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The effectiveness of cisapride in improving gastric emptying, reducing distress during meals and promoting weight gain in anorexic individuals is investigated. Results of the eight-week test showed that the administration of 10 mg cisapride daily caused anorexic patients to feel more hungry although the improvement in gastric emptying was equal in both cisapride and non-cisapride groups. In addition, the cisapride group did not exhibit more weight gain.

New macrobicyclic cage amine or “sarcophagine” (sar) bifunctional chelators have been synthesised that form copper complexes of exceptional in vivo stability and incorporate isothiocyanate (-NCS) functional groups for conjugation to an antibody. The chelators were synthesised from the methyl-capped complex [MgII(CH3)(NH2)sar]2+. Coordination of MgII within the cavity of the cage amine ligand protects the secondary amine atoms from reacting with the -NCS functional groups. Two different [MgII(NCS-sar)]2+ derivatives were conjugated to the HER2/neu-targeting antibody trastuzumab and the progress of the reaction monitored by electrospray mass spectrometry. The MgII ion was removed from the immunoconjugates under mild conditions (0.1 M citrate buffer, pH 6). Labelling of the (CH3)(p-NCS-Ph)sar-trastuzumab conjugate with 64CuII, a radioisotope suitable for positron emission tomography (PET), was fast (∼5 min) and easily performed at room temperature with high radiochemical purity (＞95%). Biodistribution and PET imaging studies in vivo showed that 64Cu-labelled (CH3)(p-NCS-Ph)sar-trastuzumab maintained high stability under physiological conditions with high and selective uptake in a HER2-positive cancer cell line. The stability of the copper complex and the 12.7 h half-life of the radioisotope allows clear visualisation of tumours out to 48 h. [ABSTRACT FROM AUTHOR]

Recently the potential of whole-body positron emission tomography scanning using [sup 18] F-fluorodeoxyglucose (FDG PET) has led to renewed interest in the use of functional imaging for the detection of occult metastatic melanoma. This study compared dedicated FDG PET with high-dose gallium-67 imaging incorporating whole-body scanning and comprehensive single-photon emission tomography (SPET) in 122 cases (121 patients) in which the two scans were performed <6 weeks apart. All patients were at high clinical risk of occult metastatic disease and 49 (40%) had abnormality suggestive of metastatic disease by at least one functional imaging technique. Discrepant scan findings were followed up to determine which technique more accurately reflected disease status. There were 23/122 (19%; 95% CI: 12%–26%) cases with discordant scan results in respect of either the presence of melanoma (11 cases) or the extent of disease (12 cases). PET correctly identified more disease than [sup 67] Ga SPET in 14 cases (including three incidental primary tumours) and was true negative in three further patients with abnormal [sup 67] Ga SPET. There were six patients with true positive [sup 67] Ga SPET in whom FDG PET was false negative (one small cutaneous deposit, one residual axillary node rated equivocal on FDG PET due to postoperative changes, one adrenal metastasis inseparable from renal activity on FDG PET and three cases in which sites missed on FDG PET were seen on [sup 67] Ga SPET. Thus, FDG PET provided incremental diagnostic information compared with [sup 67] Ga SPET in 17/23 patients, while [sup 67] Ga SPET provided incremental information compared with PET in 6/23 cases (P=0.035). Based on Australian Medicare reimbursement levels, the net cost per patient with clinical management benefit of replacing [sup 67] Ga SPET with FDG PET was estimated to be less than EUR 1,750. These results suggest that FDG PET provides incremental and clinically important information in... [ABSTRACT FROM AUTHOR]

Purpose: To communicate an important pitfall in positron emission tomography (PET) oncologic staging using 2-deoxy-2-[18F]fluoro-D-glucose (FDG).Procedure: A 60-year-old man with a right upper lobe bronchogenic carcinoma was injected with FDG through a cannula in his left cubital fossa, with a small amount of the dose extravasating.Results: Images obtained one hour post-injection with a positron emission tomography-computerized tomography (PET-CT) scanner demonstrated linear FDG activity running with the left arm brachial vascular bundle and along collateral channels, and accumulation of FDG in a low left axillary lymph node of normal size and CT appearance.Conclusions: Following inadvertent extravasation, FDG appears to accumulate in regional lymph nodes in the same fashion as bone scanning agents or lymphoscintigraphy colloid. Physicians and technologists need to be aware of this important pitfall in order to avoid the false positive diagnosis of nodal metastases. The ability of PET to demonstrate lymphatics and lymph nodes indicates its possible future use in lymphoscintigraphy. [ABSTRACT FROM AUTHOR]

Background & Objective: Fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET/CT could increase the accuracy of diagnosis, staging, and treatment effectiveness monitoring of many malignant diseases, such as lung cancer and esophageal cancer. This study was to evaluate the clinical application of (18)F-FDG PET/CT to the staging, restaging, and treatment effectiveness monitoring of nasopharyngeal carcinoma (NPC)., Methods: The reports of whole body (18)F-FDG PET/CT scans, performed from Feb. 2002 to Dec. 2005 on 43 NPC patients (26 men and 17 women with median age of 52 years) in Peter MacCallum Cancer Center, were reviewed. The final diagnoses were made according to medical records, pathologic reports and follow-up information. The accuracy, specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of (18)F-FDG PET/CT, CT and MRI were calculated and analyzed., Results: The accuracy, specificity, sensitivity, PPV, and NPV of (18)F-FDG PET/CT were 95.3%, 100.0%, 85.7%, 93.8%, and 100.0%, respectively; those of CT and MRI were 65.5%, 79.4%, 64.7%, 81.8%, and 57.9%, respectively. The results of (18)F-FDG PET/CT led to changes in the medical management of 2 staged patients, and 7 restaged patients and 5 patients in monitoring group. (18)F-FDG PET/CT scan affected the therapy plan of 3 restaged patients and 11 patients in monitoring group. Two cases of second primary malignancies(1 case of thyroid carcinoma and 1 case of low grade gastric carcinoma) were detected by (18)F-FDG PET/CT scan., Conclusion: (18)F-FDG PET/CT is better than conventional imaging in N and M staging and treatment effectiveness monitoring of NPC.