Reproducibility of (18)F-FDG PET uptake measurements in head and neck squamous cell carcinoma on both PET/CT and PET/MR

OBJECTIVE

To investigate reproducibility of fluorine-18 fludeoxyglucose ((18)F-FDG) uptake on (18)F-FDG positron emission tomography (PET)/CT and (18)F-FDG PET/MR scans in patients with head and neck squamous cell carcinoma (HNSCC).

METHODS

30 patients with HNSCC were included in this prospective study. The patients were scanned twice before radiotherapy treatment with both PET/CT and PET/MR. Patients were scanned on the same scanners, 3 days apart and according to the same protocol. Metabolic tumour activity was measured by the maximum and peak standardized uptake value (SUVmax and SUVpeak, respectively), and total lesion glycolysis from the metabolic tumour volume defined from ≥50% SUVmax. Bland-Altman analysis with limits of agreement, coefficient of variation (CV) from the two modalities were performed in order to test the reproducibility. Furthermore, CVs from SUVmax and SUVpeak were compared. The area under the curve from cumulative SUV-volume histograms were measured and tested for reproducibility of the distribution of (18)F-FDG uptake.

RESULTS

24 patients had two pre-treatment PET/CT scans and 21 patients had two pre-treatment PET/MR scans available for further analyses. Mean difference for SUVmax, peak and mean was approximately 4% for PET/CT and 3% for PET/MR, with 95% limits of agreement less than ±20%. CV was small (5-7%) for both modalities. There was no significant difference in CVs between PET/CT and PET/MR (p = 0.31). SUVmax was not more reproducible than SUVpeak (p = 0.09).

CONCLUSION

(18)F-FDG uptake in PET/CT and PET/MR is highly reproducible and we found no difference in reproducibility between PET/CT and PET/MR.

ADVANCES IN KNOWLEDGE

This is the first report to test reproducibility of PET/CT and PET/MR.

Innovations in PET/CT

There has been a longstanding interest in positron emission tomography (PET) in combination with computed tomography (CT). Mostly because of the lack of structural information in PET which makes it difficult to assess the precise location of tissue with metabolic uptake, whereas CT can provide impressive anatomical details. PET/CT designs are facing many challenges such as the conversion of CT numbers to attenuation coefficients, giving rise to artefacts due to the presence of high Zeff material. Patient motion during scans degrades image quality and subsequent analysis, and is a challenge especially as spatial resolution improves. Software based image fusion remains a complex issue outside the brain. State of the art image quality in a modern PET/CT system includes incorporation of point spread function (PSF) and time-of-flight (TOF) information into the reconstruction leading to the high resolution of today's PET/CT systems. This review outlines the background and current knowledge of the PET/CT system design, motion correction and reconstruction approaches.

Enhanced larval cyst growth of Echinococcus multilocularis in praziquantel-treated jirds (Meriones unguiculatus)

Jirds (Meriones unguiculatus) inoculated intraperitoneally with cystic material of Echinococcus multilocularis were given daily oral treatments of praziquantel at 300 mg/kg of body weight (bw) or dimethyl sulfoxide vehicle for five-day treatment regimens starting at 29 days postinoculation (PI) up to 69 days PI. At 39 or 49 days PI, the growth of the larval cystic mass (LCM) in jirds following a single or two five-day treatment regimens was significantly enhanced (P < 0.05) by 129.0% (2.3-fold) or 102.9% (2.0-fold), respectively. At 59 or 69 days PI following three or four five-day treatments with praziquantel, LCM growth was enhanced by 47.8% (1.5-fold) and 44.1% (1.4-fold), respectively, but was no longer significantly different than that in control jirds. A single five-day treatment on 29-33 days PI (with necropsy at 69 days PI) significantly enhanced the growth of the LCM by 87.6% (1.9-fold). Parasites from praziquantel treatment regimens examined ultrastructurally showed consistent damage to the germinal membrane evidenced by vacuolization and rupture of syncytial cytoplasm, rupture and coalescence of the electron-lucent vesicles just below the microvilli of the tegumental surface, and swelling and rounding of mitochondria. At 39 days PI, increased blebbing of the germinal membrane into the lumen of the LCM in praziquantel-treated animals was observed by scanning electron microscopy. The treatment-induced blebs were identified as nucleated germinal cells by transmission electron microscopy and appeared to be responsible for metastasis and enhanced growth of the LCM. Although praziquantel damaged the ultrastructural integrity of the LCM, treatment failed to inhibit larval cyst growth or protoscolex development.(ABSTRACT TRUNCATED AT 250 WORDS)

Frequency distribution of Echinococcus granulosus hydatid cysts in sheep populations in the Xinjiang Uygur Autonomous Region, China

Age-prevalence and age-intensity data of Echinococcus granulosus hydatid cysts in sheep populations were collected in an abattoir in the Xinjiang Uygur Autonomous Region, People's Republic of China. The frequency distribution of the larval cysts per sheep was empirically described by the negative binomial model, with parameter k being 0.5273. A mathematical model for the life cycle of E. granulosus was applied to the collected data and the results show that the infection pressure on sheep was 0.4362 (female) or 0.4119 (male) infections per year, the mean number of cysts increased linearly by 0.8824 (female) or 0.9971 (male) cysts every year and acquired immunity was too low to depress this rate of increase. According to certain definitions of steady states for taeniid populations, it was concluded that at least in some parts of Xinjiang, the life cycle of E. granulosus was and may still be in an endemic steady state. Consequently, the regular dog-dosing program would readily drive the infection from an endemic state towards extinction.

Frequency distribution of Echinococcus granulosus in dog populations in the Xinjiang Uygur Autonomous Region, China

Age-prevalence and age-intensity data of Echinococcus granulosus in dog populations were collected in four counties in the Xinjiang Uygur Autonomous Region, People's Republic of China. The frequency distribution of the parasite per dog was adequately described by the negative binomial model, with parameter k being 0.0571. The mathematical model of the life cycle of E. granulosus constructed by Roberts et al. (1986--Parasitology, Vol. 92, pages 621-641) was used to estimate the epidemiologic parameters of E. granulosus in Xinjiang. This model showed that the prevailing infection pressure on dogs was 0.4560 infectious insults year-1 and the mean length of an infection was 1.4975 years. The effect of acquired immunity on the prevalence of E. granulosus in dogs was considered to be insignificant.

Cystic echinococcosis in the Xinjiang/Uygur Autonomous Region, People's Republic of China. II. Comparison of three levels of a local preventive and control program

A project to compare different levels of a hydatid disease control program was instigated and evaluated in 16 randomly selected villages in the Xinjiang/Uygur Autonomous Region, PRC (China). Factors tested included the effect of: 1) the role of a village hydatid disease control officer, 2) the use of praziquantel-medicated "bait" tablets for treatment of Echinococcus granulosus tapeworms in dogs, and 3) the use of educational materials for children and adults. Evaluation of contrasting treatment levels was done by determining infection rates of E. granulosus in about 25 dogs examined from each of the 16 villages before and after the trial period, and by use of pre- and post-treatment questionnaires distributed to 40 randomly selected households in each village. Optimum results were obtained in those villages which received medicated tablets and support visits from a control officer on a monthly basis (so-called "moderate intervention level").

Immunoglobulin E and G4 antibodies in cysticercosis

The importance of immunoglobulin G (IgG) subclass responses in different infections has been elucidated for a number of organisms, but few parasitic organisms have been examined in this regard. In the current study, quantitative radioimmunoassays were used to examine the IgE and IgG4 subclass responses to larval Taenia solium. Patients were divided into clinically infected (CI) and probably uninfected (PU) groups. Unexposed normal subjects were used as controls. The CI group had elevated geometric mean levels of total IgE in serum (28.6 IU/ml) and specific IgG4 antibodies (438.8 arbitrary units [AU]/ml) compared with controls (8.3 IU/ml and 50.1 AU/ml, respectively). The CI group also had significantly elevated levels in cerebrospinal fluid of total IgG4 (18.6 micrograms/ml) and specific IgG4 antibodies (86.0 AU/ml) compared with the PU group (2.5 micrograms/ml and 1.6 AU/ml, respectively). There was no specific IgE antibody response detected in either the CI or PU patient group. The marked IgG4 response of CI patients to T. solium merits further investigation.

Cystic echinococcosis in the Xinjiang/Uygur Autonomous Region, People's Republic of China. I. Demographic and epidemiologic data

Demographic and epidemiologic data on those factors potentially related to the prevalence and transmission of hydatid disease caused by Echinococcus granulosus were collected in 1987 from each household in 85 villages in the two communities of Yuanhucun and Ershilidian within Hutubi County in the Xinjiang/Uygur Autonomous Region, PRC, with additional questionnaire data collected from approximately 40 households randomly selected from each of 16 villages within those communities. Yuanhucun and Ershilidian represent a combined area of 522.7 square km, and have 4,853 households with 25,684 inhabitants. Of those households, 69.9% are of the Han ethnic group, 22.1% Hui, 5.3% Uygur, and 2.7% Kazak. The total number of animals censused included 4,169 dogs, 41,369 sheep, 3,673 goats, 2,639 cattle, 5,400 pigs, 1,472 horses, and 59 donkeys. Levels of infection of the causative organism of cystic hydatid disease in various hosts were: dogs harboring Echinococcus granulosus tapeworms - 63 (16.2%) positive of 390 examined in 16 villages; domestic animals with hydatid cysts - 1,593 (88.6%) sheep of 1,797 examined, 69 (56.1%) of 123 goats, and 47 (94.0%) of 50 cattle; and 15 surgeries in inhabitants from 85 villages during the last 16 months prior to completion of the survey (annual case rate of 43.8/100,000). Questionnaire data collected from inhabitants in 16 villages showed that about 82% of the families owned at least one dog and 78% owned sheep. Of those families with sheep, most (84%) killed sheep for meat at least periodically, 76% had seen hydatid cysts in liver or lungs of butchered animals, and 77% routinely gave raw offal to their dog.(ABSTRACT TRUNCATED AT 250 WORDS)

In vivo efficacy and ultrastructural effects of mitomycin C against experimental alveolar hydatid disease

The in vivo efficacy and ultrastructural effects of mitomycin C were determined against alveolar hydatid disease in experimentally infected animals and compared to mebendazole treatment. Mitomycin C inhibited the mean cyst mass of treated versus control animals by 84.1% which was statistically significant at the alpha = 0.01 level. Mebendazole given daily inhibited the mean cyst mass by 80.1%, while mebendazole administration on the same treatment schedule as that used for mitomycin C inhibited the mean cyst mass by 70.4%. Ultrastructurally, mitomycin C was not observed to affect the tegumental microtriches (microvilli) or the microtubular system. However, an increase in the number and accumulation of round to oval electrondense vesicles was observed within the subtegument. These inclusion bodies became vacuolated, subsequently degenerated, and formed myelin-like figures. Mitomycin C, like mebendazole, was only cystistatic in its effects on the cyst stage of Echinococcus multilocularis as evidenced by the growth of treated cyst material following inoculation into helminth-free animals.

Efficacy of a combined paste formulation of praziquantel/febantel against immature Echinococcus granulosus and immature Echinococcus multilocularis

A combined paste formulation of praziquantel (1 mg/kg of body wt)/febantel (10 mg/kg) given for 3 consecutive days gave 100% clearance of immature Echinococcus granulosus and E multilocularis in experimentally infected dogs. The formulation was extremely convenient to administer. Adverse reactions were not noted in the treated animals.

Ultrastructural characterization of serum-induced changes in the tegument of Taenia taeniaeformis

The objective of this study was to characterize complement-dependent damage to the tegument of isolated metacestodes of Taenia taeniaeformis caused by exposure to immune or normal rat serum (IRS and NRS, respectively). Metacestodes of T. taeniaeformis (34- and 69-day-old) from rats were incubated for 1 hr in 0.85% physiological saline solution (PSS), IRS, NRS, heat-inactivated at 56 C for 1 hr (delta) IRS, or delta NRS and then fixed for 2 hr in 3% glutaraldehyde. The larvae were then prepared for freeze-etching, thin sectioning, and SEM by standard techniques. Freeze-etch replicas of PSS-, delta IRS-, and delta NRS-treated larvae showed no damage, whereas those of IRS- and NRS-treated metacestodes exhibited vesiculation in the extracellular matrices, segmentation or "beading" of the microthrix tip, significant reductions in the number of intramembranous particles (IMP) in the P face of the membrane of the microthrix base, and changes in the pattern of IMP distribution in the P face of the base. Similar results were obtained from larvae prepared for thin sectioning and SEM. Additionally, thin-sectioned preparations demonstrated that in some cases the entire tegument was stripped away in IRS- and NRS-treated metacestodes. Our results have provided supportive evidence that complement-mediated lysis of larvae of T. taeniaeformis is not enhanced by the presence of antibody in serum, and we also characterized ultrastructurally the types of tegumental damage that may contribute to lysis. In addition, a possible defense mechanism used by the parasite to counter immunological attack by host phagocytic cells is proposed.

Fine structure and freeze-etch study of the protoscolex tegument of Echinococcus multilocularis (cestoda)

Freeze-etch replicas of the protoscolex tegument of Echinococcus multilocularis were examined and compared with conventional thin sections by TEM. The microtopography of the protoscolex tegument was also examined by SEM. The protoscolex consisted of morphologically-distinct, apical and basal tegumentary regions, the latter of which lacked microtriches. The hook area of the apical region contained long, slender, filamentous microtriches that obscured the hook arrangement. These microtriches were structurally different from those found on the suckers and rostellum of the protoscolex. Freeze-etch replicas of the tegumental membrane of the sucker and rostellar microtriches showed that the protoplasmic (P) and exoplasmic (E) faces of the microthrix base and tip contained numerous intramembranous particles (IMP). The densities of the IMP on both the P and E faces of the microthrix tip were approximately twice the number of the larger diameter IMP found on the P and E faces of the microthrix base. No freeze-etch replicas of the microtriches from the hook area were obtained. The basal tegumentary region of the protoscolex consisted of irregularly-distributed, knoblike processes that were variable in size and shape, and contained an electron-dense cap. The IMP on the P face of the knoblike processes measured approximately the same diameter as those on the P face of the microthrix base. However, their density was about half that of the latter. The density of IMP on the E face of the knoblike processes could not be determined from the freeze-etch replicas.

Freeze-etch characterization of the teguments of three metacestodes: Echinococcus granulosus, Taenia crassiceps, and Taenia taeniaeformis

The objective of this study was to characterize the teguments of metacestodes of Echinococcus granulosus, Taenia crassiceps, and Taenia taeniaeformis using the freeze-etch technique. Metacestodes of E. granulosus (19 mo old), T. crassiceps (28 days old), and T. taeniaeformis (34 days old) from gerbils, mice and rats, respectively, were fixed for 2 hr in 3% glutaraldehyde and then prepared for freeze-etching and thin sectioning by standard techniques. Freeze-etch replicas of the teguments of all three species displayed morphologic characteristics that were generally in agreement with previous ultrastructural work, although some new features and interpretations arose from use of this technique. For each species there was a concentric ring structure within the microthrix base, and cytoplasmic extensions of the perikarya into the distal tegument were membrane-bound rather than confluent bridges; these extensions frequently branched within the tegument. In addition, channels running from the proximal tegumental membrane to, and opening at the distal surface of, the tegument were seen in thin sections.

Possible factors influencing distribution and prevalence of Echinococcus granulosus in Utah

A descriptive epidemiologic study was designed to test an impression that infections of Echinococcus granulosus in dogs, sheep, and human beings were concentrated in central Utah, and to determine when and how the parasite was introduced into the state, which factors were involved in the distribution of the cestode, and which factors increased either a person's risk of infection of the number of people at risk. Data were secured by review of available records, interviews, questionnaires, and field observations. It was found that 37 of 39 infections in human beings, and seven of eight counties with endemic hydatid disease in dogs and sheep, are located in central Utah. Possible factors responsible for the increasing number of people at risk were use of local people as herders, the existence of community herds, and specific dog management practices. Determinants such as trailing sheep between seasonal pastures, association of sheepmen from several counties on winter range, and sheep marketing practices undoubtedly influence distribution of infections in dogs and sheep.

Efficacy of praziquantel against immature Echinococcus multilocularis in dogs and cats

Efficacy of an injectable formulation of praziquantel (given IM at a dosage of 5 mg/kg of body weight) against immature Echinococcus multilocularis was studied in 18 experimentally infected dogs and 22 experimentally infected cats. There were no worms recovered at necropsy from any of the treated hosts. However, whereas E multilocularis worms were recovered from all nontreated control dogs (n = 9; min-max 15-1,840, mean 483), such tapeworms were recovered from only k6 of the 11 nontreated control cats (min-max 2-820; overall mean 123.4). The study demonstrates 100% clearance of E multilocularis by praziquantel in experimentally infected dogs and cats, and shows that cats are not as suitable as experimental hosts for this parasite as are dogs.

Comparison of suitability of dogs and cats as hosts of Echinococcus multilocularis

The suitability of dogs and cats as hosts of Echinococcus multilocularis was studied in animals which had each been infected orally with approximately 15,000 protoscolices. Twenty-one days after injection, the mean number of immature worms recovered from 12 dogs was 874.7 and from 12 cats was 101.7. The mean length of the worms was 1.21 mm in dogs and 1.00 mm in cats. The number and length of worms recovered from dogs were significantly greater (alpha = 0.01).

Effect of praziquantel on adult Echinococcus granulosus in vitro: scanning electron microscopy

The effect of praziquantel in vitro at concentrations of 5, 50 and 500 ppm for 1 h resulted in the progressive breakdown of the tegument and in morphologic distortion of adult Echinococcus granulosus when compared to controls. Scanning electron microscopy of all specimens treated in the various concentrations of praziquantel showed loss of most, if not all of the rostellar hooks and changes in the structure of the suckers. Many of the tapeworms immediately detached from the host's gut upon being placed in the drug, and all treated cestodes exhibited contraction or swelling, particularly in the penultimate proglottid. Intense contraction was apparent in the worms exposed to the higher drug concentrations. Characteristic conical microtriches on the terminal proglottid, as observed in the control specimens, became fused and matted when exposed to 5 ppm of praziquantel. At a drug concentration of 50 ppm, the tegumental surface developed grooves or furrows between clumps of fused microtriches, while 500 ppm caused production of holes within the denuded tegument of the parasite. Ovoid bodies, presumed to be eggs, were observed on the outer surfaces and just below the tegument of tapeworms treated with concentrations of 50 ppm. These structures also appeared to adhere to the outer surfaces of specimens exposed to 500 ppm. In view of the foregoing, special care should be taken in handling and disposing of feces from infected or suspect dogs after praziquantel treatment, since the breakdown in the tegumental surface of E. granulosus presumably results in the release of potentially infective eggs.

Immunodiagnostic tests for hydatidosis in sheep: an evaluation of double diffusion, immunoelectrophoresis, indirect hemagglutination, and intradermal tests

Immunoelectrophoresis (IEP), double diffusion (DD5), indirect hemagglutination (IHA), and intradermal (ID) tests were evaluated to determine their ability to detect echinococcosis in sheep. Four sheep were infected per os with approximately 4,00, 1-wk-old eggs of Echinococcus gradulosus; four more sheep were similarly infected with approximately 3,000 1-wk-old eggs of Taenia hydatigena, and two additional sheep were used as uninfected controls. Blood samples were collected from each sheep prior to infection, at 2 and 4 wk postinoculation, and monthly thereafter for 1 yr. Serum from each blood sample was tested by IEP and DD5 for antiantigen "5" activity and by IHA for Echinococcus-specific hemagglutination activity. Following the last blood collection, an ID test for echinococcosis was performed on each sheep, after which all sheep were necropsied, and the type, location, and size of all larval tapeworms recorded. The DD5 test was found to be more sensitive and at least as specific as IEP in detecting echinococcosis in sheep. The IHA test approached the specificity and sensitivity pattern of DD5 and IEP if a titer of greater than or equal to 1:1,024 was considered positive. The ID test supported DD5 and IEP results but demonstrated a lack of specifiity. Necropsy data verified that all sheep were infected according to the experimental design. We conclude that DD5 reliably detects echinococcosis in experimentally infected sheep, and that further research is warranted to evaluate this test for detecting echinococcosis in naturally infected sheep.

Echinococcus granulosus in dogs and sheep in central Utah, 1971-1976

During 1971 to 1976, a survey was conducted to determine the prevalence of Echinococcus granulosus infection among dogs and sheep in central Utah. For each year, the number of dogs positive for adult tapeworms of the total number examined and the percentage infected were: in 1971, 14 of 51 infected (27.4%); in 1972, 13 of 46 infected (28.3%); in 1973, 7 of 36 infected (19.4%); in 1974, 34 of 244 infected (13.9%); in 1975, 13 of 267 infected (4.9%); and in 1976, 14 of 195 infected (7.2%), or a 6-year total of 95 of 839 infected (av = 11.3%). For each year, the number of sheep positive with hydatid cysts of the total number examined and the percentage infected were: in 1971, 103 of 1,007 infected (10.2%); in 1972, 235 of 1,808 infected (13.0%); in 1973, 242 of 2,003 infected (12.1%); in 1974, 105 of 1,406 infected (7.5%); in 1975, 96 of 1,599 infected (6.0%); and in 1976, 96 of 1,171 infected (8.2%), or a 6-year total of 877 of 8,994 infected (av = 9.8%). These results represent a definite decline in numbers of infected animals and suggest that preventive and control measures advocated in central Utah are being implemented.

Survival of protoscolices of Echinococcus granulosus at constant temperatures

A study was conducted to determine the effects of storage at constant temperatures upon the survival of protoscolices of Echinococcus granulosus from hydatid cysts removed from infected sheep. Parallel tests were conducted on intact cysts from both lung and liver, and on protoscolices stored within 1-ml samples of hydatid fluid. The longest survival times of any of the samples tested at each temperature were: -20 C, 1 hr; -10 C, 4 hr; 1 C, 16 days; 10 C, 16 days; 20 C, 8 days; 30 C, 4 days; 40 C, 2 days, and 50 C, 2 hr. In general, protoscolices survived considerably better when stored within intact cysts than when in 1 ml of hydatid fluid. At temperature ranges where putrefaction occurred, protoscolices in cysts from lung survived longer than those from liver. The ability of these protoscolices to survive extended periods of time after an infected sheep has died or been killed suggests that stringent preventive and control measures should be established in areas where hydatid disease is endemic. Animal pits at community dumping grounds where sheep carcasses might be discarded should be enclosed or covered, and all stray and roving dogs in those regions should be rigidly controlled.

Hydatid disease screening: Sanpete County, Utah, 1971-1976

Between 1971 and 1976 approximately 20% (2,265) of the population of Sanpete County, Utah, was screened for hydatid disease (Echinococcus granulosus) by intradermal, indirect hemagglutination, and bentonite flocculation tests. Of 34 persons who had follow-up chest radiographs and radioisotope liver scans, 6 were found to have asymptomatic hepatic cysts. If a participant who had pulmonary cysts and negative screening tests were included, the prevalence of asymptomatic hydatid disease would be 3 per 1,000. During the same period, 82 (148 per 1,000) of 553 dogs successfully purged and examined had E. granulosus infections. Human cyst carriage was associated with dog ownership, particularly of infected dogs or in conjunction with sheep raising as the main livelihood. Combinations of immunodiagnostic tests were more efficacious in identifying cyst carriers than the tests used singly. Limitation of screening to high risk groups (e.g., sheep raisers with dogs) can reduce costs without reducing yield. Optimum management of the cyst carrier awaits further information on the natural history of asymptomatic hydatid disease.

Epidemiologic investigation of echinococcosis in American Indians living in Arizona and New Mexico

Ten cases of echinococcosis diagnosed in American Indians in Arizona and New Mexico between 1972 and 1975 were investigated as part of a regional epidemiologic study. Patients were visited at home to discover factors associated with local parasite transmission, to detect possible additional cases among family members, and to perform diagnostic tests on dogs. Six patients were Navajo, 2 Zuni, and 2 Santo Domingo Indians. An additional case in a Navajo man was detected by serologic testing of patients' family members; this was the 20th case diagnosed in the region since 1965. Dogs owned by three of the Navajo patients were infected with Echinococcus granulosus. Arecoline-purge testing of 110 dogs in the Zuni pueblo demonstrated echinococcosis in a single stray dog. The findings at slaughter of Navajo-owned sheep indicate that the infection is enzootic in this intermediate host. The epidemiologic findings suggest that humans were infected from dogs which contracted their infections from two sources. The first was sheep raised locally in rural areas of the Navajo Reservation where the infection is enzootic in the dog-sheep cycle; transmission was apparently facilitated by the widespread practice of home butchering. A second source of human infection was dogs which became infected by eating viscera of sheep of off-reservation origin; these sheep were purchased and butchered by individual families in urban areas of the Navajo Reservation and in the Zuni and Santo Domingo pueblos.

Efficacy of bunamidine hydrochloride against immature and mature stages of Echinococcus granulosus

The efficacy of bunamidine hydrochloride (given at dose levels of 25 and 50 mg/kg of body wt) against immature and mature Echinococcus granulosus tapeworms was studied in experimentally infected dogs. The compound had average efficacies of 85.9 to 98.8 percent against the immature stages and was completely efficacious (100 percent clearance) against the mature worms. These data indicate that bunamidine HCl at the given doses can be used as a control measure against hydatid disease in the United States.