Gallium chest scans of 575 patients were analyzed for their clinical usefulness in conjunction with chest radiographs. The series included patients with pulmonary carcinoma, lymphoma, tuberculosis, sarcoidosis, pneumoconiosis, and interstitial fibrosis. Gallum scintigraphy does not aid in the differential diagnosis of pulmonary diseases but is helpful in determining (a) the degree of activity of a known disease process: (b) treatment response, dosage, and duration; (c) the spatial extent of the disease; and (d) the presence of unsuspected disease foci hidden radiographically in the mediastinum, behind the heart, or in pleural or parenchymal scars.
5-Fluorouracil (5-FU) is an effective anti-tumor drug, which has been used both as a single agent and in combination with other chemotherapeutic agents for the treatment of tumors such as breast and colorectal carcinoma. We synthesized 5-FU with trace amounts of 18F-5-FU and administered the compounds intravenously to 6 cancer patients. The patients were scanned at 2 hr intervals for 12 hrs and their urine collected whenever possible. We also injected 5-FU with the tracer 18F-5-FU, at pharmacological doses, into non-tumored rats, and sampled their bile and blood for 95 mins post-injection. For comparison, 2-14C-5-FU was injected into non-tumored rats and their bile and blood sampled at the same intervals. Minute quantities of rat bile and serum were analyzed chromatographically by high-performance TLC. 5-FU and two of its metabolites (FBAL and FUPA) were identified and quantified by this technique. Both percentage and absolute amounts of 5-FU in the bile follow comparative kinetic patterns. While the liver and the urinary bladder were clearly observable in all 6 patients, the detectability of the gall-bladder was correlated to the inverse of the alkaline phosphatase level in the blood. This work suggests that the diversity of the 5-FU metabolism in cancer patients may allow the use of 18F-5-FU as a probe for understanding those individual variabilities in clinical situations.
Eleven patients with Paget's disease of bone underwent serial total body bone scars before and after therapy with calcitonin. All patients studied showed improvement clinically as well as biochemically. Scan improvement was noted in patients with mild disease. Patients with severe disease showed either to change or only slight improvement on the serial bone scars The scan was of greatest value in determining the extent of disease, especially in 3 patients in whom biochemical values were normal. A single pulse injection of 50 M.R.C. units of salmon calcitonin produced a significant increase in the blood clearance of 99mTc diphosphonate. The mechanism of this effect is not clear from this study.
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