Search

No-carrier-added DL-[1-11C]-DOPA has been synthesized by carboxylation of an alpha-lithioisocyanide with a radiochemical yield of up to 15% without correction for decay. The total synthesis time is 30 min. The resolution of the D- and L-isomers was accomplished within 16 min by HPLC using a chiral stationary phase and a phosphate buffer of pH 4.5 as eluent.

Carbon-11 (t1/2 equals 20.4 min, beta-+) labelled DL-alpha-phenylalanine and DL-alpha-phenylglycine were administered intravenously to rats and the distribution of the radioactive amino acids over pancreas, liver, spleen, kidneys and blood was measured after several time intervals. From these results the ratios of the concentration in pancreas and liver were calculated and compared with the corresponding ratios from the literature for some 18-F-labelled aromatic amino acids and L-selenomethionine-75-Se. On the basis of this study it appears that DL-alpha-phenylglycine-1-11-C, in spite of a small percentage of the administered dose reaching the pancreas, and DL-alpha-phenylalanine-1-11-C are better suited to pancreas scintigraphy than L-selenomethionine-75-Se.

Based on a double-headed rotating uncollimated scintillation camera system, a positron imaging device was developed. After a rotating data acquisition in coincidence mode, 16 transverse section images are reconstructed by back projection. To obtain a uniform response, a limited angle reconstruction option is incorporated in this process. After correction for the system response by a three-dimensional deconvolution technique, the 16 transverse section images are stored on disk as a standard patient study for further analysis. The system can also be operated in a stationary mode. In this mode longitudinal tomographic images are obtained. Return to single photon scintigraphy is possible by remounting the collimators and by switching off the coincidence electronics.

A new method for the radioimmunoassay of plasma aldosterone is described. The assay is performed directly on plasma without extracting or purifying the aldosterone. The method fulfilled the usual requirements for the demonstration of accuracy. Extensive data on the properties of the antisera are given.

Covalent complexes of a chemiluminescent compound (a luminol derivative), protein and a steroidal hapten have been used as a labelled antigen in a way analogous to the radioactive label in radioimmunoassay. The antibody-bound complex emits light when treated with hydrogen peroxide and copper acetate at high pH. The chemiluminescent complex bound to antibody can be displaced by free steroid to produce a standard curve in a way analogous to radioimmunoassay.

Tritiated 17 alpha-methylestradiol was synthesized to investigate the potential of the carbon-11-labeled analog as an estrogen-receptor-binding radiopharmaceutical. In vitro, 17 alpha-methylestradiol is bound with high affinity to the cytoplasmic estrogen receptor from rabbit uterus (Kd = 1.96 x 10(-10)M), and it sediments as an 8S hormone-receptor complex in sucrose gradients. The compound shows specific uptake in the uterus of the adult rat, within 1 hr after injection. After 30 min the uterine uptake was 1.73% dose/g. In female rats bearing DMBA-induced tumors, specific uterine and tumor uptakes were observed, although at 30 min the tumor uptake was only 23-30% of the uptake in the uterus. Tritiated 17 alpha-methylestradiol with a specific activity of 6 Ci/mmole showed a similar tissue distribution. Our results indicate that 17 alpha-methylestradiol is promising as an estrogen-receptor-binding radiopharmaceutical.

Using positron emission tomography (PET) in combination with compounds labelled with positron-emitting radionuclides like 11C, 13N and 15O, it is possible to study metabolism in vivo in a non-invasive way. Nuclear magnetic resonance (NMR) imaging takes advantage of the spin of protons in water molecules to measure both their number and relaxation times in vivo, but is, in principle, not limited to protons and can also be used for other nuclei with a non-zero spin, e.g. 13C and 31P. The use of 13C opens the possibility of studying the metabolism of a large number of compounds. In order to choose the appropriate methodology for metabolic imaging, i.e. PET or NMR, it is important to know the sensitivity of each modality. The present study outlines the sensitivity of both techniques.

Over a 5-year period 57Co-bleomycin scintigraphy for tumor detection was performed with a large-field-of-view gamma camera. The scintigrams of 268 patients with lung cancer, with a benign lesion, or with no abnormality in the chest, were reviewed. A sensitivity of 96% was found. In a group of 193 patients in whom a preoperative pathologic diagnosis could not be obtained sensitivity was 95%, specificity was 87%. Correlation between tumor size and tumor-to-non-tumor ratio was established for squamous cell carcinoma, adenocarcinoma, and small cell anaplastic carcinoma. Adenocarcinomas were smaller and showed lower tumor-to-non-tumor ratios than other histologic types. In squamous cell carcinoma a possible correlation between tumor-to-non-tumor ratio and histologic differentiation was investigated, but could not be established. It is concluded that 57Co-bleomycin scintigraphy is helpful in the evaluation of patients with possible lung cancer in whom a preoperative pathologic diagnosis cannot be obtained.

The theory of the measurement of the specificity of antigen binding by antibodies is reviewed. The specificity of steroid immunoassay has been investigated using a new solid phase radioimmunoassay system. The effects of plasma proteins on the specificity of the immunoassays have been tested. The methods used and the conclusions reached have been tested with homogeneous antibodies in order to simplify the interpretation of the results obtained. A new criterium of antibody homogeneity is proposed. The importance of correcting all results accurately for "non-specific binding" is emphasised. A new method for plotting radioimmunoassay standard curves is presented.

57-Co-bleomycin is useful in the detection and staging of lung cancer, but the long half-life of 57Co (270 days) has discouraged its widespread acceptance. We investigated the shorter living positron emitting 55Co (half-life 18.2 h) as a level for bleomycin. In eleven patients with proven lung cancer scintigraphy with 55Co-bleomycin, using a positron camera, demonstrated the tumor in ten cases. Tumor to lung ratios were calculated. The results were superior to those obtained with 55Co-bleomycin single photon imaging but inferior to those obtained with 57Co-bleomycin scintigraphy.

A method is described for analysis of xenon-133 washin and washout curves, in the presence of a slowly varying background. The method uses least-squares fitting of a single exponential together with a quadratic function to correct for the background. The method has been applied both to simulated data and to data from 25 patients. The accuracy in the relevant lung parameters was 5% over a wide range of the specific ventilation. A comparison is made with other methods in use to measure regional lung-function parameters. Our method produces reliable results even when specific ventilation is low, which can occur in patients with chronic airflow obstruction, where other methods may incur errors of more than 45%.

In the investigation of suspected lung cancer bleomycin labelled with cobalt-57 and gallium-67 labelled with citrate are currently used to detect the primary tumour and to establish the presence of metastases in the lung hilum and mediastinum. A comparative study of these radio-pharmaceuticals was performed in 63 patients with proved lung cancer. 57Co-bleomycin showed the primary tumour in 58 patients (92%) and 67 Ga-citrate in 34 (54%) (p less than 0.01). The average tumour-to-lung ratio was 3.4 with 57Co-bleomycin and 1.5 with 67Ga-citrate. Proved metastases in the hilum or the mediastinum were visualised with 57Co-bleomycin scintigraphy in 16 out of 18 patients (89%) and with 67 Ga-citrate scintigraphy in only eight (45%) (p less than 0.01). These results indicate that 57Co-bleomycin scintigraphy is more suitable for detecting and staging lung cancer than is 67Ga-citrate. 57Co-bleomycin is valuable in the detection of peripheral lesions, in which a pathological diagnosis is difficult to achieve, since a positive scintigram indicates malignancy. When 57Co-bleomycin scintigraphy suggests hilar or mediastinal metastases mediastinoscopy should be carried out; but when no metastases are apparent it is reasonable to proceed directly to thoracotomy without mediastinoscopy.

The simultaneous use of 131I-triolein and 75Se-triether, a nonabsorbable marker, in a single oral dose to estimate fat absorption from incomplete fecal collections was tested in rats with and without induced steatorrhea. The results in normal rats showed that analysis of single stool samples allows a valid estimate of fat absorption as defined by the balance study based on the total fecal recovery of 131I. However, in the few normal rats with poor absorption, the absorption values from successively excreted stools showed a tendency to increase. Similar findings were obtained from biliary fistula rats with marked steatorrhea. No evidence of different intestinal transit rates of test fat and marker was observed in bile-diverted rats, thus suggesting that the observed inconsistency in fat absorption values from different stool specimens reflects intraprandial differences in the absorption of fat. Studies on rats subjected to intestinal ischemia do not support the suggestion of others that separation of fat and triether will occur if a mucosal defect is involved as the cause of fat malabsorption. It is concluded that this dual isotope technique may be of value in the clinical estimation of fat absorption, as it offers important technical advantages over conventional fat balance studies.

The radiochemical purity of the cobalt-57 complex of bleomycin could be enhanced by adjusting the pH of the final product to a value between 5 and 6. This radiopharmaceutical appeared to have better tumor visualizing properties compared to the not neutralized preparation. The clinical use of the cobalt-57 bleomycin complex is however limited by the long physical half-life of the label, causing a risk of radioactive contamination. It appeared to be possible to label bleomycin with radioactive cations (111In3+, 99mTc4+, 197Hg2+ and 67Cu2+) having suitable gamma ray energies and short half-lifes. These bleomycin complexes showed a high radio-chemical purity judged by their behaviour on thin layer chromatography, paper chromatography, and electrophoresis, but their application as tumor visualizing radiopharmaceutical turned out to be disappointing compared with cobalt-57 bleomycin.

Due to the solubility of xenon-133 in blood and tissues, errors are introduced in the determination of regional pulmonary ventilation. We investigated these errors by comparing the results from ventilation measurements with Xe-133 and N-13 in five normal subjects (both at rest and during exercise) and in seven patients after a pneumonectomy. In the normal subjects at rest, the upper lung fields showed no significant difference in the uptake rates of the two gases. In the middle and lower lung fields, however, the uptake rate for Xe-133 was higher than for N-13. During exercise a significant increase of the specific ventilation was found in the upper lung fields for N-13 compared with Xe-133. In the pneumonectomy patients the overall uptake rate for Xe-133 in the intact hemithorax was 25% larger than for N-13. Over the pneumonectomized hemithorax the uptake of the fastest component of Xe-133 was (8.5 +/- 1.3)% of the total. The total chest-wall contribution of Xe-133 was (27 +/- 8)% of the total count rate.

Before, during, and after 19 courses of chemotherapy given to patients with disseminated malignant melanoma plasma spermidine levels were determined with a radioimmunoassay. Baseline values were normal in 17 courses, a doubling of plasma levels following chemotherapy occurred in 13 courses. There was no relation between the occurrence of a tumor response and an increase in spermidine levels nor between hematological toxicity or digestive tract toxicity and spermidine levels.

DL-[1-11C]Proline has been synthesized by carboxylation of alpha-lithiopyrrolidyl-N-tert-butyl-formamidine with a radiochemical yield of up to 18% without correction for decay. The total synthesis time is 45 min. Accumulation of DL-[1-11C]proline has been shown in Walker 256 carcinosarcoma transplanted in rats. A tumor/non-tumor ratio of 5.9 was found at 45 min after i.v. injection.

The level of the aminoterminal propeptide Col 1-3 of type III procollagen (PC-III) was determined in patients with paroxysmal nocturnal haemoglobinuria (PNH) and primary myelofibrosis (PMF), to study whether PC-III can be used as a parameter for the rate and/or degree of bone marrow replacement with collagen. Normal PC-III levels were found in PNH (6.6 +/- 1.1 micrograms/l; N: 8.6 +/- 1.8 micrograms/l), while significantly increased levels were found in PMF (24.8 +/- 2.2 micrograms/l). During a follow-up of 1 year, a slight increase of 2 micrograms/l occurred in three patients with a stable fibrosis, while one patient with more active disease demonstrated an increase of 25 micrograms/l. Treatment with acetylsalicylic acid led to a decline of PC-III as well as beta-thromboglobulin level, although normalization did not occur. It was demonstrated by means of gel filtration that the antigens related to the PC-III peptide were heterogenous, and that in PMF at least two main peaks were present, with molecular masses equal to and smaller than PC-III peptide. These data demonstrate that the radioimmunoassay cannot be used for the quantitative determination of PC-III; nevertheless it gives some insight in the process of bone marrow fibrosis.

To evaluate the feasibility of using either L-[1-11C]-methionine or L-[methyl-11C]methionine for measuring protein synthesis rates by positron emission tomography (PET) in normal and neoplastic tissues, distribution and metabolic studies with 14C- and 11C-labeled methionines were carried out in rats bearing Walker 256 carcinosarcoma. The tissue distributions of the two 14C-labeled methionines were similar except for liver tissue. Similar distribution patterns were observed in vivo by PET using 11C-labeled methionines. The highest 14C incorporation rate into the protein-bound fraction was found in the liver followed by tumor, brain, and pancreas. The incorporation rates in liver and pancreas were different for the two methionines. By chloroform-methanol fractionation of these four tissues, in liver significantly different amounts of 14C were observed in macromolecules. Also in brain tissue slight differences were found. By HPLC analyses of the protein-free fractions of plasma, tumor, and brain tissue at 60 min after injection, for both methionines several 14C-labeled metabolites in different amounts, were detected. About half of the 14C-labeled material in the protein-free fraction was found to be methionine. In these three tissues the amount of nonprotein metabolites and [14C]bicarbonate amount ranged from 10% to 17% and 12% to 15% for L-[1-14C]methionine and L-[methyl-14C]methionine, respectively. From these results it can be concluded that the minor metabolic pathways have to be investigated in order to quantitatively model the protein synthesis by PET.

DL-[1-11C]ornithine and lysine have been synthesized by carboxylation of the corresponding alpha-lithioisocyanide with a radiochemical yield of up to 14% without correction for decay. The total preparation time is 50 min. Accumulation of both DL-[1-11C]ornithine and lysine in Walker 256 carcinosarcoma is observed, with a tumor/non-tumor ratio of 4.9 and 4.5 respectively, at 45 min after intravenous injection.

Carbon-11 labelled glycine has been prepared in 30 min by carboxylation of alpha-lithiomethylisocyanide with a radiochemical yield of 10-15%. After coupling with L-phenylalanine-N-carboxyanhydride and L-leucine-N-carboxyanhydride followed by HPLC purification, the corresponding dipeptides were obtained in 20 min with a radiochemical yield of 30-40%. Consequently, starting with 11CO2, non carrier added L-phenylalanyl[1-(11)C]glycine and L-leucyl-[1-(11)C]glycine in 0.1 N NaH2PO4 were obtained in 50 min with a radiochemical yield of 3-6%. The radiochemical yield figures are not corrected for decay.

The aim of this investigation was to find a scintillation mixture for counting up to 1 ml of plasma. We succeeded in obtaining a mixture of xylene/Triton X-100/mono- and di-butylphosphate, and called it Plasmasol. The properties were ideal for radioimmunoassays of steroids. Good dissolving properties, high counting efficiency, absence of chemiluminescence and a good stability and reproducibility with respect to the disintegrations per minute were achieved. The cost was only 25% of the commercially available ready-to-use liquid scintillation mixtures, with which a comparison was made.

The validity of using triethers as markers for triglycerides during gastric emptying was investigated. Rats were given a lipid mixture containing [75Se]triether plus [131I]triolein or [3H]triether plus [14C]triolein intragastrically. Similar studies were performed on humans using a homogenized test meal to which was added [75Se]triether plus corn oil. Analysis of gastric contents at various time intervals after administration of the test meal did not show evidence of separation of triglyceride and triether in the stomach. It is discussed that the disappointing results of other workers using [3H]triether may be due to an artifact associated with instability of the tritium-to-triether bond in the preparation used.

The specificity of immunoassays can be improved by using a second antiserum to bind substances that cross-react. Both theory and practice show that the effectiveness of the procedure is dependent of the complex interplay of the concentrations of the two antibodies, the concentrations of the three antigens involved (the labelled tracer, the antigen whose concentration is to be measured and the substance that cross reacts) and the affinities of the antibodies for these antigens. Measured cross-reactions can frequently be reduced to zero in the most important concentration ranges thereby enabling one to perform assays upon unpurified materials which other wise would not be possible. Limitations of the method are discussed.

By external detection, the influence of arterial blood pressure (BP), osmolarity, and cold-induced blood-brain barrier damage was assessed on the extraction of water labeled with oxygen 15 during single-capillary transit in the rat. There was an inverse relation between arterial BP and extraction that was attributable to the influence of arterial BP on cerebral blood flow (CBF) and the relation between CBF and extraction. Neither arterial BP nor osmolarity of the injected bolus had any direct effect on extraction of water 15O, signifying that the diffusional exchange component (determined by blood flow) of extraction greatly surpasses the convection flow contribution by hydrostatic or osmotic forces. Damage to the blood-brain barrier did not change its permeability to water.

Investigations with bleomycin labelled with radionuclides other than 57Co in patients with cancer and in tumor-bearing animals are described. In patients 57Co-bleo appears to be a better tumor-seeking radiopharmaceutical than 111In-bleo, 99mTc-bleo or 197Hg-bleo. This can be explained by a higher stability in vivo and a better tumor-seeking property of 57Co-bleo and less disturbing activity in the cardiac pool and in bone and other normal tissues when assessing the scintigram. Results with 111In-bleo labelled in acidic solution are not essentially different from those with 111In-bleo labelled in neutral solution. Results of 197Hg-bleo are almost identical with those of 197HgCl2 regarding the tumor-seeking effect as well as the distribution in normal tissues and organs. Probably the complex of 197Hg to bleomycin is not stable in vivo. The superiority of 57Co-bleo over 99mTc-bleo, 197Hg-bleo and also over 67Cu-bleo is confirmed by experiments on tumor bearing animals. We may conclude that the indication for use of bleomycin as a tumor-seeking pharmaceutical labelled with 111In, 99mTc, 197Hg or 67Cu seems to be very limited.

An electromagnetic valve for use in exercise rebreathing studies is described. This valve enables the investigator to connect a rebreathing system immediately after the onset of inspiration even at high breathing frequencies. The rapid switching causes minimal leakage; the rebreathing bag can be washed out and refilled without disconnection during exercise testing. For one year this valve has been used in measurements of functional residual capacity and diffusing capacity during exercise in volunteers as well as in patients.

Bleomycin labeled with 57Co was used as a tumor-localizing agent in 132 patients. In patients with pulmonary tumors the primary localization concentrated radioactivity in 52 of the 54 appropriate cases; out of the 22 clinically known metastases, 19 were visible on the scan; 40 unknown metastases especially in hilus and mediastinum were found by the method and subsequently confirmed. In 22 patients with malignant lymphomas, 18 out of 22 known pathologic lymph glands above the diaphragm were visible on the scan; below the diaphragm the results of scanning in lymph glands and spleen were disappointing, probably because of the disturbing concentration of radioactivity in the kidneys, the bladder, the liver, and sometimes the gut. In 25 patients with various other tumors, 16 out of 22 known localizations above the diaphragm were visible; 2 were uncertain and 4 negative. Below the diaphragm the results were usually negative. In 24 patients with benign lesions, uptake of 57Co-bleomycin was visible on the scintigram in 4 patients with cavitating pulmonary tuberculosis, in 2 with pulmonary infections, in 1 with Caplan lesions of rheumatoid arthritis in the lung, and in 1 with sinusitis ethmoidalis. The significance of these results is discussed.

Forty-eight patients with a history of exercise-induced asthma were exercised on ambient breathing (T = 18-20 degrees C, relative humidity = 45-55%). There were 19 responders and 29 non-responders according to post-exercise spirometry. During the first minutes of exercise at a workload of 25-50 W, the functional residual capacity (FRC) was measured by a rebreathing technique. There was a significant increase in FRC in responders (p less than 0.025). A loose though significant correlation was found between the rise in FRC during exercise and the fall in forced expiratory volume in one second (FEV1) after exercise (r = -0.429, p less than 0.005). The effects of a sympathomimetic drug were studied in five responders submitted to a second exercise test 4 h after the first one. Spirometry returned to normal but FRC remained high between both tests. During the second test neither spirometry nor FRC changed. The results suggest that different mechanisms may be responsible for changes in FRC and in maximal expiratory flow in exercise-induced broncho constriction.

The cerebral distribution of the positron-emitting agent [1-11C]beta-(3,4-dihydroxyphenyl)-D,L-alpha-alanine ([11C]DOPA) was studied after intravenous injection in rats pretreated with the peripheral decarboxylase inhibitor, carbidopa. Within 15 min of injection the accumulation of carbon-11 was almost twice as high in cortical areas and cerebellum as in the striatum and the brain stem. After destruction of catecholamine-containing nerve endings with 6-hydroxydopamine, the level of carbon-11 in the striatum was higher than in rats not treated with this neurotoxin. Pretreatment of rats with haloperidol or L-DOPA did not change the distribution pattern of carbon-11. Without pretreatment with carbidopa a uniform distribution of the label in the brain was observed. We suggest that [11C]DOPA is a potentially useful agent for external detection with positron imaging systems in patients and large animals of brain regions rich in the enzyme dopa-decarboxylase. (EC 4.1.1.26).