ Sep-Pak column (radiochemical yield >95%). Radiochemical purity of more than 99% was obtained using RTLC with specific activity of about 260 GBq/mmol. The stability of the tracer was checked in the final product in the presence of human serum at 37 °C up to 3 days. The partition coefficient was also measured. The labeled compound was used in red blood cell (RBC) labeling. The cell uptake ratio was determined at 4, 25 and 37 °C up to 3 hours.     

Evaluation of additional absorbed radiation dose from radioactive impurities in radiopharmaceuticals

The additional absorbed radiation doses to total body from radioactive impurities in radiopharmaceuticals were estimated for a total of 10 samples (i.e., 99mTc generator eluates, 99mTc solutions, 67Ga, 81mKr generator eluates, 111In, 123I, 201Tl, 75Se, 197Hg, 198Au) selected from commonly used radiopharmaceuticals. The radioactive impurities in radiopharmaceuticals used in this estimation were previously identified. The radiation doses were calculated according to the MIRD procedures, assuming each radionuclide to be uniformly distributed throughout the body. In the case of the cyclotron-produced radioisotopes and 198Au, the additional total body absorbed doses from impurities were found to be rather high: 280% for 123I, 55% for 81mKr, 5% for 198Au, 4% for 111In and 2% for 201Tl. The absorbed doses due to impurities in the other radioisotopes were less than 1%.     

In vivo distributions of 111In and/or 3H labeled lymphocyte in C3H/He mouse (author's transl)

Although 99mTc and 51Cr have been used for lymphocyte labeling, these radionuclides have several disadvantages for study on immunological behaviour of lymphocyte; very high rate elution and low labeling efficiency for both radionuclides, and short half life for 99mTc. Indium-111 has quite suitable physical properties for clinical nuclear medicine, i.e. desirable photon energy (247,173 keV) and 2.8 day half life. 111In-oxine is lipid soluble and is known to pass through the cell membrane and attaches firmly to cytoplasmic component of the cell. On the other hand, 3H-thymidine is well known substance which incorporated to nucleic acid in the cell. In this study, distribution patterns of 111In-oxine and/or 3H-thymidine labeled lymphocyte in C3H/He mice were examined and the suitability of 111In-oxine labeled lymphocyte for radionuclide imaging in vivo was discussed. Thirty minutes after intravenous injection of 3H and/or 111In labeled lymphocyte, about 12% of lymphocyte were found in the lungs and rest of them were distributed mainly in the blood, kidneys and liver. After 24 hours the activity in the lung decreased markedly and the activity in the liver and kidneys increased with time. Between lymphocyte labeled with 111In-oxine and 3H-thymidine, there is not so much differences in terms of distribution patterns. From this study, it is concluded that the 111In-oxine labeled lymphocyte distributes in the same way as 3H labeled one, in spite of different labeling sites. This 111In-oxine labeling method can be used as a useful tool of radionuclide imaging in kinetic studies of lymphocyte in vivo.     

The difference between the mechanism of 67Ga accumulation and 59Fe accumulation in cultured tumor cells

It is well known that the mechanism of 67Ga accumulation into tumor cells is mediated with transferrin receptor as well as iron. The present study was designed to explore the difference between the mechanism of gallium accumulation and that of iron by using mouse leukemic cell line L5178Y. When monensin which inhibits the recycle of transferrin receptor was added to the incubated system, accumulation of 59Fe and 67Ga was clearly diminished compared with that of control. However, inhibition of 59Fe accumulation was more remarkable than that of 67Ga. Furthermore, monensin has a action of Na+ ionophore which decreases Na+ gradient between the inside and the outside of the plasma membrane. Following administration of monensin, 67Ga accumulation was diminished according to the loss of the Na+ gradient. On the other hand, following administration of valinomycin, 67Ga accumulation was not affected by the loss of the K+ gradient. From these results, it was suggested that the mechanism of 67Ga accumulation into tumor cells differed from that of 59Fe and transferrin receptor and Na+ gradient of tumor cells played an important role on 67Ga accumulation into tumor cells.     

Can a radioactive implant induced X-ray emission (RIXE) technique be used to in vivo measurement of heavy elements?

A radioactive implant induced X-ray emission (RIXE) technique was examined for the in vivo determination of heavy elements. By the use of⁶⁷Ga,^99mTc,¹²³I,¹²³Xe and²⁰¹Tl implant excitation sources, the excitation efficiency and X-ray attenuation were measured to reveal the potential pairs of source-heavy element of interest for in vivo elemental analysis by the RIXE technique. Detection limits for the RIXE in vivo analysis were evaluated according to Currie's criterion. Four pairs,^99mTc–Pb,²⁰¹Tl–I,¹³³Xe–Cd and¹²³I–Cd are potential.     

Gamma-ray spectra of 201Tl-radiopharmaceuticals with a scintillation camera--crosstalk of contaminating nuclides of 200Tl and/or 202Tl onto 201Tl-photopeaks

In cardiac imaging with 201Tl, the collimator for low energy high resolution is generally used, and also the energy window, which is set on the spectral display of a pulse height analyzer of a scintillation camera, is chosen 70 +/- 12.5 keV. The purpose of this study is to discuss those conditions in 201Tl imaging with the scintillation camera. Two types of collimators for HR (high resolution) and ME (medium energy) were used in this experiment, and we measured the pulse height spectra of 201TlCl radiopharmaceuticals in air and in a cuboid phantom, connecting a multi-channel pulse height analyzer to the scintillation camera. As a result of measuring of the pulse height spectra, two different energies of gamma rays which are not supposed to emit from 201Tl nuclide were observed, and we also identified the presence of a small amount of 202Tl (with 439 keV) and/or 200Tl (with 368 keV) from their half-life measurements. Thus, the use of the HR-collimator with 201Tl imaging is not suitable, because the shielding effects of its septa is poor to 439 keV gamma-rays, and the scattered radiation produced by the Compton interaction contributes to the principal photopeak on the pulse height spectrum. Here, we recommend the use ME-collimator instead of the HR-one, and of the window width of 76 +/- 25 keV for increasing the count rate.     

Thallium-201 chloride dynamic analysis using thallium-201 chloride and sodium iodide-131 thyroid subtraction scintigraphy

The mechanism of 201Tl chloride accumulation is unclear in thyroid gland and thyroid tumor. This report examines 108 patients that received thyroid scintigraphy examinations with both 201Tl chloride and sodium 131I. The patients were diagnosed clinically and histologically whenever possible. The ROI were obtained by subtraction imaging with both isotopes and by subtraction positive and negative areas of imaging. Dynamic curves were obtained for 201Tl chloride per square unit of each ROI. The dynamic curve in the radioiodide-accumulated area was examined. The data indicate that the clearance rate of 201Tl chloride (T15) was correlated with the sodium 131I uptake rate at 24 h (r = 0.70).     

Albumin metal interaction: A multielemental radiotracer study

Interaction of albumin with no-carrier-added metal radionuclides was studied in multielemental environment using dialysis technique. No-carrier-added ^197mHg, ^199–201Tl, ^199–200Pb, ²⁰⁴Bi and ^204,205Po were produced by irradiating Au target consecutively with ⁷Li and ¹²C beams. Similarly, ⁶¹Cu, ^66–68Ga, ^62,63Zn, ^66,67,69Ge, ^71,72As and ⁷³Se were produced by irradiating cobalt target consecutively with ¹⁶O, ⁷Li and ¹²C projectiles. These no-carrier-added radionuclides were chemically separated from the bulk target before studying their interaction with albumin. It was found that Hg and Ga strongly bind with albumin, whereas Bi, Po, As, and Se do not bind at all with albumin. The binding affinities of Pb, Tl, Cu and Zn radionuclides towards albumin are moderate.     

Development of Radiogallium-Labeled Peptides for Platelet-Derived Growth Factor Receptor β (PDGFRβ) Imaging: Influence of Different Linkers

The purpose of this study is to develop peptide-based platelet-derived growth factor receptor β (PDGFRβ) imaging probes and examine the effects of several linkers, namely un-natural amino acids (D-alanine and β-alanine) and ethylene-glycol (EG), on the properties of Ga-DOTA-(linker)-IPLPPPRRPFFK peptides. Seven radiotracers, ⁶⁷Ga-DOTA-(linker)-IPLPPPRRPFFK peptides, were designed, synthesized, and evaluated. The stability and cell uptake in PDGFRβ positive peptide cells were evaluated in vitro. The biodistribution of [⁶⁷Ga]Ga-DOTA-EG₂-IPLPPPRRPFFK ([⁶⁷Ga]27) and [⁶⁷Ga]Ga-DOTA-EG₄-IPLPPPRRPFFK ([⁶⁷Ga]28), which were selected based on in vitro stability in murine plasma and cell uptake rates, were determined in BxPC3-luc-bearing nu/nu mice. Seven ⁶⁷Ga-labeled peptides were successfully synthesized with high radiochemical yields (>85%) and purities (>99%). All evaluated radiotracers were stable in PBS (pH 7.4) at 37 °C. However, only [⁶⁷Ga]27 and [⁶⁷Ga]28 remained more than 75% after incubation in murine plasma at 37 °C for 1 h. [⁶⁷Ga]27 exhibited the highest BxPC3-luc cell uptake among the prepared radiolabeled peptides. As regards the results of the biodistribution experiments, the tumor-to-blood ratios of [⁶⁷Ga]27 and [⁶⁷Ga]28 at 1 h post-injection were 2.61 ± 0.75 and 2.05 ± 0.77, respectively. Co-injection of [⁶⁷Ga]27 and an excess amount of IPLPPPRRPFFK peptide as a blocking agent can significantly decrease this ratio. However, tumor accumulation was not considered sufficient. Therefore, further probe modification is required to assess tumor accumulation for in vivo imaging.     

Development of radiogallium–ethylenecysteamine cysteine complex as a possible renal imaging agent

[⁶⁷Ga]-ethylenecysteamine cysteine ([⁶⁷Ga]ECC) was prepared using freshly prepared [⁶⁷Ga]GaCl₃ and ethylenecysteamine cysteine (ECC) for 30 min at 90 °C (radiochemical purity ≈97 ± 0.88% ITLC, specific activity: 210 ± 5 GBq/mM). Stability of the complex was checked in human serum for 24 h at 37 °C. Partition co-efficient of the tracer in octanol:saline mixture was determined (log P; 0.8). The biodistribution of the radiolabeled compound in vital organs of wild-type rats were compared with that of free Ga³⁺ cation up to 48 h. Initial biodistribution results showed significant kidney excretion of the tracer comparable to that of homologous ^99mTc compound.     

Distribution of 67Ga-citrate in 3'-methyl-4-dimethylaminoazobenzene-induced hepatoma of rats

The distribution of 67Ga-citrate in the hepatoma of rat induced by 3'-methyl-4-dimethylaminoazobenzene was studied. 67Ga uptake ratio resected specimen, autoradiography and histological specimen were compared each other. 67Ga uptake ratio of the tumor was increased 1.6 to 7.2 times (average 4.4) to control group. Regardless of the size of the tumor, macroautoradiographically observed distribution of 67Ga-citrate in the hepatoma was higher in the peripheral zone than in the central zone. Histologically the degeneration of tumor cell was low or absent in the peripheral zone of tumor, whereas it was intense in the central zone. 67Ga-citrate was highly accumulated in the zone which the degeneration was low or absent. We, however, could not demonstrate the site where 67Ga-citrate was incorporated.     

Subtraction scintigraphy with 67Ga-citrate and 99mTc-colloid in the diagnosis of intrahepatic masses

Subtraction scintigraphy of the liver with 67Ga-citrate and 99mTc-colloid (99mTc-phytate) was performed by subtracting the image of the latter from the image of the former in 34 patients who were suspected of having intrahepatic masses, especially hepatoma. The computer used was Scintipac 1200 (32 KW memories and 2.4MBX2 disk memories). Both images were taken in a digital form (128 X 128 elements). After normalizing both images, 4 different factors (0.6, 0.8, 1.0, and 1.2) were applied to the 99mTc image before the subtraction from the 67Ga image. We found that this technique was very useful for the detection of abnormal 67Ga accumulation in the liver.     

Study of 67Ga distribution in neoplasms and in liver by a cell fractionation method]

Subcellular distribution of 67Ga was quantitatively determined to evaluate the role of lysosome in accumulation of 67Ga in malignant tumor tissue and liver. The following animals and transplanted tumors were used: rats implanted with Yoshida sarcoma and hepatoma AH109A; mice implanted with Ehrlich tumor. 67Ga-citrate were injected to the rats intravenously and to the mice intraperitoneally. Ten minutes to 48 hours after the administration of 67Ga-citrate, the animal were sacrificed, and the tumor tissues and liver were excised. Subcellular fractionation of tumor tissues and livers were carried out according to the method of Hogeboom and Schneider. Radioactivity of each fraction was counted by a well type scintillation counter, and protein of each fraction was measured according to Lowry's method. In Yoshida sarcoma and Ehrlich tumor, most of the radioactivity was localized in the supernatant fraction, and small amount of radioactivity was localized in the mitochodrial fraction (lysosome contains in this fraction). But in the liver, most of the radioactivity was concentrated in the mitochondrial fraction and the radioactivity of this fraction was increased with the passage of time after administration. Twenty-four hours later, about 50% of total radioactivity was accumulated in this fraction. In the case of hepatoma AH109A, radioactivity of mitochondrial fraction was increased with the passage of time after administration, and about 30% of total activity was concentrated in this fraction at 24 hours after administration. From these results it is concluded that lysosome doses not play an important role in the tumor concentration of 67Ga and lysosome plays an important role in the liver concentration of 67Ga. In the case of hepatoma AH109A it is presumed that lysosome plays considerably important role in the tumor concentration of 67Ga, hepatoma AH109A having some nature of liver.     

The use of liquid scintillation spectrometry as a very sensitive radioanalytical tool for the determination of alpha,beta and monochromatic electron emitting impurities in radiopharmaceutical compounds

Summary Many labeled compounds are used as radiopharmaceuticals (RP), for emission imaging and metabolic radiotherapy and contain as labeling agents γ, β^-, β⁺, monochromatic e^- and α emitting radionuclides (RN). These labeled compounds very often contain unexpected radionuclidic impurities. Some long-lived isotopic and non-isotopic impurities lead to undesirable radiation doses to the patient and his relatives, as well as to medical/paramedical personnel, other than the general population, due to rad-waste of contaminated specimen and excretion of biological fluids. Use was made of liquid scintillation counting/spectrometry (LSCS) for the detection of tiny amounts of charged particle emitting impurities in RPs labeled with ⁶⁴Cu, ⁶⁷Ga, ⁹⁰Y, ⁹⁰Sr/⁹⁰Y, ¹²³I, ¹⁵³Sm, ¹⁷⁷Lu and ²⁰¹Tl.     

Clinical significance of 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) in the diagnosis of intrahepatic masses

Hepatobiliary scintigraphy with 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) was carried out on 48 patients with intrahepatic masses, 44 with hepatocellular carcinoma and one each of hepatocellular adenoma, focal nodular hyperplasia, cholangiocellular carcinoma, and adenoid cystic carcinoma. Scans were performed twice, early scan (30 min post i.v.) and delayed scan (2.5 h post i.v.), and the delayed scan was used for assessing the accumulation of 99mTc-PMT in the intrahepatic masses. In the hepatocellular carcinoma group, based on individual patients, 17 out of 44 (38.6%) showed accumulation of 99mTc-PMT in various degrees; and based on individual masses, accumulation was noted in 21 out of 55 masses (38.2%). However, only the cases which had not received transarterial infusion of anti-cancer drugs (TAI) and/or blocking agents (TAE) were taken into consideration, 9 out of 18 patients (50%) and 12 out of 25 masses (48.0%) were found capable of picking up 99mTc-PMT. A case of hepatocellular adenoma showed a strong accumulation of 99mTc-PMT in the mass which was depicted as a defect on the 99mTc-colloid scan and did not show a significant accumulation of 67Ga. In a case of focal nodular hyperplasia, there were two space-occupying lesions (SOLs), one of which showed a clear-cut defect on the 99mTc-colloid scan and the other which showed only a distorted uptake pattern. However, both masses were strongly positive with 99mTc-PMT. 99mTc-PMT scintigraphy is useful in connection with 99mTc-colloid scan and sometimes with 67Ga-citrate in the diagnosis of intrahepatic masses originating from hepatocytes.     

Uptake of 67Ga into the rat liver after treatment with thioacetamide

67Ga uptake of the liver began to elevate from the 1st day and reached a maximum at the 2nd day of treatment with thioacetamide (TIAA). Incorporation of 3H-thymidine into the liver DNA fraction was reached a maximum at the 1.5th day, and the value was 5.7 times of the control. The uronic acid content and 35S incorporation in the 1.2 M NaCl-soluble fraction which contained predominantly heparan sulfate (HS), were both peaked at the 2nd day. These patterns were in good agreement with that of 67Ga uptakes in the liver treated with TIAA. Pretreatment of aminoacetonitrile, an inhibitor of fibrosis, was effective in lowering the elevated uptake of 67Ga in TIAA-treated rat liver. Uptake of the 67Ga in the TIAA-treated liver was also inhibited when they were treated with cycloheximide, an inhibitor of protein synthesis. On the other hand no significant inhibition was observed in the cytosine arabinoside-treated-TIAA rats. These results suggest that HS may be involved in the 67Ga uptake in damaged liver, and that relation between 67Ga uptake and cell proliferation is secondary.     

Direct ICP-MS determination of trace and ultratrace elements in geological materials after decomposition in a microwave oven. Part II. Quantitation of Ba, Cs, Ga, Hf, In, Mo, Nb, Pb, Rb, Sn, Sr, Ta and Tl

A new method has been developed for the rapid determination of traces of Ba, Cs, Ga, Hf, In, Mo, Nb, Pb, Rb, Sn, Sr, Ta and Tl in silicate rocks and lake, stream and river sediments. The method involved dissolution of samples in a microwave oven by heating in a pressure decomposition Teflon vessel with a mixture of HF + HNO₃ + HCl + H₃BO₃ + EDTA followed by direct multielement determination using inductively coupled plasma-mass spectrometry (ICP/MS). The method is faster than conventional dissolution of samples by open vessel acid digestion and fusion and determination by instrumental methods. The accuracy and precision of the developed method were tested by replicate analyses of a number of international geochemical reference samples of established trace element contents. Satisfactory correlation with the “recommended” or “consensus” values was found and recoveries were in most cases 95–100%. New values for Ga, In, Nb and Tl in several international geochemical reference materials are first reported in this paper.     

Thallium-201 radioactive implant induced X-ray emission scanning of stable iodine distribution in thyroid--phantom experiment

A new method has been developed for imaging the thyroid gland by the use of 201Tl radioactive implant induced X-ray emission (RIXE). The thyroid phantom was made from two cylindrical tubes embedded in plastic neck phantom. Each tube consisted of stable iodine and 201Tl radioactive source in 10 ml water solution. Some photopeaks in the energy range from 20 to 200 ke V were scanned along a horizontal axis by the collimated Ge detector with high energy resolution. The distribution on the horizontal axis was obtained for the generated I K alpha-ray and some primary 201Tl radiations. The 201Tl RIXE scanning can provide information about the distribution of iodine with 201Tl as well as 201Tl distribution in the thyroid gland. The effectiveness of the 201Tl RIXE technique as a thyroid scanning method is discussed.     

Effect of gallium nitrate on the in vivo distribution of 67Ga in rats bearing inflammatory lesions

Effect of gallium nitrate on the pharmacokinetics and tissue accumulation of 67Ga was investigated in rats bearing turpentine oil-induced abscess. Gallium nitrate accelerated the blood disappearance of 67Ga, but this effect was less potent than that of ferric nitrate. The accumulation of 67Ga in liver was significantly lowered by gallium nitrate, but no significant decrease of 67Ga accumulation in abscess was observed. On the other hand, 67Ga accumulation in bone was slightly facilitated by gallium nitrate. Ferric nitrate exerted a similar effect on tissue accumulation of 67Ga as gallium nitrate.