The Relationship between Thallium Uptake, Blood Flow, and Blood Pool Activity in Bone and Soft Tissue Tumors

Caluser, Calin; Macapinlac, Homer A.; Healey, John H.; Ghavimi, Fereshteh; Meyers, P. A.; Wollner, Norma; Kalaigian, J.; Kostakoğlu, Lale; Abdel‐Dayem, Hussein M.; Yeh, Samuel D. J.; Larson, Steven M.

doi:10.1097/00003072-199207000-00007

Cited by 40 publications

(9 citation statements)

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“…It is well established that US is a useful adjunct to mammography. Influx of Tl-201 into malignant cells seems to be closely related with increased blood flow and Na-K ATPase pump mechanism (1,2,5,19,22,23). Previous Tl-201 breast studies showed highly sensitive (80-96%) and specific (91-96%) results in palpable breast lesions.…”

Section: Discussionmentioning

confidence: 99%

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201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

Vural¹,

Atasever²,

Özdemir³

et al. 1997

Nuklearmedizin

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Summary Aim: Our goal was to determine the clinical usefulness of TI-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. Methods: TI-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of TI-201. Visual and semiquantitative interpretation was performed. Results: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. TI-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by TI-201 scintigraphy. The smallest mass lesion detected by TI-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. TI-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed TI-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated TI-201. TI-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by TI-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 ± 0.38 (mean ± SD) and 1.48 ± 0.32 (p >0.05), 1.87 ± 0.65 and 1.34 ± 0.20 (p<0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p>0.05). Conclusion: Overall, TI-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of TI-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

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Section: Discussionmentioning

confidence: 99%

“…On Tl-201 scintigraphy, the early uptake ratio in tumour reflected the angiographic vascularity and blood pooling (5). Delayed ratio reflected the viability of tumour cells (21,25).…”

Section: Sensitivity Specificity Accuracy Mammographymentioning

confidence: 99%

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

Vural¹,

Atasever²,

Özdemir³

et al. 1997

Nuklearmedizin

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“…In rats, the 201T1 accumulation revealed in inflammatory lesions decreased with time, but 201TI washout from malignant tumours tended to be delayed (Ando et al, 1987). In 201TI scintigraphy, the early ratio in a tumour reflects vascularity (Taguchi 1992) and blood pooling (Caluser et al, 1992), whereas the delayed ratio reflects the cell's ability to increase TIINa,K-ATP levels (Ando et al, 1988;Caluser et al, 1992;Takekawa et al, 1996) as well as the viability of tumour cells (Mountz, et al 1989;Sehweil et al, 1989). The retention index was defined thus: retention index = (delayed ratio -early ratio)/early ratio.…”

Section: |mentioning

confidence: 99%

Predicting chemotherapeutic response to small-cell lung cancer of platinum compounds by thallium-201 single-photon emission computerized tomography

Tokuchi

Isobe²,

Takekawa³

et al. 1998

Br J Cancer

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Summary Thallium-201 single-photon emission computerized tomography (SPECT) was used to clarify the relationship between 201TI uptake and the response in chemotherapy to platinum compounds in 21 patients with small-cell lung cancer. 201TI-SPECT scans were obtained twice: at 15 min (early scan) and 120 min (delayed scan) after an intravenous injection of 111 MBq (3 mCi) of thallium-201 chloride. We obtained the uptake ratio from each scan and calculated the retention index:uptake ratio = region of interest uptake / contralateral normal lung uptake; retention index = (delayed ratio -early ratio)/early ratio. After 201TI scintigraphy, 12 patients received chemotherapy consisting of platinum compounds and nine were treated with chemoradiation. Among patients receiving only chemotherapy, the retention index correlated with the responses to chemotherapy. In an in vitro study, ouabain, an inhibitor of the Na,K-ATPase pump, reduced sensitivity to cisplatin and inhibited intracellular thallium uptake in the small-cell lung cancer cell line. These studies suggest that 201TI-SPECT is a useful indicator of response to chemotherapy with platinum compounds in small-cell lung cancer, and that Na,K-ATPase is commonly involved in transporting both thallium and platinum compounds into cancer cells.Keywords: 201TI-SPECT; chemotherapy; inductively coupled plasma mass spectrometry; cisplatin; Na,K-ATPase Cisplatin (CDDP) is a useful anti-cancer agent, particularly when used in the treatment of human ovarian, testicular, bladder and small-cell lung cancer (Loehrer et al, 1984;Ohmori et al, 1993). Many studies on cisplatin resistance mechanisms have revealed that the decline in intracellular accumulation of cisplatin is important in carcinoma cell lines (Hromas et al, 1987;Kraker and Moore, 1988;Andrews and Howell, 1990;Mann et al, 1990). Cisplatin accumulation in these cells is reported to be regulated by an alteration in their Na,K-ATPase levels (Kawai et al, 1987;Andrews et al, 1991;Ohmori et al, 1993). Thus, the response to chemotherapy with cisplatin might depend on alterations of Na,K-ATPase.Thallium-201 (201TI) scintigraphy is now used to diagnose myocardial infarction (Strauss et al, 1975), myocardial ischaemia (Strauss and Boucher, 1986) and thyroid tumour (Bleichrodt et al, 1987;Charkes et al, 1990). Recently, 207T1 single-photon emission computerized tomography (SPECT) was reported as being used to detect lung lesion (Tonami et al, 1989), and it is reportedly superior to gallium scintigraphy in detecting lung cancer (Itoh et al, 1992;Matsuno et al, 1992). Some studies demonstrated that TI accumulation in 201T1 scintigraphy is closely related to the Na,K-ATPase levels in malignant tumours (Britten and Blank, 1968;Muranaka, 1981;Kishida, 1987;Sehweil et al, 1989). And we reported that the delayed ratio is related to low levels of Na,K-ATPase activity (Takekawa et al, 1996). We hypothesized that the degree of TI uptake to tumour in 201Tl scintigraphy is associated with the response to chemotherapy with platinum compounds th...

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Since (Na+-K+)ATPase pump activity is related to cell growth," 11-201 uptake of tumor cells is supposed to be modified by cell growth rate.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10] Many factors might be involved in the mechanism of Ti-201 accumulation in tumors. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Cell activities such as glucose metabolism and (Na+-K)ATPase pump activity are considered to be important factors while tumor blood flow, vascular permeability and vascular volume are also important for the initial distribution. There is a report showing that the level of (Na+-K)ATPase activity is correlated with cell growth."…”

Section: Introductionmentioning

confidence: 99%

Intense and prolonged Tl-201 accumulation in a slow growing bronchioloalveolar carcinoma

et al. 1996

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Thallium-201 SPECT was performed to evaluate a pulmonary lesion in a 73-year-old male which had been considered to be an inflammatory lesion for two years. The lesion has slowly increased in size on x-CT. Tl-201 was intensely taken up and retained in the lesion, suggesting a malignant lesion. Histological examination revealed that the lesion was bronchioloalveolar carcinoma. This case suggested that Tl-201 uptake of pulmonary carcinoma would not be necessarily related to cell growth rate.

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The Relationship between Thallium Uptake, Blood Flow, and Blood Pool Activity in Bone and Soft Tissue Tumors

Cited by 40 publications

References 0 publications

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

Predicting chemotherapeutic response to small-cell lung cancer of platinum compounds by thallium-201 single-photon emission computerized tomography

Intense and prolonged Tl-201 accumulation in a slow growing bronchioloalveolar carcinoma

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