99m Tc-EC20 is a folate receptor (FR)-targeted imaging agent consisting of the vitamin folate conjugated to 99m Tc. FR is expressed on a variety of epithelial cancers, with advanced cancers often expressing FR at significantly higher levels than earlier stages of the disease. The goals of this pilot study were to determine the percentages of various solid tumors that accumulate 99m Tc-EC20 in vivo and to correlate 99m Tc-EC20 uptake with immunohistochemistry (IHC) analysis of FR expression in available biopsied tumor tissue. Methods: A total of 154 patients with proven or suspected cancer and at least one lesion of $1.5 cm underwent imaging with 99m Tc-EC20. The majority of these patients (77%) had a diagnosis of renal cell carcinoma. The remaining patients had a variety of other solid tumors. Whole-body planar images were obtained 1-2 h after injection, followed by SPECT of the region containing index lesions. The uptake of 99m Tc-EC20 in tumors was scored as no uptake, mild uptake, or marked uptake. The resultant 99m Tc-EC20 data were analyzed for correlation with the expression of the a-isoform of FR, as determined by IHC analysis, in tissue available from prior or subsequent surgery or biopsy. Results: The administration of 99m Tc-EC20 was well tolerated. Tumors with increased 99m Tc-EC20 uptake were identified in 68% of patients, and IHC results were positive for the expression of the a-isoform of FR in 67% of patients. The agreement between methods was 61% overall (k 5 0.096; 95% confidence interval 5 20.085 to 0.277), with 72% agreement of positive results and 38% agreement of negative results. Conclusion: In vivo imaging with 99m Tc-EC20 identified approximately two thirds of patients as having FR-positive tumors. Agreement between imaging and in vitro IHC was poor but was potentially confounded by a lack of correlation between the time of tissue sampling and the time of 99m Tc-EC20 imaging, the heterogeneous expression of FR in metastatic lesions from the same patient, and the inability to detect the b-isoform of FR by IHC. This pilot study of 99m Tc-EC20 scintigraphy indicates that the agent is safe and well tolerated and that this noninvasive procedure may have utility in selecting patients likely to benefit from FR-targeted therapy.

The diagnostic accuracy of scintimammography is not affected by breast density.

Gray scale ultrasonography was used to measure bladder volumes. A high degree of accuracy (r = 0.097) in correlating volumes with instilled volumes is attributed to the inherently greater accuracy of gray scale as compared to bistable B-mode scanning.

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Context: Removal of the lacrosse helmet to achieve airway access has been discouraged based only on research in which cervical alignment was examined. No researchers have examined the effect of lacrosse equipment on the cervical space available for the spinal cord (SAC).Objective: To determine the effect of lacrosse equipment on the cervical SAC and cervical-thoracic angle (CTA) in the immobilized athlete.Design: Observational study. Setting: Outpatient imaging center.Patients or Other Participants: Ten volunteer lacrosse athletes (age 5 20.7 6 1.87 years, height 5 180.3 6 8.3 cm, mass 5 91 6 12.8 kg) with no history of cervical spine injury or disease and no contraindications to magnetic resonance imaging (MRI).Intervention(s): The lacrosse players were positioned supine on a spine board for all test conditions. An MRI scan was completed for each condition.Main Outcome Measure(s): The independent variables were condition (no equipment, shoulder pads only [SP], and full gear that included helmet and shoulder pads [FG]), and cervical spine level (C3-C7). The dependent variables were the SAC and CTA. The MRI scans were evaluated midsagittally. The average of 3 measures was used as the criterion variable. The SAC data were analyzed using a 3 3 5 analysis of variance (ANOVA) with repeated measures. The CTA data were analyzed with a 1-way repeated-measures ANOVA.Results: We found no equipment 3 level interaction effect (F 3.7,72 5 1.34, P 5 .279) or equipment main effect (F 2,18 5 1.20, P 5 .325) for the SAC (no equipment 5 5.04 6 1.44 mm, SP 5 4.69 6 1.36 mm, FG 5 4.62 6 1.38 mm). The CTA was greater (ie, more extension; critical P 5 .0167) during the SP (32.646 6 3.96) condition than during the no-equipment (25.346 6 2.36; t 9 5 7.67, P 5 .001) or FG (26.816 6 5.16; t 9 5 4.80, P 5 .001) condition.Conclusions: Immobilizing healthy lacrosse athletes with shoulder pads and no helmets affected cervical spine alignment but did not affect SAC. Further research is needed to determine and identify appropriate care of the lacrosse athlete with a spine injury.