Grundlagen: Zie[ dieser Studie war es, die Rolle yon 18F-FDG bei der Differenzierung yon malignen und benignen Pankreaserkrankungen, speziell Narbengewebe und chronische Entzfindungszeichnen zu fiberprfifen, da diese auch unter Verwendung der Endosonographie, der ERCP, Spiral-CT und selbst der Biopsie nicht immer m6glich ist. Methodik: Wir haben 26 Patienten untersucht (9 Frauen, 17 M~inner, im Alter yon 50.9 ± 13.5 a). Es wurden durchschnittlich 4 mCi (148 MBq) 18F-FDG (FSZ Seibersdorf, BSM) nach I]berprfilung des Blutzuckers i.v. appliziert und 1 h sp~iter fiber eine Koinzidenzkamera (ADAC, MCD) die Aufnahmen fiber dem Abdominalbereich durchgeffihrt. Ergebnisse: Bei der Auswertung land sich in unserem Patientengut eine Sensitivit~it yon 89% und eine Spezifit/it yon 84%. Falsch negative Ergebnisse erhietten wir bei Patienten mit Hyperglyk~imie und falsch positive Ergebnisse bei Patienten mit chronisch aktiver Pankreatitis. Bei Ausschlu6 der Hyperglyk~/miepatienten und Patienten mit akuten Pankreatitiszeichen kann man die Sensitividit und Spezifit/it noch verbessern. Bei 2 Patienten ffihrten nur die 18FFDG Untersuchungen zu einer richtigen Diagnose. Die Ergebnisse sind operativ oder bioptisch gesichert. SchluBfoigerungen: 18F-FDG eignet sich gut zwischen malignen und benignen Pankreaserkrankungen zu unterscheiden. 18FFDG sollte unbedingt eingesetzt werden, wenn morphologischen Untersuchungsmethoden bei Pankreastumoren unklar sind, speziell bei erh6hten Tumormarkern.

The antibody we used was the BW 250/183 produced by the Behringwerke, Germany and labelled with Tc-99m. We did planar scanning and SPECT studies 4 hours and 24 hrs with a rotating digital camera (Elscint). A total of 16 patients (6 male, 10 female; age ranging from 19-67 years) were investigated. In 1 patient the investigation was performed 3 times and in 2 patients twice. Diagnosis of fistulae was established by surgical, endosopic and X-ray procedures. We found no false-positive result, a false-negative result in 2 patients, a true positive result in 16 and a true negative result in 2 patients. This would mean a sensitivity of 88%. SPECT studies are necessary to achieve these good results.

The aim of this study was to compare the visualization of brain tumors with Iodine-123-Methyl Tyrosine (l-123-MT) and Indium-111-Octreotide (ln-111-Oc). We used l-123-MT (FZ-Seibersdorf), administering 222 MBq and planar images were performed 10min and 1hr after application. In 5 pts SPECT images were performed too. Not earlier than 48hrs 244 MBq In-111-Oc (OctreoScan{sup {reg_sign}}, Mallincrodt) were injected and planar images 4 and 24 hrs after application performed. In 9 pts SPECT images were performed (4hrs p.appl.). A digital Anger camera was used for data acquisition and processing (APEX 409A, Elscint). A total of 12 pts (8 male, 4 female age ranging from 45-71 yrs) were investigated. using a region of interest technique tumor-to-brain tissue rations (T/BT) were calculated. Diagnosis of tumor was established by neurosurgical procedures. 6 pts with glioblastoma showed a high uptake with in-111-Oc (T/BT 1.7 {plus_minus}0.5) and also with l-123-MT T/BT: 1.5{plus_minus}0.4 (10 {prime}) and 1.45 {plus_minus}0.45 (1h). In 2 menigiomas the images with ln-111-Oc were very good (T/BT: 3.1, 3.6 (4hr pl)) and were negative with l-123-MT. In 4 metastases we found a low uptake in 2 pts with l-123-MT T/BT (10{prime}): 1.3 and 1.25; T/BT (1h): 1.25 and 1.2 and ln-111-Oc (T/BT (4h pl): 1.6more » and 1.4). These were pts with brain metastases of adeno carcinoma. In two pts with brain metastases of small cell lung cancer we found good images with both substances I-123-MT T/BT: 1.6 and 1.7 (1h) and ln-111-Oc T/BT: 2.5 and 2.6 (4h pl). In summary, glioblastoma showed concordant images with both substances and also metastases, meningiomas showed discordant images. SPECT acquisition is possible with both substances and sometimes advisable.« less

Kroiss, A.; Böck, F.; Auinger, Ch.; Perneczky, G.; Angelberger, P.; Neumayr, A. Author Information

Institute of Nuclear Medicine, Department of Neurosurgery, Ludwig Boltzmann Forschungsstelle für klinische Geriatrie, Vienna, Austria

Institute of Nuclear Medicine, 1st med. Dep. Oncology Ludwig Boltzrnann Forschungsstelle f. klinische Geriatrie, Vienna, Austria

The aim of our study was to evaluate the clinical usefulness of a monoclonal antibody (MAB; BW 250/183; Behringwerke, Germany) in patients with suspected perioperative septic foci. The MAB is directed against the nonspecific crossreacting antigen (NCA 95) which has been found on the surface of human neutrophil granulocytes and which represents a murine immunoglobulin isotype of IgG1. Immunoscintigraphy was performed by labelling the MAB with 740 MBq (20mCi) Tc-99m. Data acquisition followed 4 and 18 to 24 hours after administration by a digital Anger camera (APEX 409A, Elscint). 53 patients were investigated (31 female, 22 male; average age 39 years), 4 patients were twice, 1 patient was 3 times evaluated, which results in a total of 59 studies. 45 patients experienced operation within 12 hours after our investigation, which resulted in 36 true positive, 5 true negative, 3 false negative, and 1 false positive findings. This means a sensitivity of 92%, and specificity of 83%. Immunoscintigraphy with granulocyte antibodies can be performed at any time, the preparation of the radiopharmaceutical is simple, the image quality is high; the obtained information concerning localization and size of perioperative septic infections permits the determination of the optimal point of time for surgical intervention. The accumulation of activity was visible as early as 4 hours post application. SPECT would enhance the diagnostic accuracy, but this technique cannot be applied in all such patients.

We evaluated the monoclonal antibody MAb, BW 250/183, which is easy to label with Tc-99m, with respect to its clinical application for the detection of inflammatory processes in bone and joint diseases. This monoclonal antibody is a murine immunoglobulin (IgG1 isotype), directed against NCA 95 (nonspecific cross-reacting antigen), which is also present on the surface of neutrophil granulocytes. We investigated patients with acute (n = 9) and chronic (n = 3) osteomyelitis, with coxitis (n = 3) and coxarthrosis (n = 2), with septic hip prosthesis (n = 8) and loosening hip prosthesis (n = 14), with low back pain (n = 4), with spondylitis (n = 5) and with postoperative spondylodiscitis (n = 9). With reference to the total number of patients examined in this study we found 29 true positive results, 22 true negative results, 4 false negative results and 2 false positive results. This gives a sensitivity of 88% and a specificity of 92%. The lesions were already visualized within 4 to 6 hours, but 24 hour pictures are desirable. SPECT pictures are mandatory in patients with diseases of the hip or of the spine because sensitivity is considerably improved thereby.

In 46 patients, 26 male and 20 female, age from 32 to 71 years (mean 47.4 +/- 11 years) a bloodpool-scintigraphy (BPS) with SPECT (single photon emission computed tomography) was performed. The in-vivo labelling of the erythrocytes with pyrophosphate and Tc-99m was performed in the usual way. The SPECT investigations were performed with a digital Anger-Camera (Elscint; Apex 401). In 14 patients without collaterals BPS was performed to compare the method with patients with liver diseases and collaterals. 29 patients with liver cirrhosis and portal hypertension were investigated with the BPS and additionally a scintisplenoportography (SSP) was performed. In patients with only cephalad collaterals all the results were concordant. In just 1 patient with cephalad and caudad collaterals we found a discordant result. In 8 patients we performed BPS, SSP and a katheterangiography (KA). Taking the KA as the "golden standard" we found a concordant result with the 3 methods in all patients with cephalad collaterals. In patients with cephalad and caudad collaterals we once found a discordant result with the SSP and twice with the BSP. In 2 patients the patency of surgical shunts were proved. 2 patients after sclerosis of the oesophageal varices have been proved by BPS and SSP and both patients showed good therapeutical results.