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Piñero-García F, Thomas R, Mantero J, Forssell-Aronsson E, Isaksson M. Biodistribution of naturally occurring radionuclides and radiocesium in wild European perch (Perca fluviatilis). Ecotoxicol Environ Saf 2023; 260:115085. [PMID: 37267782 DOI: 10.1016/j.ecoenv.2023.115085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/12/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
Wild European perch (Perca fluviatilis) is one of the most important freshwater fish species, in Sweden, due to its widespread and his value for recreational fishing. Little it is known regarding the biodistribution of naturally occurring radionuclides such as 238U, 234U, 226Ra, 210Po in perch. Therefore, in this study, perches from five lakes located in different counties in Sweden were collected to investigate the biodistribution of 238U, 234U, 226Ra, 210Po and 137Cs in organs and tissues of perch as well as their radiological impact. The results showed that uranium radionuclides ranged between 0.1 and 6 Bq/kg with an average value of 1.1 ± 1.5 Bq/kg. 226Ra varied from 0.4 to 8 Bq/kg with a mean concentration of 1.7 ± 1.9 Bq/kg. The ranged of 210Po was 0.5 - 250 Bq/kg, with an average value of 24 ± 52 Bq/kg. On the other hand, the highest activity concentration of 137Cs, 151 ± 1 Bq/kg, was detected in muscle samples of perch from Redsjösjön lake. For uranium radionuclides and 226Ra uptake from water is the main source whereas for 210Po and 137Cs the uptake is controlled by the perch diet. Regarding naturally occurring radionuclides, the perch tended to accumulated uranium radionuclides in fins, gills, and skin; 226Ra in bones, fins and skin and 210Po in the organs linked to digestive system. Finally, in case of consumption, it is advised the consumption of skinned fillets of perch due to the higher bioaccumulation of the radionuclides investigated in the skin and scales.
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Affiliation(s)
- F Piñero-García
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden.
| | - R Thomas
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden
| | - J Mantero
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden; Department of Applied Physics II, ETSA, University of Seville, Seville 41012, Spain
| | - E Forssell-Aronsson
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden; Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - M Isaksson
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden
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Thomas R, Mantero J, Pérez-Moreno SM, Ruiz-Canovas C, Vioque I, Isaksson M, Forssell-Aronsson E, Holm E, García-Tenorio R. 226Ra, 210Po and lead isotopes in a pit lake water profile in Sweden. J Environ Radioact 2020; 223-224:106384. [PMID: 32919820 DOI: 10.1016/j.jenvrad.2020.106384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 07/01/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
A pit lake arises as a consequence of anthropogenic activities in opencast mining areas. These water bodies may be enriched in hazardous stable contaminants and/or in naturally occurring radionuclides depending on the local geological conditions. Mining legacy in Sweden produced hundreds of these pit lakes and most of them are used for recreational purposes in the southern part of the country. In this paper, one pit lake was selected for having enhanced levels of natural radionuclides. Physico-chemical parameters (temperature, pH, oxidation-reduction potential, dissolved oxygen and depth), elemental composition (via Inductive Coupled Plasma Mass Spectrometry) and radiometric characterization (via alpha spectrometry of 226Ra, 210Po and 210Pb) were carried along the depth of a 60 m depth pit lake, with the main aim to describe how natural radionuclides and elements behaves with depth in a non-uraniferous pit lake. Based on observed changes in physico-chemical parameters, a thermocline and a chemocline region were identified at around 10 and 30 m depth respectively. Concerning radionuclides, 226Ra ranged from 75 ± 3 up to 360 ± 12 mBq/kg while 210Po ranged from 11 ± 1 up to 71 ± 3 mBq/kg. 210Pb distribution with depth was also determined via secular equilibrium with 210Po after 2 years and also stable Pb was measured. Disequilibrium 226Ra-210Pb was found and the residence time of 210Pb in the water column was assessed. Additionally, different vertical distributions between 210Pb and Pb were found which points out different sources for different lead isotopes in the water body.
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Affiliation(s)
- R Thomas
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 413 45, Sweden
| | - J Mantero
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 413 45, Sweden; Department of Applied Physics II, ETSA, Universidad de Sevilla, Seville, 41012 Spain.
| | - S M Pérez-Moreno
- Group of Radiation Physics and Environment, Universidad de Huelva, Huelva, Spain
| | - C Ruiz-Canovas
- Department of Earth Sciences & Research Center on Natural Resources, Health and the Environment. University of Huelva, Huelva, 21071, Spain
| | - I Vioque
- Department of Applied Physics II, ETSA, Universidad de Sevilla, Seville, 41012 Spain
| | - M Isaksson
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 413 45, Sweden
| | - E Forssell-Aronsson
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 413 45, Sweden
| | - E Holm
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, 413 45, Sweden
| | - R García-Tenorio
- Department of Applied Physics II, ETSA, Universidad de Sevilla, Seville, 41012 Spain; Spanish National Accelerator Centre (CNA), US-JA-CSIC, Sevilla, 41092, Spain
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3
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Biermann J, Parris TZ, Nemes S, Danielsson A, Engqvist H, Werner Rönnerman E, Forssell-Aronsson E, Kovács A, Karlsson P, Helou K. Abstract P3-07-09: Tumour clonality in paired invasive breast carcinomas. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-07-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Multiple invasive breast tumours may represent either independent primary tumours or clonal recurrences of the first tumour, where the same progenitor cell gives rise to all of the detected tumours. Consequently, the driver events for the progenitor cell need to have been identical in early tumour development. Molecular classification of tumour clonality is not currently evaluated in multiple invasive breast carcinomas, despite evidence suggesting common clonal origins. Furthermore, there is no consensus about which type of biological data (e.g. copy number, mutation, histology) and especially which statistical method is most suitable to distinguish clonal recurrences from independent primary tumours.
Methods: Thirty-seven invasive breast tumour pairs were stratified by laterality (bilateral vs. ipsilateral) and the time interval between the diagnoses of the first and second tumours (synchronous vs. metachronous). Both tumours from the same patient were analysed by integrating clinical characteristics (n = 37), DNA copy number (n = 37), DNA methylation (n = 8), gene expression microarray (n = 7), RNA sequencing (n = 3), and SNP genotyping data (n = 3). Different statistical methods, e.g. the diagnostic similarity index (SI), distance measure, shared segment analysis etc., were used to classify the tumours from the same patient as clonally related recurrences or independent primary tumours.
Results: The SI applied on DNA copy numbers derived from aCGH (array comparative genomic hybridization) data was determined as the strongest indicator of clonal relatedness as it showed the highest concordance with all other methods. The distance measure was the most conservative method and the shared segment analysis most liberal. Concordant evidence for tumour clonality was found in 46% (17/37) of the patients. Notably, no significant association was found between the clinical characteristics and molecular tumour features.
Conclusions: A more accurate classification of clonal relatedness between multiple breast tumours may help to mitigate treatment failure and relapse by integrating tumour-associated molecular features, clinical parameters, and statistical methods. In cases of extremely similar or different tumour pairs, the results showed consistency regardless of the method used. The SI can be easily integrated into clinical routine using FFPE samples to obtain copy number data. However, clinical guidelines with exact thresholds need to be defined to standardize clonality testing in a routine diagnostic setting.
Citation Format: Biermann J, Parris TZ, Nemes S, Danielsson A, Engqvist H, Werner Rönnerman E, Forssell-Aronsson E, Kovács A, Karlsson P, Helou K. Tumour clonality in paired invasive breast carcinomas [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-07-09.
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Affiliation(s)
- J Biermann
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - TZ Parris
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S Nemes
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A Danielsson
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - H Engqvist
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - E Werner Rönnerman
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - E Forssell-Aronsson
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A Kovács
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P Karlsson
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - K Helou
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
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4
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Parris TZ, Biermann J, Engqvist H, Werner Rönnerman E, Truvé K, Nemes S, Forssell-Aronsson E, Solinas G, Kovács A, Karlsson P, Helou K. Abstract P3-04-07: Novel genetic features associated with 8p11-p12 amplification in breast carcinoma. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-04-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Genome instability contributes to the neoplastic phenotype by promoting gene loss and duplications, which in turn can have a detrimental effect on patient outcome by inactivating tumor suppressor genes or hyperactivating oncogenes. In breast carcinoma, DNA amplification of the 8p11-p12 genomic region has been associated with tumor progression and poor prognosis. The aim of this study was to characterize recurrent genetic features (other than DNA amplification) associated with 8p11-p12 amplification in breast carcinoma.
Methods: DNA copy number profiling data for 229 primary invasive breast carcinomas (corresponding to 185 patients diagnosed in Western Sweden between 1988 and 1999) were evaluated to identify 8p11-p12 amplified cases. Illumina paired-end whole transcriptome sequencing (RNA-seq) and whole-genome SNP genotyping were subsequently performed on 23 breast carcinomas harboring high-level regional 8p11-p12 amplification to characterize recurrent genetic variants (SNPs and indels), expressed gene fusions, gene expression profiles and allelic imbalances. The 23 samples were stratified into the molecular subtypes, resulting in 16 Luminal B/HER2-, two Luminal B/HER2+, four HER2/ER-, and one Basal-like sample. The Cancer Genome Atlas (TCGA) RNA-seq data for 10 primary breast carcinomas lacking the 8p11-p12 amplicon (SNP segmented mean < 0.4) were used as controls. Gene fusions were validated using dual-color fluorescence in situ hybridization (FISH) with co-hybridized biotin-16-dUTP and dioxigenin-11-dUTP labeled bacterial artificial chromosome (BAC) probes.
Results: Here, we report that despite the high number of gene fusions (133±31 (±SEM)) and exonic variants (411±16) identified per tumor, few gene fusions (n=46) and exonic variants (n=11) spanned the 8p11-p12 genomic region. Gene fusions predominantly contained at least one fusion partner spanning non-coding RNAs (ncRNAs; 86%), in particular MALAT1, which is induced by estrogen and of prognostic value in breast cancer. The majority of fusion breakpoints were associated with DNA copy number gains and losses, as well as, extensive intratumoral heterogeneity for specific fusion events. Intriguingly, novel 8p11-p12 amplification-specific genetic variants (HIST1H1E frameshift insertion, UQCRHL nonsynonymous SNV, MTUS1 frameshift insertion, NPIPA5 frameshift deletion) were identified that also resulted in mutation-dependent changes in gene expression levels.
Conclusions: Taken together, these findings have provided further insight into the genetic landscape of 8p11-p12 amplified breast carcinomas, including novel gene fusions and genetic variants. However, further studies are required to develop effective strategies to target 8p11-p12 amplification in breast carcinoma.
Citation Format: Parris TZ, Biermann J, Engqvist H, Werner Rönnerman E, Truvé K, Nemes S, Forssell-Aronsson E, Solinas G, Kovács A, Karlsson P, Helou K. Novel genetic features associated with 8p11-p12 amplification in breast carcinoma [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-04-07.
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Affiliation(s)
- TZ Parris
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - J Biermann
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - H Engqvist
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - E Werner Rönnerman
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - K Truvé
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - S Nemes
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - E Forssell-Aronsson
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - G Solinas
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - A Kovács
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - P Karlsson
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - K Helou
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Bioinformatics Core Facility, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Gothenburg, Sweden; The Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
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5
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Forssell-Aronsson E, Quinlan RA. THE IMPACT OF CIRCADIAN RHYTHMS ON MEDICAL IMAGING AND RADIOTHERAPY REGIMES FOR THE PAEDIATRIC PATIENT. Radiat Prot Dosimetry 2017; 173:16-20. [PMID: 27885090 DOI: 10.1093/rpd/ncw328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Daily rhythmic changes are found in cellular events in cell cycle, DNA repair, apoptosis and angiogenesis in both normal and tumour tissue, as well as in enzymatic activity and drug metabolism. In this paper, we hypothesize that circadian rhythms need to be considered in radiation protection and optimization in personalized medicine, especially for paediatric care. The sensitivity of the eye lens to ionizing radiation makes the case for limiting damage to the lens epithelium by planning medical radio-imaging procedures for the afternoon, rather than the morning. Equally, the tumour and normal tissue response to radiotherapy is also subject to diurnal variation enabling optimization of time of treatment.
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Affiliation(s)
- E Forssell-Aronsson
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center,Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, SE 413 45 Gothenburg, Sweden
| | - R A Quinlan
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH1 3LE, UK
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6
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Parris T, Kovács A, Aziz L, Hajizadeh S, Nemes S, Semaan M, Forssell-Aronsson E, Karlsson P, Helou K. Prognostic Value of a Four-Marker Panel Associated with Breast Cancer-Specific Survival. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt084.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Spetz J, Dalmo J, Nilsson O, Wängberg B, Ahlman H, Forssell-Aronsson E. Specific binding and uptake of 131I-MIBG and 111In-octreotide in metastatic paraganglioma--tools for choice of radionuclide therapy. Horm Metab Res 2012; 44:400-4. [PMID: 22566195 DOI: 10.1055/s-0032-1311603] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Tumor-specific uptake of the radiolabeled nor-epinephrine analogue meta-iodobenzylguanidine via norepinephrine transporter or radiolabeled somatostatin analogues octreotide/octreotate via somatostatin receptors offers possibilities to diagnose and treat metastatic pheochromocytoma/paraganglioma. High uptake of 123I-meta-iodobenzylguanidine is dependent on high expression of vesicular monoamine transporters responsible for mediating uptake of biogenic amines into dense core granules. A patient with metastatic paraganglioma (liver and bone metastases) underwent surgical removal of the primary after injection of 131I-meta-iodobenzylguanidine and 111In-octreotide. Radioactivity was determined in biopsies from tumor and normal tissue biopsies. The tumor/blood concentration value was high: 180 for 131I-meta-iodobenzylguanidine 3 h after injection and 590 for 111In-octreotide 27 h after injection. Studies of primary tumor cell cultures demonstrated increased cell membrane binding and internalization over time for 131I-meta-iodobenzylguanidine. The vesicular monoamine transporter antagonist reserpine and the norepinephrine transporter inhibitor clomipramine reduced internalization by 90% and 70%, respectively, after 46 h of incubation. The results demonstrated increased cell membrane binding and internalization over time also for 111In-octreotide. Internalization was highest for a low concentration of 111In-octreotide. Excess of octreotide reduced internalization of 111In-octreotide with 75% after 46 h of incubation. In conclusion, uptake and tumor/blood concentration values of radiolabeled meta-iodobenzylguanidine and somatostatin analogues can be determined for metastatic pheochromocytoma/paraganglioma to evaluate the possibility to use one or both agents for therapy. For this patient, the high tumor/blood values clearly demonstrated that therapy using both radiopharmaceuticals would be most beneficial. In vitro studies verified specific cell-membrane binding and internalization in tumor cells of both radiopharmaceuticals.
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Affiliation(s)
- J Spetz
- Department of Radiation Physics, Sahlgrenska Cancer Center, University of Gothenburg, Göteborg, Sweden
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8
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Abstract
Background: Current standards for assessment of tumour response to therapy (a) categorise therapeutic efficacy values, inappropriate for patient-specific and deterministic studies, (b) neglect the natural growth characteristics of tumours, (c) are based on tumour shrinkage, inappropriate for cytostatic therapies, and (d) do not accommodate integration of functional/biological means of therapeutic efficacy assessed with, for example, positron emission tomography or magnetic resonance imaging, with data from anatomical changes in tumour. Methods: A quantity for tumour response was formulated assuming that an effective treatment may decrease the cell proliferation rate (cytostatic) and/or increase the cell loss rate (cytotoxic) of the tumour. Tumour response values were analysed for 11 non-Hodgkin's lymphoma patients treated with 131I-labelled anti-B1 antibody and 12 prostate cancer patients treated with a nutritional supplement. Results: Tumour response was found to be equal to the logarithm of the ratio of post-treatment tumour volume to the volume of corresponding untreated tumour. Neglecting the natural growth characteristics of tumours results in underestimation of treatment effectiveness based on currently used methods. The model also facilitates the integration of data from tumour volume changes, with data from functional imaging. Conclusion: Tumour response to therapy can be assessed with a continuous dimensionless quantity for both cytotoxic and cytostatic treatments.
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Affiliation(s)
- E Mehrara
- Department of Radiation Physics, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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9
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Lagerstrand KM, Plewes DB, Vikhoff-Baaz B, Forssell-Aronsson E. Flow-induced disturbances in balanced steady-state free precession images: means to reduce or exploit them. Magn Reson Med 2009; 61:893-8. [PMID: 19191282 DOI: 10.1002/mrm.21656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this work computer simulations and phantom measurements are presented that show the effect of flow on in-plane balanced steady-state free precession images. The images were studied for various flow velocities, excitation regions, relaxation times, RF-pulse angles, and off-resonance frequencies. The work shows that flow-induced disturbances are present in the images, but can be reduced by the application of inhomogeneous excitation regions. Also, a velocity quantification method that utilizes the disturbances was developed and proved to quantify flow velocities accurately. The work concluded that the flow-induced disturbances can be reduced to improve image quality, but can also be exploited to quantify the flow velocity.
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Affiliation(s)
- K M Lagerstrand
- Department of Radiation Physics, Göteborg University, Göteborg, Sweden.
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10
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Starck G, Carlsson A, Ljungberg M, Forssell-Aronsson E. k-space analysis of point-resolved spectroscopy (PRESS) with regard to spurious echoes in in vivo (1)H MRS. NMR Biomed 2009; 22:137-147. [PMID: 18759377 DOI: 10.1002/nbm.1289] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The spurious echo artefact, not uncommon in (1)H MRS in the brain, comes from refocusing outer volume signal. Application of MRS in small volumes in susceptibility-affected regions often results in large shim gradients. The artefact problem is accentuated when the global effect of the shim gradient shifts the water resonance outside the water suppression band in the outer volume. This scenario brings the issue of spurious echoes once again to the fore. In this paper, spurious signals of the point-resolved spectroscopy (PRESS) sequence are analysed using the concept of k-space. This new approach facilitates a more geometrical view of the problem, well suited for studying the effect of gradient spoiling and refocusing of signal. Several spoiling options are shown, and the probability of the global effects of shimming being a primary cause of the artefact is discussed. Fourier transform analysis of realistic slice profiles, combined with the k-space description of spurious echoes, shows that unsuppressed water signal in outer regions greatly increases the demands on spoiling. Gradient spoiling adequate for artefact suppression at a given size of MRS volume may not be sufficient at a smaller size. Several ways to improve PRESS measurements with regard to suppression of spurious signal are discussed.
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Affiliation(s)
- G Starck
- Division of Medical Physics and Medical Engineering, Sahlgrenska University Hospital, Göteborg, Sweden
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11
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Bernhardt P, Forssell-Aronsson E. Estimation of metastatic cure after radionuclide therapy. Q J Nucl Med Mol Imaging 2007; 51:297-303. [PMID: 17464278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Targeted radionuclide therapy of disseminated tumor disease involves many factors that will affect the therapeutic outcome. For optimization of such therapy, it is important to know how these factors affect the therapeutic outcome. In this paper, the metastatic cure probability (MCP) model is described. The MCP model is a valuable tool for analyses of the various factors influencing the metastatic cure. The factors discussed are: 1) the physical parameters (the energy and range of emitted particles, absorbed dose-distributions, and cross-irradiation of tumors from the surrounding normal tissue) and 2) the biological parameters (radiosensitivity of tumors, tumor distributions, tumor growth rate, metastasis formation rate, variable tumor activity concentration and non-homogeneous tumor activity distributions).
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Affiliation(s)
- P Bernhardt
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital Göteborg, Sweden.
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12
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Kölby L, Bernhardt P, Johanson V, Schmitt A, Ahlman H, Forssell-Aronsson E, Mäcke H, Nilsson O. Successful receptor-mediated radiation therapy of xenografted human midgut carcinoid tumour. Br J Cancer 2005; 93:1144-51. [PMID: 16251870 PMCID: PMC2361494 DOI: 10.1038/sj.bjc.6602845] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Somatostatin receptor (sstr)-mediated radiation therapy is a new therapeutic modality for neuroendocrine (NE) tumours. High expression of sstr in NE tumours leads to tumour-specific uptake of radiolabelled somatostatin analogues and high absorbed doses. In this study, we present the first optimised radiation therapy via sstr using [(177)Lu-DOTA(0)-Tyr(3)]-octreotate given to nude mice xenografted with the human midgut carcinoid GOT1. The tumours in 22 out of 23 animals given therapeutic amounts showed dose-dependent, rapid complete remission. The diagnostic amount (0.5 MBq [(177)Lu-DOTA(0)-Tyr(3)]-octreotate) did not influence tumour growth and was rapidly excreted. In contrast, the therapeutic amount (30 MBq [(177)Lu-DOTA(0)-Tyr(3)]-octreotate) induced rapid tumour regression and entrapment of (177)Lu so that the activity concentration of (177)Lu remained high, 7 and 13 days after injection. The entrapment phenomenon increased the absorbed dose to tumours from 1.6 to 4.0 Gy MBq(-1) and the tumours in animals treated with 30 MBq received 120 Gy. Therapeutic amounts of [(177)Lu-DOTA(0)-Tyr(3)]-octreotate rapidly induced apoptosis and gradual development of fibrosis in grafted tumours. In conclusion, human midgut carcinoid xenografts can be cured by receptor-mediated radiation therapy by optimising the uptake of radioligand and taking advantage of the favourable change in biokinetics induced by entrapment of radionuclide in the tumours.
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Affiliation(s)
- L Kölby
- Department of Surgery, Lundberg Laboratory for Cancer Research, Institute for Surgical Sciences, Göteborg University, Sahlgrenska University Hospital, Sweden.
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Tisell LE, Ahlman H, Wängberg B, Hansson G, Mölne J, Nilsson O, Lindstedt G, Fjälling M, Forssell-Aronsson E. Somatostatin receptor scintigraphy in medullary thyroid carcinoma. Br J Surg 2005. [DOI: 10.1046/j.1365-2168.1997.02625.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Kölby L, Bernhardt P, Levin-Jakobsen AM, Johanson V, Wängberg B, Ahlman H, Forssell-Aronsson E, Nilsson O. Uptake of meta-iodobenzylguanidine in neuroendocrine tumours is mediated by vesicular monoamine transporters. Br J Cancer 2003; 89:1383-8. [PMID: 14520475 PMCID: PMC2394326 DOI: 10.1038/sj.bjc.6601276] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The radio-iodinated noradrenaline analogue meta-iodobenzylguanidine (MIBG) can be used for scintigraphy and radiation therapy of neuroendocrine (NE). The aim of the present study was to study the importance of vesicular monoamine transporters (VMATs) for the uptake of 123I-MIBG in NE tumours. In nude mice, bearing the human transplantable midgut carcinoid GOT1, all organs and xenografted tumours accumulated 123I after i.v. injection of 123I-MIBG. A high concentration of 123I was maintained in GOT1 tumours and adrenals, which expressed VMATs, but rapidly decreased in all other tissues. In the VMAT-expressing NE tumour cell lines GOT1 and BON and in VMAT-expressing primary NE tumour cell cultures (carcinoids, n=4 and pheochromocytomas, n=4), reserpine significantly reduced the uptake of 123I-MIBG. The membrane pump inhibitor clomipramine had no effect on the uptake of 123I-MIBG in GOT1 and BON cells, but inhibited the uptake in one out of four primary carcinoid cell cultures and three out of four primary pheochromocytoma cell cultures. In conclusion, VMATs and secretory granules are of importance for the uptake and retention of 123I-MIBG in NE tumours. Information about the type and degree of expression of VMATs in NE tumours may be helpful in future to select patients suitable for radiation therapy with radio-iodinated MIBG.
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Affiliation(s)
- L Kölby
- Department of Surgery, Göteborg University, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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15
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Ljungberg M, Sunnerhagen KS, Vikhoff-Baaz B, Starck G, Forssell-Aronsson E, Hedberg M, Ekholm S, Grimby G. 31P MRS evaluation of fatigue in anterior tibial muscle in postpoliomyelitis patients and healthy volunteers. Clin Physiol Funct Imaging 2003; 23:190-8. [PMID: 12914557 DOI: 10.1046/j.1475-097x.2003.00494.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Changes in concentration of high energy phosphates and pH were studied during rest, exercise and subsequent recovery in the anterior tibial muscle of 10 patients with late effects of poliomyelitis and 10 age- and sex-matched healthy volunteers using 31P MRS. The exercise was dynamic and isometric, and the force levels were individually adapted to each subject and stepwise increased. In general, there were no differences in metabolite changes between the groups, except for lower Pi and Pi/PCr for the volunteers during the recovery phase, also reflected by shorter recovery half-time for Pi. The interindividual variation was much higher for the patient group. Some of the patients showed deviating results probably because of differences in muscle fibre type.
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Affiliation(s)
- M Ljungberg
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden.
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16
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Hashemi SH, Benjegård SA, Ahlman H, Wängberg B, Forssell-Aronsson E, Billig H, Nilsson O. 111In-labelled octreotide binding by the somatostatin receptor subtype 2 in neuroendocrine tumours. Br J Surg 2003; 90:549-54. [PMID: 12734860 DOI: 10.1002/bjs.4069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study was to investigate the importance of somatostatin receptor subtype 2 (SSTR2) expression for 111In-labelled diethylenetriamine-pentaacetic acid (DTPA)-D-Phe1-octreotide binding and uptake of 111In in neuroendocrine tumours. METHODS 111In activity concentrations in surgical biopsies from neuroendocrine tumours (midgut carcinoid and medullary thyroid carcinoma), breast carcinoma and blood were determined 1-8 days after intravenous injection of 111In-labelled DTPA-D-Phe1-octreotide (140-350 MBq). The ratio of 111In activity concentrations between tumour tissue and blood (T/B value) was calculated. The expression of SSTR2 messenger RNA (mRNA) in tumour biopsies was quantitated by ribonuclease protection assay and SSTR2 protein was localized by immunocytochemistry. RESULTS T/B values were highest for tumour biopsies from midgut carcinoids (mean 160 (range 4-1200); n = 65) followed by medullary thyroid carcinoma (mean 38 (range 2-350); n = 88) and breast carcinoma (mean 18 (range 4-41); n = 4). The expression of SSTR2 mRNA (relative to the NCI-H69 cell line) was highest in tumour biopsies from midgut carcinoids (mean 2.5 (range 0.83-6.0); n = 40) followed by medullary thyroid carcinoma (mean 1.3 (range 0.20-6.0); n = 7) and breast carcinoma (mean 0.66 (range 0.29-1.0); n = 9). In tumour biopsies SSTR2 protein was localized exclusively to tumour cells. CONCLUSION Midgut carcinoid tumours showed a much higher level of SSTR2 expression than medullary thyroid carcinoma in accordance with superior tumour imaging by octreotide scintigraphy. The high SSTR2 mRNA values and T/B values observed in midgut carcinoid tumours were positively correlated.
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Affiliation(s)
- S H Hashemi
- Lundberg Laboratory for Cancer Research at the Department of Pathology, Göteborg University, Göteborg, Sweden
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17
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Bernhardt P, Ahlman H, Nilsson O, Benjegård SA, Forssell-Aronsson E. Evaluation of (111)In labeled somatostatin analogs for targeted therapy of somatostatin receptor positive tumors. Cancer Biother Radiopharm 2003; 18:249-52. [PMID: 12804051 DOI: 10.1089/108497803765036427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P Bernhardt
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospita, Sweden.
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Lagerstrand KM, Lehmann H, Starck G, Vikhoff-Baaz B, Ekholm S, Forssell-Aronsson E. Method to correct for the effects of limited spatial resolution in phase-contrast flow MRI measurements. Magn Reson Med 2002; 48:883-9. [PMID: 12418004 DOI: 10.1002/mrm.10288] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Phase-contrast (PC) magnetic resonance imaging (MRI) flow measurements suffer from the effect of the point spread function (PSF) due to the limited sampling of k-space. The PSF, which in this case is a sinc function, deforms the flow profile and forms a ringing pattern around the vessel. In this work, an empirical method is presented that corrects for errors due to the deformation of the flow profile. The ringing pattern is used to obtain a well-defined vessel segmentation, which after correction provides more accurate vessel radius and volume flow rate (VFR). The correction method was developed from phantom measurements at constant flow and applied on phantom measurements at moderately pulsatile flow. After correction, the error of the estimated tube radius and the VFR was less than 10% and 5%, respectively. Corresponding errors without correction overestimated the radius by 60% and the VFR by 35%. Preliminary results indicate that the method is also valid in vivo. The variation in the estimated radius and VFR for different spatial resolution decreased when the method was applied. The presented method gives a more accurate estimation of the radius and VFR in vessels of the size of a few pixels without prior knowledge about the true vessel radius.
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Affiliation(s)
- K M Lagerstrand
- Department of Radiation Physics, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
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19
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Starck G, Lönn L, Cederblad A, Forssell-Aronsson E, Sjöström L, Alpsten M. A method to obtain the same levels of CT image noise for patients of various sizes, to minimize radiation dose. Br J Radiol 2002; 75:140-50. [PMID: 11893638 DOI: 10.1259/bjr.75.890.750140] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to develop a method of obtaining the same levels of CT image noise for patients of various sizes to minimize radiation dose. Two CT systems were evaluated regarding noise characteristics using phantoms and dosimetric measurements. Both CT systems performed well at dose levels used in normal clinical imaging, but only one was found to be suitable for low radiation dose applications. The CT system with the lowest noise level was used for further detailed studies. A simple strategy for manual selection of patient-specific scan parameters, considering patient size and required image quality, was implemented and verified on 11 volunteers. Images were obtained with at least the prescribed image quality at significantly reduced radiation dose levels compared with standard scan parameters. Depending on the diameter of the tomographic section, i.e. size of the subject, the dose levels could be reduced to 1-45% of the radiation dose with standard scan parameters (120 kV, 250 mAs, 10 mm). The results indicate a general potential for dose reduction in CT for slim patients. For tissue volume determination, large dose reductions can be achieved by adjusting the scan parameters for each individual. The concept of patient-specific scan parameters could be fully automated in the CT system design, but would require the scan to be specified in terms of image quality rather than X-ray tube load.
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Affiliation(s)
- G Starck
- Division of Medical Physics and Medical Engineering, Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, Bruna Stråket 13, SE-413 45 Göteborg, Sweden
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Abstract
The possibility of using electron emitters to cure a cancer with metastatic spread depends on the energy of the emitted electrons. Electrons with high energy will give a high, absorbed dose to large tumours, but the absorbed dose to small tumours or single tumour cells will be low, because the range of the electrons is too long. The fraction of energy absorbed within the tumour decreases with increasing electron energy and decreasing tumour size. For tumours smaller than 1 g, the tumour-to-normal-tissue mean absorbed dose-rate ratio, TND, will be low, e.g. for 131I and 90Y, because of the high energy of the emitted electrons. For radiotherapy of small tumours, radionuclides emitting charged particles with short ranges (a few microm) are required. A mathematical model was constructed to evaluate the relation between TND and electron energy, photon-to-electron energy ratio, p/e, and tumour size. Criteria for the selection of suitable radionuclides for the treatment of small tumours were defined based on the results of the TND model. In addition, the possibility of producing such radionuclides and their physical and chemical properties were evaluated. Based on the mathematical model, the energy of the emitted electrons should be < or = 40 keV for small tumours (< 1000 cells), and the photon-to-electron energy ratio, p/e, should be < or = 2 to achieve a high TND. Using the selection criteria defined, five low-energy electron emitters were found to be suitable: 58Co, 103mRh, 119Sb, 161Ho, and 189mOs. All of these nuclides decay by internal transition or electron capture, which yields conversion and Auger electrons, and it should be possible to produce most of them in therapeutic amounts. The five low-energy electron-emitting radionuclides identified may be relevant in the radiation treatment of small tumours, especially if bound to internalizing radiopharmaceuticals.
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Affiliation(s)
- P Bernhardt
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, Sweden.
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Vikhoff-Baaz B, Starck G, Ljungberg M, Lagerstrand K, Forssell-Aronsson E, Ekholm S. Effects of k-space filtering and image interpolation on image fidelity in (1)H MRSI. Magn Reson Imaging 2001; 19:1227-34. [PMID: 11755733 DOI: 10.1016/s0730-725x(01)00456-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
2D MRSI suffers from the effect of the spatial response function due to the truncation of the sampling of k-space. Filtering of the k-space data-set is often used to suppress the side lobes caused by the effects of the SRF, where the sampled data-set is multiplied with a weighting function before inverse FT. Commonly used filters in MRSI are the cosine, Hanning and Hamming filters. The data-set is often interpolated into a larger image matrix size for analysis, where "Fourier interpolation" (FoI) and "cubic spline interpolation" (CSpI) are two common methods. In this work, the effects of k-space filtering in practical usage was examined, and the image representations of the object for the two interpolation methods were compared. This study showed that application of filtering improves the image representation of the structures in the object and should be used in MRSI. FoI correctly visualizes the information inherent in the data-set, while the features of the object were dependent on the position of the object relative the original matrix in the CSpI interpolated images. FoI should therefore be used for quantitative evaluation of MRSI images.
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Affiliation(s)
- B Vikhoff-Baaz
- Division of Medical Physics and Biomedical Engineering, Göteborg University, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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22
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Jakobsen AM, Andersson P, Saglik G, Andersson E, Kölby L, Erickson JD, Forssell-Aronsson E, Wängberg B, Ahlman H, Nilsson O. Differential expression of vesicular monoamine transporter (VMAT) 1 and 2 in gastrointestinal endocrine tumours. J Pathol 2001; 195:463-72. [PMID: 11745679 DOI: 10.1002/path.973] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neuroendocrine tumours are characterized by their capacity to produce hormones, which are stored in vesicles and secretory granules. Demonstration of granule/vesicle proteins in tumours is taken as evidence of neuroendocrine differentiation. Vesicular monoamine transporters (VMAT1 and VMAT2) mediate the transport of amines into vesicles of neurons and endocrine cells. The expression of VMAT1 and VMAT2 and the usefulness of VMAT1 and VMAT2 in the histopathological diagnosis of gastrointestinal endocrine tumours have not been fully explored. This study therefore investigated the expression of VMAT1 and VMAT2 in 211 human gastrointestinal tumours by immunocytochemistry and western blotting. VMAT1 and/or VMAT2 were demonstrated in the majority of amine-producing endocrine tumours of gastric, ileal, and appendiceal origin. Serotonin-producing endocrine tumours (ileal and appendiceal carcinoids) expressed predominantly VMAT1, while histamine-producing endocrine tumours (gastric carcinoids) expressed VMAT2 almost exclusively. In peptide-producing endocrine tumours such as rectal carcinoids and endocrine pancreatic tumours, only a small number of immunopositive tumour cells were observed. No labelling was found in non-endocrine tumours, including gastric, colorectal and pancreatic adenocarcinomas and gastrointestinal stromal tumours. In conclusion, VMAT1 and VMAT2 are differentially expressed by gastrointestinal endocrine tumours, with a pattern specific for each tumour type, reflecting their neuroendocrine differentiation and origin. VMAT1 and VMAT2 may therefore become valuable markers in the classification of neuroendocrine tumours and may also indicate patients suitable for radioisotope treatment operating via these transporter systems.
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Affiliation(s)
- A M Jakobsen
- Lundberg Laboratory for Cancer Research, University of Göteborg, Sweden
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Benjegård SA, Forssell-Aronsson E, Wängberg B, Skånberg J, Nilsson O, Ahlman H. Intraoperative tumour detection using 111In-DTPA-D-Phe1-octreotide and a scintillation detector. Eur J Nucl Med 2001; 28:1456-62. [PMID: 11685487 DOI: 10.1007/s002590100600] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2001] [Accepted: 06/18/2001] [Indexed: 10/27/2022]
Abstract
Intraoperative tumour detection has been used in many applications. The examined tumour forms have varied and different detector systems and radiopharmaceuticals have also been used. The aim of this study was to evaluate and compare the ability of an NaI(T1) scintillation detector to detect primary tumours and metastases in patients with different endocrine tumour types (e.g. carcinoid tumours, endocrine pancreatic tumours and thyroid tumours) and in patients with breast carcinoma or benign thyroid lesions, on the basis of their somatostatin receptor expression after i.v. injection of 111In-DTPA-D-Phe1-octreotide. Thirty patients were injected with 111In-DTPA-D-Phe1-octreotide intravenously. Scintigraphic images were taken 1 day after injection of the radiopharmaceutical, and surgery was performed 1-7 days post injection. An NaI(T1) scintillation detector was used for intraoperative tumour detection. Tissue samples were collected during surgery for determination of 111In activity concentration and histopathological examination. The scintigraphic images were positive in 29 out of 30 patients. Intraoperative tumour detection was successful in 43 of 66 collected biopsies: 10 out of 11 for carcinoid tumours, 7 out of 10 for medullary thyroid carcinoma (MTC) and 14 out of 22 for breast cancer. On the basis of our findings we conclude that intraoperative tumour detection with 111In-DTPA-D-Phe1-octreotide using this NaI(T1) detector can be successful especially for carcinoid tumours and endocrine pancreatic tumours, due to the relatively high activity concentrations in these tumour types, but is less successful in other forms of thyroid cancer, including MTC, and breast cancer. For successful intraoperative detection, the detector characteristics are also very important, and further improvement of the detector systems is required to increase the sensitivity and specificity.
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Affiliation(s)
- S A Benjegård
- Department of Radiation Physics, University of Göteborg, Sahlgrenska University Hospital, Sweden
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Bernhardt P, Benjegård SA, Kölby L, Johanson V, Nilsson O, Ahlman H, Forssell-Aronsson E. Dosimetric comparison of radionuclides for therapy of somatostatin receptor-expressing tumors. Int J Radiat Oncol Biol Phys 2001; 51:514-24. [PMID: 11567828 DOI: 10.1016/s0360-3016(01)01663-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Therapy of tumors expressing somatostatin receptors, sstr, has recently been clinically tested using somatostatin analogues labeled with (111)In and (90)Y. Several other radionuclides, i.e., (131)I, (161)Tb, (64)Cu, (188)Re, (177)Lu, and (67)Ga, have also been proposed for this type of therapy. The aim of this work was to investigate the usefulness of the above-mentioned radionuclides bound to somatostatin analogues for tumor therapy. METHODS Biokinetic data of (111)In-labeled octreotide in mice and man were used, primarily from our studies but sometimes from the literature. Dosimetric calculations were performed with the assumption that biokinetics were similar for all radionuclides bound to somatostatin analogues. The cumulated tumor:normal-tissue activity concentration, TNC was calculated for the various physical half-lives of the radionuclides. Using mathematical models, the tumor:normal-tissue mean absorbed dose rate ratio, TN D and tumor:normal-tissue mean absorbed dose ratio, TND, were calculated for various tumor sizes in mice and humans. RESULTS TNC of radionuclide-labeled octreotide increased with physical half-life for most organs, both in mice and in humans. TN D showed that radionuclides emitting electrons with too high energy are not suitable for therapy of small tumors. Furthermore, radionuclides with a higher frequency of photon emissions relative to electron emissions will yield lower TN D and are thus less suitable for therapy than radionuclides with a lower frequency of photon emissions. The TND was highest for (161)Tb in both mice and humans. CONCLUSIONS The results demonstrate that long-lived radionuclides, which emit electrons with rather low energy and which have low frequency of photon emissions, should be the preferred therapy for disseminated small sstr-expressing tumors.
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Affiliation(s)
- P Bernhardt
- Department of Radiation Physics, Lundberg Laboratory for Cancer Research, Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden.
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Vikhoff-Baaz B, Malmgren K, Jönsson L, Starck G, Ljungberg M, Forssell-Aronsson E, Uvebrant P, Ekholm S. Lateralisation with magnetic resonance spectroscopic imaging in temporal lobe epilepsy: an evaluation of visual and region-of-interest analysis of metabolite concentration images. Neuroradiology 2001; 43:721-7. [PMID: 11594420 DOI: 10.1007/s002340100560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We carried out spectroscopic imaging (MRSI) on nine consecutive patients with temporal lobe epilepsy being assessed for epilepsy surgery, and nine neurologically healthy, age-matched volunteers. A volume of interest (VOI) was angled along the temporal horns on axial and sagittal images, and symmetrically over the temporal lobes on coronal images. Images showing the concentrations of N-acetylaspartate (NAA) and of choline-containing compounds plus creatine and phosphocreatine (Cho + Cr) were used for lateralisation. We compared assessment by visual inspection and by signal analysis from regions of interest (ROI) in different positions, where side-to-side differences in NAA/(Cho + Cr) ratio were used for lateralisation. The NAA/ (Cho + Cr) ratio from the different ROI was also compared with that in the brain stem to assess if the latter could be used as an internal reference, e. g., for identification of bilateral changes. The metabolite concentration images were found useful for lateralisation of temporal lobe abnormalities related to epilepsy. Visual analysis can, with high accuracy, be used routinely. ROI analysis is useful for quantifying changes, giving more quantitative information about spatial distribution and the degree of signal loss. There was a large variation in NAA/ (Cho + Cr) values in both patients and volunteers. The brain stem may be used as a reference for identification of bilateral changes.
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Kölby L, Bernhardt P, Ahlman H, Wängberg B, Johanson V, Wigander A, Forssell-Aronsson E, Karlsson S, Ahrén B, Stenman G, Nilsson O. A transplantable human carcinoid as model for somatostatin receptor-mediated and amine transporter-mediated radionuclide uptake. Am J Pathol 2001; 158:745-55. [PMID: 11159212 PMCID: PMC1850312 DOI: 10.1016/s0002-9440(10)64017-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A human midgut carcinoid tumor was successfully transplanted into nude mice and propagated for five consecutive generations (30 months) with well-preserved phenotype. Tumor cells in nude mice expressed identical neuroendocrine markers as the original tumor, including somatostatin receptors (somatostatin receptors 1 to 5) and vesicular monoamine transporters (VMAT1 and VMAT2). Because of the expression of somatostatin receptors and VMAT1 and VMAT2 the grafted tumors could be visualized scintigraphically using the somatostatin analogue 111In-octreotide and the catecholamine analogue 123I-metaiodobenzylguanidine. The biokinetics of the somatostatin analogue 111In-octreotide in the tumors was studied and showed a high retention 7 days after administration. Cell cultures were re-established from transplanted tumors. Immunocytochemical and ultrastructural studies confirmed the neuroendocrine differentiation. The human origin of transplanted tumor cells was confirmed by cytogenetic and fluorescence it situ hybridization analyses. Spontaneous secretion of serotonin and its metabolite, 5-hydroxyindole acetic acid, from tumor cells was demonstrated. The tumor cells increased their [Ca2+]i in response to beta-adrenoceptor stimulation (isoproterenol) and K+-depolarization. All somatostatin receptor subtypes could be demonstrated in cultured cells. This human transplantable carcinoid tumor, designated GOT1, grafted to nude mice, will give unique possibilities for studies of somatostatin receptor- and VMAT-mediated radionuclide uptake as well as for studies of secretory mechanisms.
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Affiliation(s)
- L Kölby
- Lundberg Laboratory for Cancer Research, the Department of Surgery, Sahlgrenska University Hospital, University of Göteberg, Göteberg, Sweden.
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Bernhardt P, Kölby L, Johanson V, Benjegård SA, Nilsson O, Ahlman H, Forssell-Aronsson E. Biokinetics of 111In-DTPA-D-Phe(1)-octreotide in nude mice transplanted with a human carcinoid tumor. Nucl Med Biol 2001; 28:67-73. [PMID: 11182566 DOI: 10.1016/s0969-8051(00)00204-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The long time biokinetics of the radiolabeled somatostatin analogues 111In-DTPA-D-Phe(1)-octreotide was studied in nude mice transplanted with the human carcinoid tumor, GOT1. The results were compared with those from the patient with the original tumor. This patient has been diagnosed and later treated with 111In-DTPA-D-Phe(1)-octreotide. The animals received about 2 MBq 111In-DTPA-D-Phe(1)-octreotide (0.1 microg) by injection into a tail vein. The animals were killed 0.5 h-14 d after injection of the radiopharmaceutical. Tumor tissue and normal tissues were collected and weighed and measured for 111In activity. The 111In uptake in the tumor was higher than in all normal tissues except the kidneys. The tumor-to-normal-tissue activity concentration, TNC, increased with time for all normal tissues studied. These data were similar to those observed for the original tumor in the patient. The similar biokinetics for 111In-DTPA-D-Phe(1)-octreotide in the tumor-bearing mice and the patient makes this animal model suitable as a model for evaluation of therapy of somatostatin receptor (sstr) expressing tumors with radiolabeled somatostatin analogues. Furthermore, the increase with time of TNC both in mice and the patient indicates that long-lived radionuclides are preferred for therapy with radiolabeled somatostatin analogues.
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Affiliation(s)
- P Bernhardt
- Department of Radiation Physics, the Lundberg Laboratory for Cancer Research, Göteborg University, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden.
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28
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Lindencrona U, Nilsson M, Forssell-Aronsson E. Similarities and differences between free 211At and 125I- transport in porcine thyroid epithelial cells cultured in bicameral chambers. Nucl Med Biol 2001; 28:41-50. [PMID: 11182563 DOI: 10.1016/s0969-8051(00)00179-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The transport and accumulation of free 211At and 125I- were investigated in thyrocytes cultured as monolayers in bicameral chambers under the influence of thyroid-stimulating hormone, stable iodide, ouabain and perchlorate. The results indicate that there are similarities and differences in the transport mechanisms of free 211At and 125I-. These results will be valuable in the development of radiation protection when handling and using 211At-labeled radiopharmaceuticals, and for the potential use of free 211At in radiation therapy of poorly differentiated thyroid cancer.
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Affiliation(s)
- U Lindencrona
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, SE-413 45, Göteborg, Sweden.
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29
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Kölby L, Wängberg B, Ahlman H, Jansson S, Forssell-Aronsson E, Erickson JD, Nilsson O. Gastric carcinoid with histamine production, histamine transporter and expression of somatostatin receptors. Digestion 2000; 59:160-6. [PMID: 9586830 DOI: 10.1159/000007482] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A case of sporadic, histamine-producing gastric carcinoid with liver metastases is reported. The patient was treated with somatostatin analogue (octreotide) combined with cortisone and blockade of histamine receptors prior to surgery, which included subtotal gastrectomy, excision of lymph node metastases and superficial liver metastases. Residual liver metastases were injected with ethanol. These interventions markedly reduced the urinary excretion of the main histamine metabolite (MelmAA). Eighteen months later combined immuno- and chemotherapy was initiated due to tumour progression and recurrent hormonal symptoms with good clinical results over 12 months. Scintigraphy, using 111In-DTPA-D-Phe1-octreotide, visualized somatostatin receptors (sstr) in primary tumour, lymph node metastases and liver metastases. The tissue/blood 111In concentration ratios of tumour biopsies were very high. Northern analyses confirmed expression of all subtypes of sstr1-5. Immunocytochemically, tumour cells were strongly positive for chromogranin A, histamine and vesicular monoamine transporter (VMAT) 2 (histamine transporter), but negative for VMAT 1, suggesting an origin from gastric enterochromaffin-like cells. In primary tumour cell cultures, histamine, 5-HTP and 5-HIAA, but not 5-HT, could be detected in conditioned culture medium, indicating a defective decarboxylation of the tryptamine precursor. This rare case of histamine-producing gastric carcinoid demonstrates that excellent symptom relief can be achieved despite disseminated disease, if active, multimodal treatment strategy is instituted. The presence of high numbers of sstr in tumour tissue also raises the possibility of receptor-guided radiotherapy.
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Affiliation(s)
- L Kölby
- Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
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Abstract
Image selected in vivo spectroscopy (ISIS) is a volume selection method often used for in vivo (31)P MRS, since it is suitable for measurements of substances with short T(2). However, ISIS can suffer from significant signal contributions caused by T(1) smearing from regions outside the VOI. A computer model was developed to simulate this contamination. The simulation results for the ISIS experiment order implemented in our MR system (ISIS-0) were in agreement with results obtained from phantom measurements. A new extended ISIS experiment order (E-ISIS) was developed, consisting of four "optimal" ISIS experiment orders (ISIS-1 to ISIS-4) performed consecutively with dummy ISIS experiments in between. The simulation results show that contamination due to T(1) smearing is, effectively, eliminated with E-ISIS and is significantly lower than for ISIS-0 and ISIS-1. E-ISIS offers increased accuracy for quantitative and qualitative determination of substances studied using in vivo MRS. Hence, E-ISIS can be valuable for both clinical and research applications.
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Affiliation(s)
- M Ljungberg
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden.
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31
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Starck G, Ljungberg M, Vikhoff-Baaz B, Alpsten M, Ekholm S, Forssell-Aronsson E. Point-wise measurements of MRS volume selection performance are insensitive to magnetic susceptibility effects of phantom materials. Magn Reson Imaging 2000; 18:867-74. [PMID: 11027881 DOI: 10.1016/s0730-725x(00)00184-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose was to analyse magnetic susceptibility effects on accuracy of point-wise measurements of signal profiles in the assessment of MRS volume selection performance. An existing phantom design consisting of a sphere with a movable signal source was used for the investigation. The influence from the phantom on magnetic field homogeneity was measured with phase sensitive 1H imaging and 31P spectroscopy on a 1.5 T whole body MR system. The susceptibility effects for such a phantom design can be separated in 1/ A variation in the background magnetic field, which is caused by the stationary structures and has a significant influence on spatial accuracy. 2/ A magnetic field distortion, which is caused by the movable signal source and has very little influence on accuracy. The spatial inaccuracy due to susceptibility effects in this phantom, was 0.03 mm for positions of the signal source covering a 40-mm VOI. Susceptibility effects from the movable signal source were substantial but had very little influence on spatial accuracy. Still, improvements of this phantom design are possible. Point-wise measurements using a phantom with a movable signal source is inherently insensitive to susceptibility effects from the signal source and permits accurate signal profile measurements of high spatial (sub-mm) resolution.
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Affiliation(s)
- G Starck
- Division of Medical Physics and Medical Engineering, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden.
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32
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Tolmachev V, Bernhardt P, Forssell-Aronsson E, Lundqvist H. 114mIn, a candidate for radionuclide therapy: low-energy cyclotron production and labeling of DTPA-D-phe-octreotide. Nucl Med Biol 2000; 27:183-8. [PMID: 10773548 DOI: 10.1016/s0969-8051(99)00096-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A method for production of carrier-free (114m)In (half-life 49.5 days), which is a potential radionuclide for radionuclide therapy of slowly growing tumors, is presented. A target consisting of five enriched cadmium ((114)Cd) foils, each 50 microm thick, was irradiated by protons (from 12.6-6.5 MeV) giving a target yield of 0. 8 MBq/microAh. A simple and cost-efficient thermal diffusion method was used for the separation. The irradiated target foils were heated for 2 h at 306 degrees C and then etched in 0.05 M HCl. The obtained cadmium/indium solution was purified using a cation ion-exchange resin (AG 1 x 8, Bio-Rad Laboratories, Hercules, CA USA). An overall yield of approximately 60% was obtained, whereas the loss of the target material was <1% per separation cycle. The (114m)In production gave (114m)In with high specific radioactivity and was successfully used to label diethylenetriamine pentaacetic acid (DTPA)-D-Phe-octreotide. Furthermore, no difference in biodistribution between [(114m)In]- and [(111)In]-DTPA-D-Phe(1)-octreotide in tumor-bearing nude mice was seen. The high radionuclide uptake in the tumors indicates a good receptor binding of the labeled octreotide.
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Affiliation(s)
- V Tolmachev
- Division of Biomedical Radiation Sciences, Rudbecklaboratoriet, Uppsala University, Uppsala, Sweden.
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33
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Benjegård SA, Sauret V, Bernhardt P, Wängberg B, Ahlman H, Forssell-Aronsson E. Evaluation of three gamma detectors for intraoperative detection of tumors using 111In-labeled radiopharmaceuticals. J Nucl Med 1999; 40:2094-101. [PMID: 10616891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
UNLABELLED Attempts to detect tumors with intraoperative scintillation using tumor-binding radiopharmaceuticals have intensified recently. In some cases previously unknown lesions were found, but in most cases no additional lesions were detected. In this study the physical characteristics of three detector systems and their ability to detect tumors through accumulation of an 111In-labeled radiopharmaceutical were investigated. The first was a sodium iodide (NaI[TI]) detector; the second, a cesium iodide (CsI[TI]) detector; and the third, a cadmium telluride (CdTe) detector. METHODS A body phantom and tumor phantoms (diameter 5-20 mm) made of water, agarose gel or epoxy with a density and attenuation coefficient similar to those of soft tissue were used to simulate a clinical situation. The activity concentration in the body phantom was based on reported values of 111In-octreotide in normal tissue in humans. The 111In activity concentration in the tumor phantoms varied from 3 to 80 times the 111In activity concentration in the body phantom. Data were processed to determine tumor detection levels. RESULTS The NaI(TI) detector showed the lowest values for full width at half maximum because this detector had the best collimation, leading to a high ratio between counts from tumor and counts from background, i.e., small tumors could be detected. Because of high efficiency, the CsI(TI) detector sometimes required a somewhat shorter acquisition time to produce a statistically significant difference between tumor phantom and background. For deep-lying tumors the NaI(TI) detector was superior, whereas the CdTe detector was best suited for superficial tumors with a high activity concentration in the underlying tissue. CONCLUSION At a maximum acquisition time of 30 s, almost all superficial tumors with a diameter of 10 mm or larger were detected if the ratio between the 111In concentration in the tumor and the 111In concentration in the background exceeded 3. However, in clinical situations, biologic variations in the uptake of 111In-octreotide in tumors and in normal tissue makes difficult the determination of a distinct detection level. For such clinical conditions, the NaI(TI) detector is the best choice because it has good resolution despite a lower efficiency. Documentation of detector characteristics is important so that clinicians can make an adequate device in relation to tumor location and receptor expression.
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Affiliation(s)
- S A Benjegård
- Department of Radiation Physics, Sahlgrenska University Hospital, Göteborg University, Sweden
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34
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Amiri-Mosavi A, Ahlman H, Tisell LE, Wängberg B, Kölby L, Forssell-Aronsson E, Lundberg PA, Lindstedt G, Nilsson O. Expression of cholecystokinin-B/gastrin receptors in medullary thyroid cancer. Eur J Surg 1999; 165:628-31. [PMID: 10452255 DOI: 10.1080/11024159950189663] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To characterise the cholecystokinin (CCK) receptor subtypes in medullary thyroid cancer by measuring the expression of CCK-A and CCK-B/gastrin receptor mRNA. DESIGN Open study. SETTING Teaching hospital, Sweden. SUBJECTS 6 patients with medullary thyroid cancer. INTERVENTION Pentagastrin stimulation test and measurement of calcitonin concentration. Biopsy specimens were analysed using reverse transcription polymerase chain reaction (RT-PCR). MAIN OUTCOME MEASURE Presence of CCK-A and CCK-B/gastrin receptors. RESULTS All 6 patients with medullary thyroid cancer had positive pentagastrin tests preoperatively. CCK-B/gastrin receptors but not CCK-A receptors were detected by RT-PCR in all six biopsy specimens. By contrast, no CCK receptors were found in normal thyroid tissues or in other thyroid tumours (follicular adenoma, papillary carcinoma, or anaplastic carcinoma). CONCLUSION The presence of CCK-B/gastrin receptors in medullary thyroid tumours may have important clinical implications.
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Affiliation(s)
- A Amiri-Mosavi
- Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden
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35
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Vikhoff-Baaz B, Ljungberg M, Starck G, Forssell-Aronsson E, Jönsson L, Alpsten M, Ekholm S. Performance of 2D 1H spectroscopic imaging of the brain: some practical considerations regarding the measurement procedure. Magn Reson Imaging 1999; 17:919-31. [PMID: 10402599 DOI: 10.1016/s0730-725x(99)00023-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper deals with some of the practical considerations in the planning and performance of chemical shift imaging (MRSI or CSI) of the brain. It contains some aspects of 1) the imaging procedure (MRI), i.e., suggestions of an imaging protocol useful for the spectroscopic planning, 2) the planning of the spectroscopic volume, i.e., size and position, 3) evaluation and judgment of the preparation results, and 4) evaluation of the MRSI images. The paper also contains suggestions of developmental work and quality assessment to be done before patient studies are begun. Examples are given for MRSI studies of temporal lobe epilepsy. Several of the aspects described are obvious for the experienced spectroscopist but may be useful in the initiation of MRSI. The goal of this paper was to share our experiences of how to achieve high quality MRSI, experiences that we would had been grateful for in our prelude of MRSI experiments.
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Affiliation(s)
- B Vikhoff-Baaz
- Department of Radiation Physics, Göteborg University, Sweden.
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36
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Tisell LE, Ahlman H, Wängberg B, Kölby L, Fjälling M, Forssell-Aronsson E, Mölne J, Nilsson O. Expression of somatostatin receptors in oncocytic (Hürthle cell) neoplasia of the thyroid. Br J Cancer 1999; 79:1579-82. [PMID: 10188909 PMCID: PMC2362738 DOI: 10.1038/sj.bjc.6690251] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ten consecutive patients with Hürthle cell lesions of the thyroid (nodule/adenoma/carcinoma) were studied by (111)In-DTPA-D-Phe1-octreotide scintigraphy. Octreotide scintigraphy localized the primary Hürthle cell tumour in eight patients as distinct areas of increased uptake of radionuclide. Two patients with Hürthle cell carcinoma, previously thyroidectomized, had their metastases visualized by octreotide scintigraphy. Northern analyses showed expression of multiple somatostain receptor subtypes. Visualization of the Hürthle cell tumour may be due to a higher expression of somatostatin receptors in the lesions than in surrounding normal thyroid tissue. The tissue/blood (111)In concentration ratios for tumour samples from five patients showed clearly higher values than observed for normal connective tissue, muscle or lymph nodes. A relatively high uptake of (111)In was also observed in goiter tissue, which may lead to misinterpretations. The main indication for octreotide scintigraphy in patients with Hürthle cell carcinoma is suspicion of metastatic disease.
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Affiliation(s)
- L E Tisell
- Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
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37
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Bovée W, Canese R, Decorps M, Forssell-Aronsson E, Le Fur Y, Howe F, Karlsen O, Knijn A, Kontaxis G, Kügel H, McLean M, Podo F, Slotboom J, Vikhoff B, Ziegler A. Absolute metabolite quantification by in vivo NMR spectroscopy: IV. Multicentre trial on MRSI localisation tests. Magn Reson Imaging 1998; 16:1113-25. [PMID: 9839995 DOI: 10.1016/s0730-725x(98)00120-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The difference between the experimental and theoretical spatial response function (SRF) of a narrow tube with water is used for a localization test for magnetic resonance spectroscopic imaging (MRSI). From this difference a quantitative performance parameter is derived for the relative amount of signal within a limited region in the field of view. The total signal loss by the MRSI experiment and eddy currents is described by a parameter SL derived from the signal intensities of two echoes. Results of a European multi-centre trial show that this approach is suited for assessment of MRSI localization performance.
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Affiliation(s)
- W Bovée
- Department of Applied Physics, University of Technology, Delft, The Netherlands.
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38
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Ljungberg M, Starck G, Vikhoff-Baaz B, Forssell-Aronsson E, Alpsten M, Ekholm S. Signal profile measurements of single- and double-volume acquisitions with image-selected in vivo spectroscopy for 31P magnetic resonance spectroscopy. Magn Reson Imaging 1998; 16:829-37. [PMID: 9811147 DOI: 10.1016/s0730-725x(98)00007-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The volume-selection performance was studied for single- and double-volume-of-interest (VOI) acquisition with the volume-selection method image-selected in vivo spectroscopy for 31P magnetic resonance spectroscopy. High-resolution signal profiles were measured using a phantom simulating a brain. Inside the phantom there was a small, remotely controlled, movable signal source filled with ortho-phosphoric acid. Signal profiles of the VOI were measured in three perpendicular directions for 1VOI (single VOI) and 2VOI (double VOI) acquisition. The measured signal profiles for both acquisitions were very similar, but they showed a discrepancy with regard to the intended VOI (iVOI). The transition regions were on average 3.8 mm and the average full width at half maximum of the signal profile was 30 mm for an iVOI size of 30*30*30 (mm3). No displacement was observed in the signal profiles. To avoid overlapping signal profiles, the minimum separation between two iVOIs was found to be 10 mm in our magnetic resonance (MR) system. A substantial negative signal contribution from regions outside the iVOI was measured in the y-direction for 1VOI acquisition and one of the two VOIs in 2VOI acquisition. The other VOI in 2VOI acquisition exhibited only minor contamination. The measurements presented underline the importance of detailed knowledge on the volume selection performance in in vivo magnetic resonance spectroscopy.
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Affiliation(s)
- M Ljungberg
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, Sweden.
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39
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Kölby L, Wängberg B, Ahlman H, Tisell LE, Fjälling M, Forssell-Aronsson E, Nilsson O. Somatostatin receptor subtypes, octreotide scintigraphy, and clinical response to octreotide treatment in patients with neuroendocrine tumors. World J Surg 1998; 22:679-83. [PMID: 9606281 DOI: 10.1007/s002689900452] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Several types of neuroendocrine tumor express high numbers of somatostatin receptors (sstr). We have compared the expression of sstr subtypes with the outcome of octreotide scintigraphy in patients with carcinoids and medullary thyroid carcinoma (MTC) in comparison with Hürthle cell tumors. The effect of sstr activation (octreotide treatment) on tumor markers was also studied in patients with disseminated carcinoid tumors. Six patients with carcinoid tumors (four midgut and two foregut), and three patients with thyroid tumors (one MTC, one Hürthle cell carcinoma, and one Hürthle cell adenoma) were studied. Octreotide scintigraphy visualized tumor sites in all nine patients. Macroscopic tumor was verified at these sites at subsequent surgical exploration. Using Northern blotting and subtype-specific riboprobes, sstr could be detected in all tumors examined. All five sstr subtypes were detected in most of the carcinoid tumors. All six carcinoids expressed sstr2. This was in contrast to the findings for the thyroid tumors analyzed, which also expressed several sstr subtypes but in some cases lacked expression of sstr2. This was also the case for normal thyroid tissue. Clinically, octreotide treatment of the patients with midgut carcinoid tumors resulted in palliation of hormonal symptoms accompanied by a significant reduction of urinary 5-HIAA levels (28-71%). These results indicate that carcinoid tumors frequently express all five sstr subtypes. The thyroid tumors also expressed multiple sstr but could lack expression of sstr2. Nevertheless, these tumors were visualized by octreotide scintigraphy, indicating that sstr2 expression is not a prerequisite for tumor imaging.
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Affiliation(s)
- L Kölby
- Department of Surgery, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden
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40
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Nilsson O, Kölby L, Wängberg B, Wigander A, Billig H, William-Olsson L, Fjälling M, Forssell-Aronsson E, Ahlman H. Comparative studies on the expression of somatostatin receptor subtypes, outcome of octreotide scintigraphy and response to octreotide treatment in patients with carcinoid tumours. Br J Cancer 1998; 77:632-7. [PMID: 9484822 PMCID: PMC2149934 DOI: 10.1038/bjc.1998.101] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We have compared the expression of somatostatin receptor (sstr) subtypes with the outcome of somatostatin receptor scintigraphy and the effect of somatostatin receptor activation in patients with disseminated carcinoid tumours. Tumour tissues from nine patients with midgut carcinoids (ileal) and three patients with foregut carcinoids (gastric, thymic) were analysed using Northern blotting. Expression of somatostatin receptors was demonstrated in all tumours (12 out of 12), with all five receptor subtypes present in 9 out of 12 tumours. Somatostatin receptor scintigraphy using [111In]DTPA-D-Phe1-octreotide visualized tumours in all patients (12 out of 12). The 111In activity concentrations in tumour tissue (T) and blood (B) were determined in three tumours 1-7 days after injection of the radionuclide. The T/B 111In activity concentration ratios ranged between 32 and 651. Clinically, treatment with the long-acting somatostatin analogue octreotide resulted in marked symptom relief accompanied by a significant reduction in tumour markers, for example urinary-5-HIAA levels (28-71% reduction). Incubation of midgut carcinoid tumours in primary culture with octreotide (10 microM) resulted in a reduction in spontaneously secreted serotonin (45-71% reduction) and 5-HIAA (41-94% reduction). The results demonstrate that carcinoid tumours possess multiple somatostatin receptor subtypes and that somatostatin analogues such as octreotide, which preferentially bind to somatostatin receptor subtype 2 and 5, can be used in the diagnosis and medical treatment of these tumours. In the future, novel somatostatin analogues with subtype specific receptor profiles may prove to be of value for individualizing the treatment of disseminated carcinoid tumour disease.
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Affiliation(s)
- O Nilsson
- Department of Pathology, Sahlgrenska University Hospital, University of Gothenburg, Göteborg, Sweden
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41
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Tisell LE, Ahlman H, Wängberg B, Hansson G, Mölne J, Nilsson O, Lindstedt G, Fjälling M, Forssell-Aronsson E. Somatostatin receptor scintigraphy in medullary thyroid carcinoma. Br J Surg 1997. [DOI: 10.1002/bjs.1800840431] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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42
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Tisell LE, Ahlman H, Wängberg B, Hansson G, Mölne J, Nilsson O, Lindstedt G, Fjälling M, Forssell-Aronsson E. Somatostatin receptor scintigraphy in medullary thyroid carcinoma. Br J Surg 1997; 84:543-7. [PMID: 9112914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND 111In-radiolabelled (DTPA-D-Phe1)-octreotide scintigraphy can be used to localize neuroendocrine tumours expressing somatostatin receptors (SSTRs). The aim of this paper was to analyse the importance of tumour volume and growth for the visualization by SSTR scintigraphy of metastases from medullary thyroid carcinoma (MTC). METHODS Serum calcitonin concentrations were used to estimate volume and growth rate of MTC. Twenty-two patients who had persistent hypercalcitoninaemia after total thyroidectomy for MTC, indicating the presence of metastases, were studied. RESULTS SSTR scintigraphy visualized 15 tumours in 11 patients. Patients with scintigraphically visualized tumours had higher serum calcitonin and carcinoembryonic antigen concentrations and larger tumours, and the serum calcitonin concentration increased more rapidly with time. Tumour-associated symptoms and death from MTC occurred only in patients with scintigraphically visualized tumours. CONCLUSION Scintigraphically visualized tumours grow more rapidly and are more aggressive than nonvisualized lesions. SSTR scintigraphy can be helpful in the planning of palliative surgery for MTC and for diagnosing distant metastases, but cannot localize microscopic metastases.
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Affiliation(s)
- L E Tisell
- Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
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43
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Wängberg B, Nilsson O, Wigander A, Johansson V, Forssell-Aronsson E, Andersson P, Fjälling M, Tisell LE, Ahlman H. [Somatostatin receptors. A new way to diagnosis and therapy of neuroendocrine tumors]. Lakartidningen 1997; 94:829-30, 835-8. [PMID: 9102509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Verification of the presence of somatostatin receptors on neuroendocrine tumour cells opened up unique diagnostic and therapeutic possibilities. Long-acting somatostatin analogues are currently used to alleviate symptoms of excessive hormone synthesis in patients with such tumours. Radiolabelled somatostatin analogues can be used both for high specificity and high sensitivity scintigraphic localisation of such tumours and for intraoperative scintillation detection. Detailed studies in patients and in tumour cells in vitro have shown 111In-octreotide uptake to be high and retention times long in tumour tissue, and have yielded evidence of intracellular localisation of the radionuclide. These findings thus showed somatostatin receptor-mediated radiotherapy to be a possible treatment alternative after close characterisation of the individual tumour. In the future, it may be possible to use other peptide receptors (e g, growth factor receptors) according to the same principles as applied in the case of somatostatin receptors.
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Affiliation(s)
- B Wängberg
- Avdelningen för kirurgi, Sahlgrenska sjukhuset, Göteborg
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Ahlman H, Tisell LE, Wängberg B, Fjälling M, Forssell-Aronsson E, Kölby L, Nilsson O. The relevance of somatostatin receptors in thyroid neoplasia. Yale J Biol Med 1997; 70:523-33. [PMID: 9825479 PMCID: PMC2589271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
111In-octreotide scintigraphy in patients with persistent medullary thyroid carcinoma (MTC) visualized tumors in about half of the surgically explored sites. Tumor visualization correlated with rapid tumor growth and large tumor volume as judged from calcitonin levels. The 111In concentration ratio between tumor (T) and blood (B) in surgically excised lymph node metastases of MTC showed a large variation, with low values for microscopic and high values for macroscopic metastases in individual patients. Three cases of MTC, Hürthle cell adenoma and papillary thyroid cancer are reported with preoperative scintigraphy, T/B ratios and Northern analyses of the surgical biopsies. Visualization of tumors was possible in the absence of sstr2 (the high affinity receptor for octreotide) with the exception of microscopic tumor growth. T/B values in the patient with Hürthle cell adenoma were similar to those found in the contralateral thyroid lobe with goitre. The relatively high uptake of 111In in benign thyroid conditions probably limits the use of octreotide scintigraphy in the diagnosis of primary tumors. The technique has certain advantages over radioiodine scintigraphy after the surgical treatment of thyroid tumors: no need for withdrawal of thyroxin substitution; a possibility to diagnose metastases of tumors that do not concentrate radioiodine (MTC, Hürthle cell cancer); and complementary information about metastatic sites of non-medullary thyroid cancer (papillary and follicular tumors).
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Affiliation(s)
- H Ahlman
- Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
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Andersson P, Forssell-Aronsson E, Johanson V, Wängberg B, Nilsson O, Fjälling M, Ahlman H. Internalization of indium-111 into human neuroendocrine tumor cells after incubation with indium-111-DTPA-D-Phe1-octreotide. J Nucl Med 1996; 37:2002-6. [PMID: 8970523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
UNLABELLED Neuroendocrine tumor cells frequently overexpress somatostatin receptors at their cell surfaces. To evaluate the possibility of using the somatostatin analog 111In-DTPA-D-Phe1-octreotide for radiation therapy, we studied the binding and subsequent internalization of 111In into three types of cultured human neuroendocrine tumor cells. METHODS Primary cultures of gastric carcinoid, midgut carcinoid and glucagonoma cells were incubated with 111In-DTPA-D-Phe1-octreotide and cell-surface bound, internalized and released 111In activity was measured. Electron microscopic autoradiography was also performed. RESULTS All three cell types specifically (80%-95%) bound 111In-DTPA-D-Phe1-octreotide and internalized 111In. After 1 hr pulse incubation with 111In-DTPA-D-Phe1-octreotide, there was an initial decrease in intracellular 111In to about 50% during the subsequent 6-hr incubation. Almost no further release was observed during the remaining 18-42 hr studied. Autoradiography showed that the internalized 111In was found in the cytoplasm and nucleus in the midgut carcinoid cells. CONCLUSION Indium-111 DTPA-D-Phe1-octreotide might be useful for radiation therapy of patients with surgically incurable tumors having high somatostatin receptor densities.
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Affiliation(s)
- P Andersson
- Department of Radiation Physics, Göteborg University, Sahlgrenska University Hospital, Sweden
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Fjälling M, Andersson P, Forssell-Aronsson E, Grétarsdóttir J, Johansson V, Tisell LE, Wängberg B, Nilsson O, Berg G, Michanek A, Lindstedt G, Ahlman H. Systemic radionuclide therapy using indium-111-DTPA-D-Phe1-octreotide in midgut carcinoid syndrome. J Nucl Med 1996; 37:1519-21. [PMID: 8790206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
A 55-yr-old woman with a midgut carcinoid syndrome due to metastatic spread of an ileal tumor to the liver, paraortic and mediastinal lymph nodes and to the skeleton was given systemic radionuclide therapy with 111In-DTPA-D-Phe1-octreotide. Before therapy, dosimetric calculations were performed on whole-body scintigraphs and 111In retention was shown to be long-lasting. Excretion was mainly seen during the first 24 hr after injection; thereafter whole-body retention remained stationary at 30%. Indium-111 activity in tumor biopsies and blood was measured using a gamma counter. Very high tumor-to-blood ratios were obtained: 150 for the primary tumor and 400-650 for liver metastases, which further justified radiation therapy. Indium-111-DTPA-D-Phe1-octreotide treatment was given on three separate occasions (3.0, 3.5 and 3.1 GBq) 8 and 4 wk apart. After each therapy, the patient experienced facial flush and pain over the skeletal lesions followed by symptomatic relief, even though no objective tumor regression was found radiologically after 5 mo. After initiation of octreotide treatment, there was a 14% reduction of the main tumor marker, urinary 5-HIAA. After three subsequent radionuclide therapies, there was a further 31% reduction of 5-HIAA levels. No adverse reactions, other than a slight decrease in leukocyte counts, were seen. The mean absorbed radiation dose after the three treatments was estimated to be about 10-12 Gy in liver metastases and 3-6 Gy in other tumors, depending on the size and location of the metastases. Assuming internalization of 111In into tumor cells and a radiobiological effect from short range Auger and conversion electrons, there might be a therapeutic effect on the tumor.
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Affiliation(s)
- M Fjälling
- Department of Nuclear Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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Andersson K, Wängberg B, Tisell LE, Nilsson O, Fjälling M, Forssell-Aronsson E, Ahrén B, Ahlman H. [Glucagonoma. A tumor disease with multiple clinical manifestations]. Lakartidningen 1996; 93:2935-9. [PMID: 8815353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Glucagon-producing neoplasms are rare pancreatic tumours that may give rise to a characteristic syndrome including, diabetes and typical skin manifestations (necrolytic migrating erythema). Dermatological problems are often the first signs of the disease and the diagnosis is easily overlooked. In most series reported to date, glucagonomas had already metastasized at diagnosis, which means that curative surgery was possible to perform in less than half of the patients. To increase awareness of glucagonoma symptomatology a review of the syndrome is presented together with the clinical histories of three patients, recently treated. These cases illustrate aspects of modern diagnosis and treatment.
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Ekholm S, Forssell-Aronsson E, Starck G, Kjellman L, Lundh T, Holm J, Volkmann R, Blomstrand C. Phosphorus-31 MR spectroscopy in the preoperative evaluation of symptomatic unilateral carotid artery stenosis. Acta Radiol 1996; 37:288-93. [PMID: 8845255 DOI: 10.1177/02841851960371p161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to examine the potential of 31P-MRS (MR spectroscopy) in the pre- and postoperative evaluation of patients referred for endarterectomy. MATERIAL AND METHODS Nine patients with unilateral, hemodynamically significant stenosis in the region of the common carotid bifurcation were examined pre- and post-operatively with CT, SPECT (regional cerebral blood flow), transcranial Doppler, and duplex sonography, and they also underwent neuropsychologic investigation. Phosphorus-31 MRS of each hemisphere was performed before and 27-148 days after surgery. The relative concentrations of phosphomono- and -diesters, inorganic phosphate, phosphocreatine, and ATP were estimated. RESULTS No definite changes in concentrations could be detected for any of the metabolites. CONCLUSION The lack of changes was probably due to well-functioning collaterals and to the partial volume effect, whereby changes in a focal region are hidden when larger volumes are studied.
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Affiliation(s)
- S Ekholm
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Wangberg B, Forssell-Aronsson E, Tisell LE, Nilsson O, Fjalling M, Ahlman H. Intraoperative detection of somatostatin-receptor-positive neuroendocrine tumours using indium-111-labelled DTPA-D-Phe1-octreotide. Br J Cancer 1996; 73:770-5. [PMID: 8611378 PMCID: PMC2074371 DOI: 10.1038/bjc.1996.134] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
After injection of 111In-labelled DTPA-D-Phe1-octreotide, intraoperative tumour localisation was performed using a scintillation detector in 23 patients with neuroendocrine tumours. Count rates from suspect tumour lesions and adjacent normal tissue were expressed as a ratio before (Rin situ) and after (Rex vivo) excision. 111In activity concentration ratios of tumour tissue to blood (T/B) were determined in a gamma counter. In patients with midgut carcinoids, (all scintigraphy positive), false Rin situ recordings were found in 4/29 macroscopically identified tumours. T/B ratios were all high (27-650). In patients with medullary thyroid carcinomas (eight out of ten scintigraphy positive), misleading Rin situ results were found in 4/37 macroscopically identified tumours. T/B ratios were lower (3-39) than those seen in midgut carcinoids. Two out of four patients with endocrine pancreatic tumours had positive scintigraphy, reliable intraoperative measurements and very high T/B ratios (910-1500). One patient with a gastric carcinoid had correct measurements in situ and ex vivo with high T/B ratios (71-210). In situ measurements added little information to preoperative scintigraphy and surgical findings using the present detection system. Rex vivo measurements were more reliable. The very high T/B ratios seen in midgut carcinoids and some endocrine pancreatic tumours would be favourable for future radiation therapy via somatostatin receptors.
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Affiliation(s)
- B Wangberg
- Department of Surgery, Sahlgrenska Hospital, Gothenburg, Sweden
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Ekholm S, Forssell-Aronsson E, Starck G, Kjellman L, Lundh T, Holm J, Volkmann R, Blomstrand C. Phosphorus-31 MR Spectroscopy in the Preoperative Evaluation of Symptomatic Unilateral Carotid Artery Stenosis. Acta Radiol 1996. [DOI: 10.3109/02841859609177652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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