Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Technetium-99m labeled radiopharmaceuticals are the currently accepted agents of choice for skeletal imaging. Their introduction in 1971 literally initiated a new era in clinical bone scanning. The development of techniques for reducing Tc(VII) with Sn(II) provided the means for complexing this useful radionuclide with various phosphorus-containing compounds which were already known to be avid bone seekers. Long chain polyphosphates were widely used at first, but have been superceded by pyrophosphate and its organic analogs, the diphosphonates. Pyrophosphate is characterized chemically by P--O--P bonds, and the diphosphonates by P--C--P bonds. The chemical forms of their complexes with tin and technetium are not known, but they behave in many respects as weak chelates. Labeling efficiencies for 99mTc of 95% or better are routinely obtainable with both "in house" preparations and commercial kits. Proper molar concentrations and ratios of phosphorus-compound to tin are necessary for both for good labeling and to achieve optimum tissue distribution. Unreacted TcO4- and reduced unbound 99mTc are both potential contaminants in these preparations and must be considered in radiochemical quality control. In vivo tissue distribution and kinetics of the 99mTc-Sn-phosphorus compounds differ with details of preparation, category of agent, and clinical status of the patient. Blood clearance is multi-exponential, with skeletal uptake and urinary clearance accounting for most of the activity. Scanning may be started in 2 1/2 to 4 hr, at which time skeletal activity is on the order of 40 to 50% of the injected dose. The primary indication for bone scanning remains the detection of metastases from extraskeletal malignancies, and the 99mTc labeled agents are more sensitive than either radiographs or Fluorine-18 for demonstrating active lesions. In addition, many new applications in evaluating benign bone disease have widened the clinical scope of skeletal imaging which is rapidly becoming one of the most important studies in nuclear medicine.
 ...
PMID:Technetium-99m labeled agents for skeletal imaging. 78 10

Rhenium-186 (tin)hydroxyethylidene diphosphonate (HEDP) is a new radiopharmaceutical that localizes in skeletal metastases in patients with advanced cancer. A single intravenous administration of approximately 34 mCi (1,258 MBq) resulted in significant improvement in pain in 33 of 43 evaluable patients (77%) following the initial injection, and in 7 of 14 evaluable patients (50%) following a second treatment. Patients responding to treatment experienced an average decrease in pain of about 60%, with one in five treatments resulting in a complete resolution of pain. The only adverse clinical reaction was the occurrence after about 10% of the administered doses of a mild, transient increase in pain within a few days following injection. Statistically significant but clinically unimportant decreases in total white blood cell counts and total platelet counts were observed within the first 8 weeks following the injection; no other toxicity was apparent. Rhenium-186(Sn)HEDP is a useful new compound for the palliation of painful skeletal metastases.
 ...
PMID:Rhenium-186 hydroxyethylidene diphosphonate for the treatment of painful osseous metastases. 137

Rhenium-186(tin) hydroxyethylidene diphosphonate (HEDP) is a new radiopharmaceutical that localizes in areas of osseous metastases in a manner similar to that of standard bone-scanning agents. It also emits beta particles with sufficient energy to be therapeutically useful. A single intravenous injection of about 33 mCi (1,221 MBq) was given to each of 20 elderly patients with advanced skeletal metastases from hormonally resistant prostate cancer. Prompt, significant relief of pain occurred 80% of the time with no significant side effects and only minimal, transient marrow toxicity. Re-186(Sn) HEDP appears to be a useful new agent for the palliation of painful osseous metastases in prostate cancer.
 ...
PMID:Re-186(Sn) HEDP for treatment of painful osseous metastases: initial clinical experience in 20 patients with hormone-resistant prostate cancer. 169 84

Rhenium-186 (tin) hydroxyethylidene diphosphonate (HEDP) is a new radiopharmaceutical that simultaneously localizes in multiple skeletal metastases in patients with advanced cancer. A single intravenous administration of 30-35 mCi (1110-1295 MBq) is associated with a prompt, significant relief of osseous pain in about 80% of such patients. The efficacy of this new compound was evaluated further by utilizing a double-blind crossover comparison with 99mTc-methylene diphosphonate (MDP) as a radioactive placebo. The new rhenium compound resulted in a significantly (p less than 0.05) greater decrease in pain than did treatment with the radioactive placebo. Rhenium-186(Sn)HEDP appears to be a useful new compound for the palliation of painful skeletal metastases.
 ...
PMID:Rhenium-186(Sn)HEDP for treatment of painful osseous metastases: results of a double-blind crossover comparison with placebo. 171 69

Uptake of Tc-99m di-isopropyliminodiacetic acid (DISIDA) by hepatocellular carcinoma was assessed in 30 patients showing obvious liver defects on a Tc-99m tin colloid image. In none of these patients was there complete "filling in" of the defects, and even partial "filling in" occurred in only 11 (36.7%). There was no uptake of Tc-99m DISIDA by the primary tumor in the remaining 19 patients (63.3%). In 19 of the 30 patients an attempt was made to correlate the degree of histologic differentiation of the tumor with the uptake of DISIDA by the tumor. No difference in uptake could be demonstrated between well, moderately, and poorly differentiated tumors. Tc-99m DISIDA was not taken up by pulmonary metastases in the only two patients tested. We conclude that imaging with Tc-99m DISIDA in conjunction with Tc-99m colloid is of no value in the specific diagnosis of hepatocellular carcinoma.
 ...
PMID:Uptake of Tc-99m di-isopropyliminodiacetic acid by hepatocellular carcinoma: concise communication. 631 2

The association between pre-operative serum carcinoembryonic antigen (CEA) and liver scanning employing technetium (99mTc)-tin colloid was investigated in 30 women subsequently proven to have primary epithelial ovarian carcinoma to determine whether these two investigations improve the detection of hepatic metastases. The upper limit of normal for CEA (greater than or equal to 5 ng/ml) did not represent the optimal levels for use in predicting ovarian carcinoma nor the presence of liver metastases. But with CEA levels greater than 10 ng/ml sensitivity for liver metastases was 57%. Liver scanning alone demonstrated metastases in five out of seven patients (71%) with parenchymal liver metastases. The combination of CEA and liver scan was positive in six out of these seven patients (86%).
 ...
PMID:Screening for liver metastases from ovarian cancer with serum carcinoembryonic antigen and radionuclide hepatic scintiphotography. 669 63

For decades the results of elective lymph node dissection (ELND) are differently discussed, so that it is not definitely recommended at present the less so since the morbidity of this operation can't be neglected. Since the beginning of 1995 we practice a gamma-probe guided sentinel lymphonodectomy (SLNE) on patients with melanoma from a Breslow tumor thickness of 1 mm upward, after injecting a colloidal 99m-Tc labelled tin (II) - sulfide solution around the tumor or the scar, if the tumor has been excided before. By this method, that allows a selection of patients who according clinically to a stage I or II (UICC) but even histopathologically to a stage III and who are profiting of a removal of the regional lymph nodes, the sentinel node can be exactly localised, tissue-sparing removed at minimal complication rates and the completeness of the removal can be verified by measurements of the radioactivity. When finding metastases in the histopathological examination of the node a dissection of the whole region follows.
 ...
PMID:["Sentinel" lymphonodectomy with scintillation detector. A new strategy in treatment of malignant melanoma]. 903 23

The physical characteristics of Sn-117m combined with the biodistribution of the compound tin-117m (Stannic, 4+) diethylenetriaminepentaacetic acid (Sn-117m DTPA) suggest that it should be an excellent agent for the palliation of pain from bony metastases. Prior work has established the dosimetry and the safety for the material in human beings. The presence of low-energy conversion electrons should result in the relative sparing of the bone marrow while delivering a high radiation dose to sites of bony metastatic disease. Forty-seven patients with painful bone metastases from various malignancies were treated with Sn-117m DTPA. The patients were assigned to five different dose levels ranging from 2.64 to 10.58 MBq (71-286 microCi) per kg of body weight. Follow-up included review of pain diaries, performance scores, analgesic requirements, blood chemistries, and hematological assessment. Three patients received a second treatment. There was an overall response rate for relief of pain of 75% (range, 60-83%) in the 40 treatments that could be evaluated. No correlation was apparent in this limited series between response rate and the five dose levels used. The relief was complete in 12 patients (30%). The time to onset of pain relief was 19 +/- 15 days with doses < or = 5.29 MBq/kg and 5 +/- 3 days with doses > or = 6.61 MBq/kg. Myelotoxicity was minimal, with only one patient having a marginal grade 3 WBC toxicity. On the basis of our data, Sn-117m DTPA should be an effective and safe radiopharmaceutical for palliation of painful bony metastases. A large-scale trial is warranted to evaluate it in comparison to other similar agents.
 ...
PMID:Treatment of metastatic bone pain with tin-117m Stannic diethylenetriaminepentaacetic acid: a phase I/II clinical study. 951 53

The treatment of painful skeletal metastases is a common clinical problem, and the use of therapeutic radionuclides which localize at metastatic sites has been found to be an effective method for treatment of pain, especially for multiple sites for which the use of external beam irradiation is impractical. There are currently several metastatic-targeted agents radiolabeled with various therapeutic radionuclides which are in various stages of clinical investigation. Since neutron-rich radionuclides are produced in research reactors and often decay by emission of beta- particles, most radionuclides used for bone pain palliation are reactor-produced. Key examples of radionuclides produced by single neutron capture of enriched targets include rhenium-186 and samarium-153. In addition, generator systems are also of interest which provide therapeutic daughter radionuclides from the decay of reactor-produced parent radionuclides. One important example is rhenium-188, available from generators via decay of reactor-produced tungsten-188. Tin-117m is an example of a reactor-produced radionuclide which decays with the emission of low-energy conversion electrons rather than by beta- decay. Each of these agents and/or radionuclides has specific advantages and disadvantages, however, the ideal agent for bone pain palliation has not yet been identified. The goal of this paper is to briefly review the production and use of several reactor-produced radionuclides for bone pain palliation, and to discuss the role of the ORNL High Flux Isotope Reactor (HFIR) for the production of many of these radionuclides.
 ...
PMID:Reactor-produced radioisotopes from ORNL for bone pain palliation. 951 40

Bone pain from osteoblastic metastases can be ameliorated 40% to 80% of the time. Although we can predict nonresponders, we cannot predict responders; however, patients with a better performance scale may have a better chance of pain relief. Radiopharmaceuticals containing phosphorus 32, strontium 89, samarium 153, rhenium 186, and tin 117m are effective, but we do not know which is the most efficacious and the safest. Toxicity includes the flare phenomenon and mild to moderate pancytopenia, but disseminated intravascular coagulation can cause severe, life-threatening thrombocytopenia. This treatment may be repeated at about 9- to 12-week intervals, perhaps earlier with (153)Sm lexidronam, (186)Re etidronate, and (117m)Sn pentetate, with a success rate approaching that of the initial injection. The duration of action of pain reduction ranges from 2 weeks to many months. Tumorical effects are probably not the only mechanism of pain relief.
 ...
PMID:Systemic radiopharmaceutical therapy of painful osteoblastic metastases. 1103 34


1 2 Next >>