290 results on '"Britton, KE"'
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2. Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]
- Author
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Mukherjee, JJ, Kaltsas, GA, Islam, N, Plowman, PN, Foley, R, Hikmat, J, Britton, KE, Jenkins, PJ, Chew, SL, Monson, JP, Besser, GM, and Grossman, AB
- Abstract
OBJECTIVE: Meta-iodo-benzyl-guanidine labelled with 131-iodine [(131)I-mIBG] has been used extensively for imaging tumours originating from the neural crest but experience with its therapeutic use is limited, particularly for non-catecholamine secreting tumours. In order to assess the therapeutic response and potential adverse effects of the therapeutic administration of (131)I-mIBG, we have reviewed all patients who had received this form of treatment in our department. DESIGN: Retrospective analysis of the case notes of patients with neuroendocrine tumours who received treatment with (131)I-mIBG and were followed-up according to a defined protocol in a given time frame. PATIENTS: Thirty-seven patients (18 with metastatic carcinoid tumours, 8 metastatic phaeochromocytoma, 7 metastatic paraganglioma and 4 metastatic medullary carcinoma of the thyroid) treated with (131)I-mIBG over a 15-year period were included in this analysis. MEASUREMENTS: The symptomatic, hormonal and tumoural responses before and after (131)I-mIBG therapy over a median follow-up duration of 32 months (range 5-180 months) were recorded. Of the 37 patients (22 males; median age 51 years, range 18-81 years), 15 were treated with (131)I-mIBG alone whereas the other 22 received additional therapy. RESULTS: A total of 116 therapeutic (131)I-mIBG doses were administered [mean cumulative dose 592 mCi (21.9 GBq); range 200-1592 mCi (7.4-58.9 GBq)]. None of the patients showed a complete tumour response. However, 82% of patients treated with (131)I-mIBG alone and 84% who received additional therapy showed stable disease over the period of follow-up. Overall survival during the period of the study was 71%. The overall 5-year survival rate was 85% (95% confidence interval, 72-99%) for all patients and 78% (95% confidence interval, 55-100%) for the carcinoid group alone, according to Kaplan-Meier analysis. Symptomatic control was achieved in all the patients treated with (131)I-mIBG alone, and in 72% of those receiving additional therapy. Hormonal control was noted in 50% and 57% of patients, respectively. (131)I-mIBG therapy was safe and well tolerated. Serious side-effects necessitating the termination of (131)I-mIBG therapy were seen in only 2 of our patients. CONCLUSIONS: (131)I-mIBG therapy produces symptomatic and hormonal improvement and moderate tumour regression/stabilization in patients with metastatic neuroendocrine tumours with minimal adverse effects. It may be a valuable alternative or additional therapeutic option to the currently available conventional treatment modalities.
- Published
- 2016
3. Radionuclide treatment of neuroendocrine tumours with the novel radiolabelled analogue Y-90-SMT 487
- Author
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Carroll, PV, Maher, K, Foley, R, Stewart, PM, Bevan, JS, Franklyn, JA, Besser, GM, Monson, JP, Britton, KE, and Grossman, AB
- Published
- 2016
4. Carcinoid tumours presenting as breast cancer: the utility of radionuclide imaging with 123I-MIBG and 111In-DTPA pentetreotide
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Kaltsas, GA, Putignano, P, Mukherjee, JJ, Satta, MA, Lowe, DG, Britton, KE, Monson, JP, Grossman, AB, and Besser, GM
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neoplasms ,digestive system diseases - Abstract
Secondary tumours of any type in the breast are rare. A review of the literature demonstrated only 23 cases of carcinoid tumours with associated breast metastasis, as distinct from primary carcinoid tumours of the breast. Distant metastases from carcinoid tumours are correlated with poor prognosis and survival. Although both primary and metastatic mammary carcinoid tumours are uncommon, the recognition of the true origin of the tumours may be of importance owing to the different clinical management and prognosis of the two conditions. Recently, radionuclide-labelled imaging techniques have been applied to the localization of such lesions, based on isotope uptake by receptors present in these neuroendocrine tumours. We report two new cases of carcinoid tumours with breast metastases, the primaries being in the ileocaecal valve and the bronchus, respectively. The diagnosis of a carcinoid tumour was based on the clinical, biochemical, histopathological and immunostaining features. Furthermore, these patients had both 123I-MIBG and 111In pentetreotide scintigraphy performed. These radionuclides play a useful role in the localization and potentially in the management of carcinoid tumours and their distant metastases.
- Published
- 2016
5. Can the estimation of ejection fraction during gated single photon emission computed tomography at rest add information to the cardiac perfusion study?
- Author
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H. Al-Kaylani, Britton Ke, Canizales A, and Nermina Beslic
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Adult ,Male ,animal structures ,Heart Ventricles ,Gated SPECT ,Statistics as Topic ,Coronary Artery Disease ,Single-photon emission computed tomography ,Coronary artery disease ,Ventricular Dysfunction, Left ,Organophosphorus Compounds ,Coronary Circulation ,medicine ,Humans ,Tissue Distribution ,Radiology, Nuclear Medicine and imaging ,End-systolic volume ,Aged ,Tomography, Emission-Computed, Single-Photon ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Technetium (99mTc) tetrofosmin ,Gated Blood-Pool Imaging ,Stroke Volume ,Organotechnetium Compounds ,General Medicine ,Middle Aged ,medicine.disease ,Exercise Test ,End-diastolic volume ,Female ,Radiopharmaceuticals ,Nuclear medicine ,business ,Perfusion ,medicine.drug - Abstract
Left ventricular function is an important prognostic indicator in patients with coronary artery disease. The electrocardiogram gated, myocardial, single photon emission tomography (SPECT) program is coming into wide use. This program permits measurement of end diastolic volume, end systolic volume, and ejection fraction. This study was designed to show whether the measurement of ejection fraction by using 99m Tc tetrofosmin gated SPECT at rest could give additional information to the interpretation of perfusion. Exercise 99mTc tetrofosmin SPECT and gated 99m Tc tetrofosmin SPECT at rest were performed in 33 patients with or suspected of having coronary artery disease. Left ventricular ejection fraction was calculated from reconstructed gated SPECT at rest with a software quantitative gated SPECT. The results showed a poor correlation between segmental ejection fraction and segmental perfusion in stress and rest. There was an increasing probability of reversibility as the ejection fraction increased, while there was a greater chance of a fixed defect as the ejection fraction decreased. It is concluded that gated SPECT using 99m Tc tetrofosmin provides clinically satisfactory functional data that, in combination with the perfusion information, will improve diagnostic and prognostic accuracy without an increase in cost or radiation dose to patients.
- Published
- 2002
6. Immunotechnological trends in radioimmuno targeting
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Britton Ke, Sandeep Saran, A. K. Gupta, P. Khanna, D. K. Hazra, and V. L. Lahiri
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Yeast artificial chromosome ,biology ,Chemistry ,medicine.medical_treatment ,General Medicine ,Immunotherapy ,Computational biology ,In vitro ,Antigen ,Radioimmunotherapy ,Immunology ,medicine ,biology.protein ,Radiology, Nuclear Medicine and imaging ,Antibody ,Magic bullet ,Clinical evaluation - Abstract
The impact of recent advances in the chemical and genetic engineering manipulations of antibodies on radioimmunotargeting is reviewed both in relation to radioimmunoscintigraphy and radioimmunotherapy. The resulting trends are: (1) the linking of parts of the mouse/rat and human antibody molecule; (2) the creation of molecules with dual antigen or multiple antigen recognition capabilities; (3) the making of smaller and smaller antigen recognition molecules; and (4) the development of molecules with dual capabilities, e.g. antigen recognition and enzyme activity. The various methods of creating antibodies in vitro are reviewed with reference to bacteria, using phage selection and a combinatorial library, mammalian cells, yeast cells and, finally, mice containing giant yeast artificial chromosomes. The advantages and disadvantages of smaller fragments as well as of the human anti-mouse antibody (HAMA) reaction are discussed and the need for early clinical evaluation and widespread availability of the newer antibodies is emphasized. It is envisaged that these immunotechnological advances will permit the large-scale production of precisely engineered humanized antibodies, and the specificity and affinity rate constant of these antibodies can be optimized using in vitro phage selection as well as by computer modelling where the stereo chemistry of the antigen is known precisely.
- Published
- 1995
7. Factors influencing the accuracy of renal output efficiency
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Britton Ke
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business.industry ,Posture ,Medicine ,Humans ,Reproducibility of Results ,Urination ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Kidney ,Radionuclide Imaging - Published
- 2001
8. Imaging the adrenal cortex
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Britton Ke
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Text mining ,medicine.anatomical_structure ,business.industry ,Adrenal cortex ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Neuroscience - Published
- 1992
9. Preoperative imaging of parathyroid glands
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Chesser, AMS, primary, Carroll, MJ, additional, Britton, KE, additional, and Baker, LRI, additional
- Published
- 1999
- Full Text
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10. 99mTc-labelled SM3 in the preoperative evaluation of axillary lymph nodes and primary breast cancer with change detection statistical processing as an aid to tumour detection
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Biassoni, L, primary, Granowska, M, additional, Carroll, MJ, additional, Mather, SJ, additional, Howell, R, additional, Ellison, D, additional, MacNeill, FA, additional, Wells, CA, additional, Carpenter, R, additional, and Britton, KE, additional
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- 1998
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11. The use of 99mTc-MIBI scanning in multiple myeloma
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Tirovola, EB, primary, Biassoni, L, additional, Britton, KE, additional, Kaleva, N, additional, Kouykin, V, additional, and Malpas, JS, additional
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- 1996
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12. Peroperative radioimmunodetection of ovarian carcinoma using a hand-held gamma detection probe
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Ind, TEJ, primary, Granowska, M, additional, Britton, KE, additional, Morris, G, additional, Lowe, DG, additional, Hudson, CN, additional, and Shepherd, JH, additional
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- 1994
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13. A study comparing SPECT with CT and MRI after closed head injury
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Newton, MR, primary, Greenwood, RJ, additional, and Britton, KE, additional
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- 1992
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14. The optimization of nuclear medicine procedures for the diagnosis and management of thyroid disorders in developing countries
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Vavrejn B, Belcher Eh, Nofal M, Dudley Ra, Volodin, Pfannenstiel P, Nemec J, and Britton Ke
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Thyroid Hormones ,Thyroiditis ,endocrine system ,endocrine system diseases ,Biopsy ,Radioimmunoassay ,Thyroid Gland ,Developing country ,Thyroid Function Tests ,Hyperthyroidism ,Fine needle biopsy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Thyroid Neoplasms ,Radionuclide Imaging ,Developing Countries ,Sodium Pertechnetate Tc 99m ,Goiter ,business.industry ,Thyroid disease ,Thyroid ,General Medicine ,medicine.disease ,Thyroid Diseases ,medicine.anatomical_structure ,Thyroid function ,Nuclear medicine ,business - Abstract
Thyroid disease is common in developing countries and its management is based on the measurement of thyroid function and the investigation of thyroid masses. This report discusses techniques and outlines a strategy for the measurement of thyroid function using radioimmunoassays of thyroid-related hormones in the blood. It makes proposals for the evaluation of thyroid morphology using echography, pertechnetate imaging and fine needle biopsy. Note is taken of the difficulties facing laboratories in developing countries and the International Atomic Energy Agency is concerned with the practical assessment of these recommendations and of any alternative proposals in this field.
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- 1984
15. A Brief Guide to the Practice of Radioimmunoscintigraphy and Radioimmunotherapy in Cancer
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Britton Ke, Buraggi Gl, Bischof-Delaloye A, Granowska M, Udalrich Buell, Bares R, and Emrich D
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0301 basic medicine ,Cancer Research ,Task group ,medicine.medical_specialty ,biology ,business.industry ,medicine.medical_treatment ,Association (object-oriented programming) ,Clinical Biochemistry ,Cancer ,medicine.disease ,Pathology and Forensic Medicine ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Radioimmunotherapy ,biology.protein ,Medicine ,Medical physics ,Antibody ,business ,Nuclear medicine - Published
- 1989
16. Mitral Rexlurgitation Assessed by Comparioon of Ejection Fraction with Forward Flow
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Wiseman, MN, primary, Sobnack, R, primary, Dyke, LJ, primary, Crowther, T, primary, Britton, KE, primary, and Dymond, DS, primary
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- 1988
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17. Annual subscriptions
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Brown Nj and Britton Ke
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Computer analysis ,Calculus ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Derivation ,Mathematics - Published
- 1971
18. A new approach to stopping the spread of invasive insects and pathogens : early detection and rapid response via a global network of sentinel plantings
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Britton, Kerry O.
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- 2010
19. Pendred syndrome--100 years of underascertainment?
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Reardon, W, Coffey, R, Phelps, PD, Luxon, LM, Stephens, D, Kendall-Taylor, P, Britton, KE, Grossman, A, and Trembath, R
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- 1997
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20. Tumour-associated monoclonal antibodies for the diagnosis and assessment of ovarian cancer
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Shepherd, JH, Granowska, M, and Britton, KE
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- 1988
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21. Privacy and Security Issues Surrounding the Protection of Data Generated by Continuous Glucose Monitors.
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Britton KE and Britton-Colonnese JD
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- Confidentiality, Humans, Medical Records Systems, Computerized, Mobile Applications, Blood Glucose Self-Monitoring, Computer Security, Diabetes Mellitus, Equipment Safety
- Abstract
Being able to track, analyze, and use data from continuous glucose monitors (CGMs) and through platforms and apps that communicate with CGMs helps achieve better outcomes and can advance the understanding of diabetes. The risks to patients' expectation of privacy are great, and their ability to control how their information is collected, stored, and used is virtually nonexistent. Patients' physical security is also at risk if adequate cybersecurity measures are not taken. Currently, data privacy and security protections are not robust enough to address the privacy and security risks and stymies the current and future benefits of CGM and the platforms and apps that communicate with them.
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- 2017
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22. 99mTc-interleukin-2 scintigraphy in normal subjects and in patients with autoimmune thyroid diseases: a feasibility study.
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Chianelli M, Mather SJ, Grossman A, Sobnak R, Fritzberg A, Britton KE, and Signore A
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- Adult, Case-Control Studies, Feasibility Studies, Female, Granulocytes drug effects, Granulocytes metabolism, Humans, Kinetics, Lymphocytes drug effects, Lymphocytes metabolism, Male, Metabolic Clearance Rate, Radiation Dosage, Radionuclide Imaging, Tissue Distribution, Autoimmune Diseases diagnostic imaging, Interleukin-2 pharmacokinetics, Interleukin-2 toxicity, Organotechnetium Compounds pharmacokinetics, Organotechnetium Compounds toxicity, Thyroid Diseases diagnostic imaging
- Abstract
Purpose: Radiolabelled interleukin-2 is a radiopharmaceutical used for the study of chronic inflammatory processes. (123)I-labelled interleukin-2 has successfully been used in a large number of patients affected by several immune-mediated diseases. (123)I, however, is expensive and not readily available. We have, therefore, developed a method for labelling interleukin-2 with (99m)Tc to high specific activity based on the use of an N(3)S bifunctional chelating agent. In this paper, we describe the results obtained with (99m)Tc-interleukin-2 in a series of eight normal subjects and of 12 patients with autoimmune thyroid diseases., Methods: Biodistribution, pharmacokinetics, haematological and systemic toxicity, radiation absorbed dose and in vivo targeting were studied., Results: Results showed rapid plasma clearance of (99m)Tc-interleukin-2 with retention mainly in the kidneys. Biodistribution and kinetics were similar to that observed for (123)I-interleukin-2. No acute systemic toxicity was found; a small decrease in peripheral blood lymphocytes was observed in the first hours only in patients, but it was mild and transient. (99m)Tc-interleukin-2 accumulated, to varying extents, in the thyroid of all patients affected by autoimmune thyroid diseases but not in the thyroid of normal subjects. The effective dose equivalent of a diagnostic activity of (99m)Tc-interleukin-2 (185 MBq) was 1.35 mSv. No correlation was observed between thyroid autoantibodies and uptake of (99m)Tc-interleukin-2., Conclusions: The use of (99m)Tc-interleukin-2 is safe and simple; the favourable dosimetry and biodistribution and the rapid clearance make it potentially useful for the study of chronic inflammatory diseases such as autoimmune thyroid disease.
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- 2008
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23. International Scientific Committee of Radionuclides in Nephrourology (ISCORN) consensus on renal transit time measurements.
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Durand E, Blaufox MD, Britton KE, Carlsen O, Cosgriff P, Fine E, Fleming J, Nimmon C, Piepsz A, Prigent A, and Samal M
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- Humans, Internationality, Diagnosis, Computer-Assisted standards, Kidney Diseases diagnosis, Nephrology standards, Practice Guidelines as Topic, Practice Patterns, Physicians' standards, Radioisotope Renography standards, Urology standards
- Abstract
This report is the conclusion of the international consensus committee on renal transit time (subcommittee of the International Scientific Committee of Radionuclides in Nephrourology) and provides recommendations on measurement, normal values, and analysis of clinical utility. Transit time is the time that a tracer remains within the kidney or within a part of the kidney (eg, parenchymal transit time). It can be obtained from a dynamic renogram and a vascular input acquired in standardized conditions by a deconvolution process. Alternatively to transit time measurement, simpler indices were proposed, such as time of maximum, normalized residual activity or renal output efficiency. Transit time has been mainly used in urinary obstruction, renal artery stenosis, or renovascular hypertension and renal transplant. Despite a large amount of published data on obstruction, only the value of normal transit is established. The value of delayed transit remains controversial, probably due to lack of a gold standard for obstruction. Transit time measurements are useful to diagnose renovascular hypertension, as are some of the simpler indices. The committee recommends further collaborative trials.
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- 2008
- Full Text
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24. Differential diagnosis of adnexal masses: risk of malignancy index, ultrasonography, magnetic resonance imaging, and radioimmunoscintigraphy.
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van Trappen PO, Rufford BD, Mills TD, Sohaib SA, Webb JA, Sahdev A, Carroll MJ, Britton KE, Reznek RH, and Jacobs IJ
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- Adnexa Uteri diagnostic imaging, Adnexa Uteri pathology, Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Diagnosis, Differential, Female, Genital Diseases, Female diagnostic imaging, Genital Diseases, Female pathology, Humans, Magnetic Resonance Imaging, Middle Aged, Neoplasms, Adnexal and Skin Appendage diagnostic imaging, Neoplasms, Adnexal and Skin Appendage pathology, Prospective Studies, Risk Factors, Sensitivity and Specificity, Ultrasonography, Genital Diseases, Female diagnosis, Neoplasms, Adnexal and Skin Appendage diagnosis
- Abstract
A risk of malignancy index (RMI), based on menopausal status, ultrasound (US) findings, and serum CA125, has previously been described and validated in the primary evaluation of women with adnexal masses and is widely used in selective referral of women from local cancer units to specialized cancer centers. Additional imaging modalities could be useful for further characterization of adnexal masses in this group of women. A prospective cohort study was conducted of 196 women with an adnexal mass referred to a teaching hospital for diagnosis and management. Follow-up data was obtained for 180 women; 119 women had benign and 61 women malignant adnexal masses. The sensitivity and specificity of specialist US, magnetic resonance imaging (MRI), radioimmunoscintigraphy (RS), and the RMI were determined. We identified a subgroup of women with RMI values of 25-1000 where the value of further specialist imaging was evaluated. Sensitivity and specificity for specialist US were 100% and 57%, for MRI 92% and 86%, and for RS 76% and 87%, respectively. Analysis of 123 patients managed sequentially, using RMI cutoff values of > or =25 and <1000 and then US and MRI provided a sensitivity of 94% and a specificity of 90%. Using this RMI cutoff followed by specialist US and MRI, as opposed to the traditional RMI cutoff value of 250, can increase the proportion of patients with cancer appropriately referred in to a cancer center, with no change in the proportion of patients with benign disease being managed in a local unit.
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- 2007
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25. The management of differentiated thyroid cancer using 123I for imaging to assess the need for 131I therapy.
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Ali N, Sebastian C, Foley RR, Murray I, Canizales AL, Jenkins PJ, Drake WM, Plowman PN, Besser GM, Chew SL, Grossman AB, Monson JP, and Britton KE
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- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prognosis, Radionuclide Imaging, Reproducibility of Results, Sensitivity and Specificity, Treatment Outcome, Iodine Radioisotopes therapeutic use, Neoplasm Recurrence, Local diagnostic imaging, Neoplasm Recurrence, Local prevention & control, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms radiotherapy, Whole Body Imaging methods
- Abstract
Background: Follow-up of 131I whole-body scanning after 131I ablation is associated with potential stunning. Previous studies have suggested that, for scanning, 123I is more sensitive than 131I in identifying thyroid tissue, but its specificity when positive is less certain., Aim: The use of 123I as an imaging agent in place of serial 131I imaging has been evaluated in the surveillance and treatment of differentiated thyroid carcinoma., Results: A total of 186 studies in 136 patients with differentiated thyroid carcinoma were evaluated after total or near total thyroidectomy followed by 131I ablation. In 125 studies 123I scanning was negative and no 131I therapy was given; four patients were positive on 123I scanning but for other reasons no 131I therapy was given. In 48/49 patients a positive 123I scan was followed by positive 131I therapeutic uptake. Only one patient failed to show positive uptake of I when first treated and she subsequently demonstrated uptake on a second therapy., Conclusion: High-dose 123I imaging is the correct predictor of the 131I post-therapy scan findings in most cases, at an administered activity that avoids stunning. As a diagnostic agent it is preferable to 131I in differentiated thyroid carcinoma.
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- 2006
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26. The prospective clinical and scintigraphic assessment of patients with preserved left ventricular systolic function after transmyocardial laser revascularisation.
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Dziuk MA, Canizales A, Ali N, El-Deeb H, Britton KE, Dymond DS, and Edmondson SJ
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- Aged, Angina Pectoris therapy, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Coronary Artery Disease physiopathology, Diastole, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Reperfusion, Observer Variation, Prospective Studies, Stroke Volume, Systole, Thallium Radioisotopes, Tomography, Emission-Computed, Single-Photon methods, Treatment Outcome, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease therapy, Laser Therapy, Myocardial Revascularization methods, Radionuclide Ventriculography, Ventricular Function, Left
- Abstract
Aim: To analyse the clinical outcome and myocardial perfusion and function after transmyocardial revascularisation (TMR) in patients with normal left ventricular function and multivessel coronary artery disease non-amenable for standard revascularisation., Method and Results: Twenty three severely symptomatic patients (CCS score median 4) with normal left ventricular systolic function but coronaries non-amenable for either PTCA or CABG were subjected to TMR. The angina score, left ventricular systolic and diastolic function in radionuclide ventriculography at rest, exercise tolerance and myocardial perfusion--Thallium-201 SPECT (adenosine stress 74 and 37 MBq under nitrate cover) were evaluated before and 3, 6, 12 months post-operatively. After an average of 40 +/- 12 (range 14-56) TMR channels angina score decreased significantly (p< 0.0001) and the exercise tolerance increased (from 6.0 +/- 4.5 to 9.1 +/- 4.6 after 6 months, p< 0.05) in 21 patients. During the follow up period two patients had a myocardial infarction and one committed suicide after 6 months. Ejection fraction dropped significantly only after 1 year post-TMR from 70 +/- 13 to 63 +/- 0.13%, p < 0.05. The overall perfusion improved initially in 14 patients with subsequent deterioration in time. The changes in segmental perfusion were not associated with the symptomatic improvement., Conclusion: Transmyocardial revascularisation in patients with normal ejection fraction may improve the angina class, exercise tolerance and overall but not segmental perfusion and does not show any immediate effect on left ventricular function.
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- 2005
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27. Imaging with radiolabelled monoclonal antibody (MUJ591) to prostate-specific membrane antigen in staging of clinically localized prostatic carcinoma: comparison with clinical, surgical and histological staging.
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Nargund V, Al Hashmi D, Kumar P, Gordon S, Otitie U, Ellison D, Carroll M, Baithun S, and Britton KE
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- Aged, Humans, Iodine Radioisotopes, Male, Middle Aged, Radionuclide Imaging, Radiopharmaceuticals, Technetium, Yttrium Radioisotopes, Antibodies, Monoclonal radiation effects, Antigens, Surface immunology, Glutamate Carboxypeptidase II immunology, Neoplasm Staging methods, Prostatic Neoplasms diagnostic imaging
- Abstract
Objective: To evaluate the reliability of prostate scintigraphy using a radiolabelled antibody (MUJ591) raised against the external domain of prostate-specific membrane antigen (PSMA) in the staging of early prostate cancer., Patients and Methods: This was a prospective study of 16 patients who had radical retropubic prostatectomies (median PSA 9.75 ng/mL). All patients underwent PSMA imaging using MUJ591 radiolabelled with (99m)Tc using a photo-reduction technique., Results: The findings of prostate imaging and histology were identical in seven patients. Scans showed understaging and overstaging in six and three patients, respectively., Conclusions: PSMA scintigraphy using (99m)Tc-labelled MUJ591 identifies the presence of prostate cancer, but is not sensitive in delineating micro-invasion of the capsule, seminal vesicles or bladder neck. As in other studies it seems to be useful in detecting prostate bed recurrence and distant micrometastasis.
- Published
- 2005
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28. Radioimmunotherapy. Progress, potential and problems.
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Mather SJ and Britton KE
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- Humans, Radioimmunotherapy trends, Treatment Outcome, Antibodies adverse effects, Antibodies therapeutic use, Neoplasms radiotherapy, Radiation Injuries etiology, Radioimmunotherapy adverse effects, Radioimmunotherapy methods, Radioisotopes therapeutic use
- Published
- 2004
29. Radioimmunotherapy of Non-Hodgkin's lymphoma.
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Britton KE
- Subjects
- Antibodies, Monoclonal therapeutic use, Humans, Iodine Radioisotopes therapeutic use, Lymphoma, Non-Hodgkin radiotherapy, Radioimmunotherapy, Yttrium Radioisotopes therapeutic use
- Published
- 2004
30. Ability of (99m)tc-ciprofloxacin scintigraphy to discriminate between septic and sterile osteoarticular diseases.
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Britton KE, Das SS, and Solanki KK
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- Colloids, Diagnosis, Differential, Humans, Radionuclide Imaging, Radiopharmaceuticals, Arthritis, Infectious diagnostic imaging, Bone Diseases diagnostic imaging, Ciprofloxacin, Joint Diseases diagnostic imaging, Organotechnetium Compounds
- Published
- 2004
31. Tositumomab and iodine I 131 tositumomab for recurrent indolent and transformed B-cell non-Hodgkin's lymphoma.
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Davies AJ, Rohatiner AZ, Howell S, Britton KE, Owens SE, Micallef IN, Deakin DP, Carrington BM, Lawrance JA, Vinnicombe S, Mather SJ, Clayton J, Foley R, Jan H, Kroll S, Harris M, Amess J, Norton AJ, Lister TA, and Radford JA
- Subjects
- Adult, Aged, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal adverse effects, Antineoplastic Agents, Humans, Iodine Radioisotopes therapeutic use, Middle Aged, Neoplasm Recurrence, Local drug therapy, Radioimmunotherapy, Survival Rate, Antibodies, Monoclonal therapeutic use, Antigens, CD20 immunology, Immunoconjugates therapeutic use, Lymphoma, B-Cell drug therapy
- Abstract
Purpose: An open-label phase II study was conducted at two centers to establish the efficacy and safety of tositumomab and iodine I 131 tositumomab at first or second recurrence of indolent or transformed indolent B-cell lymphoma., Patients and Methods: A single dosimetric dose was followed at 7 to 14 days by the patient-specific administered radioactivity required to deliver a total body dose of 0.75 Gy (reduced to 0.65 Gy for patients with platelets counts of 100 to 149 x 10(9)/L). Forty of 41 patients received both infusions., Results: Thirty-one of 41 patients (76%) responded, with 20 patients (49%) achieving either a complete (CR) or unconfirmed complete remission [CR(u)] and 11 patients (27%) achieving a partial remission. Response rates were similar in both indolent (76%) and transformed disease (71%). The overall median duration of remission was 1.3 years. The median duration of remission has not yet been reached for those patients who achieved a CR or CR(u). Eleven patients continue in CR or CR(u) between 2.6+ and 5.2+ years after therapy. Therapy was well tolerated; hematologic toxicity was the principal adverse event. Grade 3 or 4 anemia, neutropenia, and thrombocytopenia were observed in 5%, 45%, and 32% of patients, respectively. Secondary myelodysplasia has occurred in one patient. Four patients developed human antimouse antibodies after therapy. Five of 38 assessable patients have developed an elevated thyroid-stimulating hormone; treatment with thyroxine has been initiated in one patient., Conclusion: High overall and CR rates were observed after a single dose of tositumomab and iodine I 131 tositumomab in this patient group. Toxicity was modest and easily managed.
- Published
- 2004
- Full Text
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32. Elimination of the influence of total renal function on renal output efficiency and normalized residual activity.
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Nimmon CC, Sámal M, and Britton KE
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- Female, Humans, Male, Metabolic Clearance Rate, Models, Biological, Quality Control, Radiopharmaceuticals pharmacokinetics, Reproducibility of Results, Sensitivity and Specificity, Statistics as Topic, Urologic Diseases blood, Image Interpretation, Computer-Assisted methods, Kidney diagnostic imaging, Kidney metabolism, Radioisotope Renography methods, Technetium Tc 99m Mertiatide pharmacokinetics, Urologic Diseases diagnostic imaging, Urologic Diseases metabolism
- Abstract
Unlabelled: One of the potential limitations in the usefulness of both renal output efficiency (ROE) and normalized residual activity (NORA) is their residual dependence on total renal function. The purpose of this study was to present and examine a new quantitative method whereby the effects of this dependence may be removed., Methods: The analytic method involves the determination of a retention function using an unconstrained matrix algorithm deconvolution technique followed by reconvolution with a chosen standard input function to yield a new secondary renal activity time (A/T) curve from which normalized values of ROE and NORA, denoted as N_ROE and N_NORA, respectively, can then be obtained using conventional definitions. The method has been applied in a series of 50 patient studies, which had been acquired using (99m)Tc-mercaptoacetyltriglycine (99(m)Tc-MAG3) and a standard F+18 furosemide protocol, with values of the ratio of plasma clearance to plasma volume (C/V) in the range 0.013-0.242 min(-1)., Results: Pre- and postnormalization values of NORA, calculated at 30 min after injection, showed a significant difference in mean values (paired t test; P < 0.001), with a maximum observed difference, DeltaNORA(30), of -4.82 (-482%) and with a SD on the paired differences, DeltaNORA(30), of 0.56 (56%) or 0.63 (63%) if background subtraction on the input function (BSIF) had been performed. In contrast, corresponding values of ROE showed a nonsignificant difference in means (P > 0.05) and a SD on the paired differences, DeltaROE(30), of 3.7% or 3.2% with and without BSIF, respectively. The normalized parameters N_ROE and N_NORA were found to be strongly linearly correlated (r = -0.99; P < 0.001), in agreement with theoretical predictions., Conclusion: These results suggest that renal function affects NORA significantly more than ROE. The effects can be corrected by our normalization technique, resulting in equivalent values of normalized ROE and normalized NORA.
- Published
- 2004
33. [Clinical outcome of patients after transmyocardial laser revascularization alone and combined with coronary artery bypass grafting].
- Author
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Dziuk M, el-Deeb H, Britton KE, Edmondson SJ, Piechota W, and Cholewa M
- Subjects
- Female, Humans, Male, Middle Aged, Preoperative Care, Surveys and Questionnaires, Coronary Artery Bypass methods, Laser Therapy methods, Myocardial Infarction surgery, Myocardial Revascularization instrumentation
- Abstract
The aim of the study was to assess the effect of transmyocardial laser revascularization (TMLR) alone and in combination with coronary artery bypass grafting (CABG) on the angina score (CCS--Canadian Cardiovascular Society class), exercise tolerance and left ventricular function 6 months after the procedures. Sixty two patients were subjected to revascularization, 38 to sole TMLR procedure and 24 to combination CABG and TMLR (CABG/TMLR group). The angina score and exercise stress test together with radionuclide ventriculography were performed before and 6 months after the operation. The angina class and exercise tolerance were similar in both groups preoperatively. After the operation the improvement was seen in both groups with no statistical difference. The left ventricular ejection fraction were 61 +/- 8% and 54 +/- 8% (p < 0.05) before operation and after 6 months respectively. Transmyocardial laser revascularisation alone and in combination with coronary artery bypass grafting may relieve the angina and improve the exercise tolerance. However the left ventricular ejection fraction may drop significantly.
- Published
- 2003
34. Should high hTg levels in the absence of iodine uptake be treated?
- Author
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Britton KE, Foley RR, and Chew SL
- Subjects
- Combined Modality Therapy, False Negative Reactions, Neoplasm Metastasis diagnosis, Neoplasm Metastasis diagnostic imaging, Predictive Value of Tests, Radionuclide Imaging, Thyroid Neoplasms metabolism, Thyroid Neoplasms radiotherapy, Thyroid Neoplasms surgery, Thyroidectomy, Whole-Body Counting methods, Withholding Treatment, Iodine Radioisotopes pharmacokinetics, Iodine Radioisotopes therapeutic use, Neoplasm Recurrence, Local blood, Neoplasm Recurrence, Local diagnostic imaging, Thyroglobulin blood, Thyroid Neoplasms diagnostic imaging
- Published
- 2003
- Full Text
- View/download PDF
35. Radioimmunoscintigraphy with Tc-99m-labelled SM3 in differentiating malignant from benign adnexal masses.
- Author
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Ali N, Jan H, Van Trappen P, Nasreen F, Canizales A, Carroll MJ, Granowska M, Jacobs I, and Britton KE
- Subjects
- Adnexal Diseases diagnostic imaging, Adult, Aged, CA-125 Antigen analysis, False Positive Reactions, Female, Humans, Middle Aged, Mucin-3, Prospective Studies, Radionuclide Imaging, Sensitivity and Specificity, Adnexa Uteri, Antibodies, Monoclonal, Mucins immunology, Ovarian Neoplasms diagnostic imaging, Radiopharmaceuticals, Technetium Tc 99m Sestamibi
- Abstract
Objective: Ultrasound scanning, serum CA125 and menopausal status have previously been combined in a risk of malignancy index for the differential diagnosis of adnexal masses. Although this approach has greater accuracy than either individual tests or clinical assessment, it has a significant false positive and false negative rate. Efforts have been directed at refining differential diagnosis and this study assessed the role of radioimmunoscintigraphy using the stripped mucin 3 (SM3) antibody that has a 17-fold greater uptake in malignant than benign ovarian tumours in vitro., Design: Prospective study of patients with a pelvic mass using radioimmunoscintigraphy., Setting: Department of Nuclear Medicine of St Bartholomew's Hospital in collaboration with Cancer Network., Population: A total of 93 patients with pelvic masses were recruited for this study of which 32 had ovarian cancer and 61 had benign lesions., Methods: Radioimmunoscintigraphy was performed with Tc-99m-labelled SM3 (600 MBq), anterior and posterior pelvis imaged at 10 minutes and at 4 and 24 hours and evaluated with change detection analysis and probability mapping., Main Outcome Measures: Sensitivity and specificity of radioimmunoscintigraphy for ovarian cancer., Results: Radioimmunoscintigraphy had a sensitivity for ovarian cancer of 84% (27 true positive and 5 false negatives) and a specificity of 87% (53 true negatives and 8 false positives) giving a negative predictive value of 91%., Conclusion: These results suggest that radioimmunoscintigraphy could be used to reduce the number of false positive findings in a strategy to refine differential diagnosis of the pelvic mass.
- Published
- 2003
36. Influence of renal function on renal output efficiency.
- Author
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Nimmon CC and Britton KE
- Subjects
- Computer Simulation, Humans, Time Factors, Kidney physiology, Models, Biological, Radioisotope Renography
- Published
- 2003
37. Neuro-otological findings in Pendred syndrome.
- Author
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Luxon LM, Cohen M, Coffey RA, Phelps PD, Britton KE, Jan H, Trembath RC, and Reardon W
- Subjects
- Adolescent, Adult, Audiometry, Pure-Tone methods, Child, Female, Hearing Loss, Sensorineural diagnosis, Hearing Loss, Sensorineural genetics, Humans, Iodine metabolism, Male, Middle Aged, Perchlorates pharmacology, Reflex, Acoustic physiology, Severity of Illness Index, Sodium Compounds pharmacology, Syndrome, Thyroid Diseases genetics, Thyroid Diseases metabolism, Ear, Inner abnormalities, Hearing Loss, Sensorineural complications, Thyroid Diseases complications, Vestibule, Labyrinth abnormalities
- Abstract
Pendred syndrome is an autosomal recessive inherited disorder characterized by profound hearing impairment and inappropriate iodine release by the thyroid on perchlorate challenge. Thirty-three cases comprising members of 13 families and eight isolated cases were studied, with detailed audiological and vestibular investigation and computerized tomography. A uniform, profound, symmetrical sensorineural hearing loss was identified in all cases. Approximately one-third of the group reported progressive hearing impairment, in childhood or adolescence, associated with head injury, infection, or delayed secondary hydrops. Ninety per cent of the cases scanned showed dilated vestibular aqueducts, and all cases with progression of the hearing impairment demonstrated this structural abnormality. Approximately one-third of the cases had normal vestibular function, but a further third demonstrated a unilateral peripheral deficit, while the remaining third showed bilateral vestibular hypofunction. There was no intra-familial concordance of vestibular findings, and no correlation between vestibular abnormality and presence or absence of a dilated vestibular aqueduct, with or without a Mondini malformation. In older children and adults, Pendred syndrome was associated with a profound, symmetrical, sensorineural auditory impairment, and a variety of vestibular abnormalities, which are not uniform within families, or correlated with structural labyrinthine deformities.
- Published
- 2003
- Full Text
- View/download PDF
38. 123I-Interleukin-2: biochemical characterization and in vivo use for imaging autoimmune diseases.
- Author
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Signore A, Picarelli A, Annovazzi A, Britton KE, Grossman AB, Bonanno E, Maras B, Barra D, and Pozzilli P
- Subjects
- Adolescent, Adult, Amino Acid Sequence, Celiac Disease diagnostic imaging, Celiac Disease immunology, Cells, Cultured, Child, Diabetes Mellitus immunology, Diabetes Mellitus, Type 1 diagnostic imaging, Female, Humans, Interleukin-2 chemistry, Isotope Labeling methods, Lymphocyte Count, Male, Molecular Sequence Data, Reference Values, Reproducibility of Results, Thyroiditis, Autoimmune diagnostic imaging, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed, Autoimmune Diseases diagnostic imaging, Diabetes Mellitus diagnostic imaging, Interleukin-2 pharmacokinetics, Iodine Radioisotopes, Lymphocytes diagnostic imaging
- Abstract
We describe in detail the labelling of interleukin-2 with I ( I-IL2), its biochemical characterization, the binding assay and its use for the detection of tissues infiltrated with mononuclear cells. Human recombinant IL2 was labelled using an enzymatic method and its biochemical characterization was performed using high performance liquid chromatography (HPLC) analysis of cyanogen bromide-cleaved protein. biological and binding assays were performed on CTLL-2 cell line and on activated peripheral blood lymphocytes. studies were performed 1 h after administration of 2-3 mCi of I-IL2 in 10 newly diagnosed type 1 diabetes patients, five pre-diabetic patients, 10 Hashimoto's thyroiditis patients, 10 coeliac disease patients and 10 normal volunteers. I-IL2 scintigraphy allowed the detection and quantification of activated mononuclear cells in several affected tissues. In detail, I-IL2 accumulation was detected in the thyroid of all patients affected by Hashimoto's thyroiditis, in the bowel of all coeliac disease patients and in the pancreas of all pre-type 1 diabetic patients. By contrast, in newly diagnosed type 1 diabetics, I-IL2 scan was positive in five of the 10 studied patients. I-IL2 scintigraphy may be useful for studying autoimmune phenomena and in diagnostic protocols to evaluate the presence of other tissue involvement in patients with an organ-specific autoimmune disease.
- Published
- 2003
- Full Text
- View/download PDF
39. Left ventricular function assessed by gated spet after an exercise-augmented adenosine infusion. Correlation with myocardial ischaemia.
- Author
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Dziuk M, Canizales A, and Britton KE
- Subjects
- Aged, Female, Gated Blood-Pool Imaging methods, Humans, Male, Middle Aged, Myocardial Ischemia complications, Ventricular Dysfunction, Left etiology, Adenosine, Exercise, Myocardium metabolism, Tomography, Emission-Computed, Single-Photon, Vasodilator Agents, Ventricular Dysfunction, Left diagnosis
- Abstract
Background: Gated single photon emission tomography (SPET) may simultaneously assess perfusion and function of the myocardium., Aim: To evaluate the relationship between the presence of ischaemia during an adenosine stress test and the changes in left ventricular (LV) function obtained after stress and at rest with gated SPET by using adenosine same-day stress and rest protocol., Methods: The study population consisted of twenty eight patients. The gated SPET acquisition was performed both after adenosine vasodilatation and at rest with a protocol as follows: 300 MBq of Tc-99m Myoview at stress, 700 MBq reinjection at rest and double head gamma camera. Global left ventricular ejection fraction (LVEF) and end-diastolic and end-systolic volumes (EDV, ESV) as well as the regional wall motion reversibility from post-stress and resting scan were analysed., Results: Wall motion disturbances were present in the stress study in 15 patients with subsequent improvement in 14 cases on the rest scans. An independent evaluation of the perfusion data revealed significant reversible myocardial ischaemia in 18 patients and negative result in 10. There was a significant difference between EDV change in patients with or without ischaemia (p<0.02). The post-stress LVEF and ESV were significantly different from those measured at rest. Reversible regional wall motion impairment indicated the presence of significant reversible myocardial ischaemia with an 88% positive predictive value (70% and 75% for sensitivity and specificity, respectively)., Conclusions: The post-stress LVEF with gated SPET may not reflect true resting measurements. The qualitative assessment of regional wall motion reversibility shows better correlation with the ischaemic scan pattern than the difference in the LVEF and may be helpful in assessing the significance of reversible myocardial ischaemia.
- Published
- 2003
40. (99m)Tc-ciprofloxacin scintigraphy in rabbit model of prosthetic joint infection.
- Author
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Das SS, Britton KE, Solanki KK, and Wareham DW
- Subjects
- Animals, Autoradiography, Female, Prosthesis-Related Infections etiology, Rabbits, Radionuclide Imaging, Staphylococcal Infections etiology, Tissue Distribution, Anti-Infective Agents pharmacokinetics, Ciprofloxacin pharmacokinetics, Knee Joint diagnostic imaging, Knee Prosthesis adverse effects, Prosthesis-Related Infections diagnostic imaging, Staphylococcal Infections diagnostic imaging, Technetium pharmacokinetics
- Published
- 2003
41. Is deconvolution applicable to renography?
- Author
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Britton KE, Carroll MJ, and Cosgriff PS
- Subjects
- Humans, Nephrons physiopathology, Reproducibility of Results, Kidney diagnostic imaging, Kidney metabolism, Nephrons metabolism, Radioisotope Renography methods, Radiopharmaceuticals pharmacokinetics
- Published
- 2003
- Full Text
- View/download PDF
42. Infection is not specific for bacterial osteo-articular infective pathology.
- Author
-
Solanki KK, Das SS, and Britton KE
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Arthritis, Infectious pathology, Child, Child, Preschool, Diagnosis, Differential, False Negative Reactions, False Positive Reactions, Female, Fibromyalgia diagnostic imaging, Humans, Infant, Newborn, Intervertebral Disc Displacement diagnostic imaging, Joints diagnostic imaging, Kidney metabolism, Liver metabolism, Lumbar Vertebrae diagnostic imaging, Male, Middle Aged, Osteoarthritis diagnostic imaging, Osteomyelitis pathology, Radionuclide Imaging, Radiopharmaceuticals pharmacokinetics, Reference Values, Sensitivity and Specificity, Thyroid Gland metabolism, Urinary Tract Infections diagnostic imaging, Arthritis, Infectious diagnostic imaging, Ciprofloxacin analogs & derivatives, Ciprofloxacin pharmacokinetics, Organotechnetium Compounds pharmacokinetics, Osteomyelitis diagnostic imaging
- Published
- 2003
- Full Text
- View/download PDF
43. The comparison of two gated SPET protocols: adenosine Tc-99m tetrofosmin and treadmill exercise Tc-99m MIBI.
- Author
-
Dziuk MA, Pietrzykowski J, Canizales AL, Britton KE, and Cholewa M
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Myocardial Ischemia complications, Myocardial Ischemia diagnosis, Radiopharmaceuticals, Reproducibility of Results, Sensitivity and Specificity, Tomography, Emission-Computed, Single-Photon methods, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left etiology, Adenosine, Exercise Test, Gated Blood-Pool Imaging methods, Myocardial Ischemia diagnostic imaging, Organophosphorus Compounds, Organotechnetium Compounds, Technetium Tc 99m Sestamibi, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Background: The effect of adenosine and exercise on gated SPET left ventricular ejection fraction (LVEF), end diastolic volume (EDV) and end systolic volume (ESV) has not been fully investigated. The aim of the study was to compare functional measurements obtained in one-day adenosine rest and two-day stress-rest protocols in relation to ischaemia., Material and Methods: Out of 226 consecutive patients examined with submaximal treadmill stress-rest 700 MBq Tc-99m MIBI, 26 were chosen to match those subjected to adenosine (140 micro g/kg/min) enhanced by a low level exercise protocol (300 MBq and 700 MBq Tc-99m tetrofosmin for stress and rest respectively). All images were acquired on a double head system and were gated using 8 frames, 25 s per frame., Results: ED and ES volumes increased after adenosine but decreased after treadmill resulting in the post-stress LVEF being significantly greater than after adenosine, 60 +/- 11 v. 51 +/- 13% (p < 0.01). This was caused by the smaller post-stress ESV in the treadmill group 40 +/- 20 v. 51 +/- 34, p < 0.05. In non-ischaemic scans the LVEF was greater (61 +/- 8 v. 51 +/- 14, p < 0.01) and EDV and ESV smaller after both stress and rest., Conclusions: The adenosine test may have an opposite influence on the EDV and ESV in comparison to the submaximal treadmill test and therefore the left ventricular function measurements after adenosine infusion should be interpreted carefully and may not represent those acquired after physical exercise. In the gated SPET scans showing ischaemia the post-stress EDV and ESV may be greater and the LVEF lower than at rest.
- Published
- 2003
44. Imaging bacterial infection with (99m)Tc-ciprofloxacin (Infecton).
- Author
-
Britton KE, Wareham DW, Das SS, Solanki KK, Amaral H, Bhatnagar A, Katamihardja AH, Malamitsi J, Moustafa HM, Soroa VE, Sundram FX, and Padhy AK
- Subjects
- Abscess diagnostic imaging, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Endocarditis, Bacterial diagnostic imaging, Female, Humans, Infant, Male, Middle Aged, Osteomyelitis diagnostic imaging, Prosthesis-Related Infections diagnostic imaging, Radionuclide Imaging, Radiopharmaceuticals, Soft Tissue Infections diagnostic imaging, Tuberculosis diagnostic imaging, Bacterial Infections diagnostic imaging, Ciprofloxacin analogs & derivatives, Organotechnetium Compounds
- Abstract
Aims: The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection., Methods: Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes's criteria., Results: Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections., Conclusions: Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.
- Published
- 2002
- Full Text
- View/download PDF
45. Can the estimation of ejection fraction during gated single photon emission computed tomography at rest add information to the cardiac perfusion study?
- Author
-
Al-Kaylani H, Britton KE, Beslic N, and Canizales A
- Subjects
- Adult, Aged, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease metabolism, Exercise Test, Female, Heart Ventricles diagnostic imaging, Heart Ventricles metabolism, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Organophosphorus Compounds pharmacokinetics, Organotechnetium Compounds pharmacokinetics, Radiopharmaceuticals pharmacokinetics, Statistics as Topic, Tissue Distribution, Coronary Circulation, Gated Blood-Pool Imaging, Stroke Volume, Tomography, Emission-Computed, Single-Photon, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left physiopathology
- Abstract
Left ventricular function is an important prognostic indicator in patients with coronary artery disease. The electrocardiogram gated, myocardial, single photon emission tomography (SPECT) program is coming into wide use. This program permits measurement of end diastolic volume, end systolic volume, and ejection fraction. This study was designed to show whether the measurement of ejection fraction by using (99c)Tc tetrofosmin gated SPECT at rest could give additional information to the interpretation of perfusion. Exercise 99mTc tetrofosmin SPECT and gated (99c)Tc tetrofosmin SPECT at rest were performed in 33 patients with or suspected of having coronary artery disease. Left ventricular ejection fraction was calculated from reconstructed gated SPECT at rest with a software quantitative gated SPECT. The results showed a poor correlation between segmental ejection fraction and segmental perfusion in stress and rest. There was an increasing probability of reversibility as the ejection fraction increased, while there was a greater chance of a fixed defect as the ejection fraction decreased. It is concluded that gated SPECT using (99c)Tc tetrofosmin provides clinically satisfactory functional data that, in combination with the perfusion information, will improve diagnostic and prognostic accuracy without an increase in cost or radiation dose to patients.
- Published
- 2002
- Full Text
- View/download PDF
46. 99mTc-labeled antimicrobial peptides for detection of bacterial and Candida albicans infections.
- Author
-
Das SS, Wareham DW, and Britton KE
- Subjects
- Humans, Radionuclide Imaging, Bacterial Infections diagnostic imaging, Candidiasis diagnostic imaging, Ciprofloxacin analogs & derivatives, Organotechnetium Compounds
- Published
- 2002
47. Ocular metastases secondary to carcinoid tumors: the utility of imaging with [(123)I]meta-iodobenzylguanidine and [(111)In]DTPA pentetreotide.
- Author
-
Isidori AM, Kaltsas G, Frajese V, Kola B, Whitelocke RA, Plowman PN, Britton KE, Monson JP, Grossman AB, and Besser GM
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoid Tumor pathology, Eye Neoplasms pathology, Female, Fundus Oculi, Humans, Iodine Radioisotopes, Male, Middle Aged, Radionuclide Imaging, 3-Iodobenzylguanidine, Carcinoid Tumor diagnostic imaging, Carcinoid Tumor secondary, Eye Neoplasms diagnostic imaging, Eye Neoplasms secondary, Indium Radioisotopes, Pentetic Acid analogs & derivatives, Radiopharmaceuticals
- Abstract
Ocular metastases from carcinoid tumors are considered rare. They can be the primary presentation of a carcinoid tumor or develop during the course of the disease. The extent of distant metastases from carcinoid tumors correlates with poor prognosis and survival; early detection of metastasis may change the overall management. Radiopharmaceutical-labeled imaging techniques have been widely applied for the detection and localization of such lesions based on isotope uptake by neuroendocrine tumors. Routine application of these imaging modalities may reveal previously unsuspected lesions and may also be used to help stage the disease and to identify patients who may be treated with radiopharmaceuticals. Of 40 patients with carcinoid tumors reviewed in our department since we started routine scanning, we identified 6 (15%) who demonstrated ocular metastases: 5 with obvious lesions and 1 with presumed metastasis according to the results of nucleotide scanning. All 6 were negative on screening with [(123)I]meta-iodobenzylguanidine, whereas 3 of 4 who were screened with [(111)In]octreotide showed positive uptake. All patients responded well to radiotherapy and chemotherapy and did not require surgical treatment. The orbit and its contents appear to be a common site for carcinoid metastasis, and radiopharmaceutical imaging with labeled octreotide is useful in identifying many of these lesions.
- Published
- 2002
- Full Text
- View/download PDF
48. Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1.
- Author
-
Al-Yasi AR, Carroll MJ, Ellison D, Granowska M, Mather SJ, Wells CA, Carpenter R, and Britton KE
- Subjects
- Adult, Aged, Aged, 80 and over, Axilla, Breast diagnostic imaging, Female, Humans, Middle Aged, Breast Neoplasms diagnostic imaging, Lymph Nodes diagnostic imaging, Mucin-1 immunology, Radioimmunodetection, Technetium
- Abstract
In early breast cancer axillary nodes are usually impalpable and over 50% of such patients may have an axillary clearance when no nodes are involved. This work identifies axillary node status by imaging with a Tc-99m radiolabelled anti-Polymorphic Epithelial Mucin, humanised monoclonal antibody (human milk fat globule 1), prior to surgery in 30 patients. Change detection analysis of image data with probability mapping is undertaken. A specificity of 93% and positive predictive value of 92% (both 100% if a second cancer in the axilla with negative nodes is considered) were found. A strategy for combining negative imaging with the sentinel node procedure is presented., (Copyright 2002 Cancer Research UK)
- Published
- 2002
- Full Text
- View/download PDF
49. Cancer imaging with radiolabelled antibodies and peptides.
- Author
-
Britton KE and Granowska M
- Published
- 2002
50. The role of 123I-diagnostic imaging in the follow-up of patients with differentiated thyroid carcinoma as compared to 131I-scanning: avoidance of negative therapeutic uptake due to stunning.
- Author
-
Siddiqi A, Foley RR, Britton KE, Sibtain A, Plowman PN, Grossman AB, Monson JP, and Besser GM
- Subjects
- Adult, Aged, Carcinoma blood, Carcinoma radiotherapy, Carcinoma, Papillary blood, Carcinoma, Papillary diagnostic imaging, Carcinoma, Papillary radiotherapy, Carcinoma, Papillary, Follicular blood, Carcinoma, Papillary, Follicular diagnostic imaging, Carcinoma, Papillary, Follicular radiotherapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Radionuclide Imaging, Thyroglobulin blood, Thyroid Neoplasms blood, Thyroid Neoplasms radiotherapy, Carcinoma diagnostic imaging, Iodine Radioisotopes therapeutic use, Neoplasm Recurrence, Local diagnostic imaging, Thyroid Gland radiation effects, Thyroid Neoplasms diagnostic imaging
- Abstract
Objective: Some patients with relapsed differentiated thyroid cancer may show rising thyroglobulin (Tg) levels despite a lack of 131I uptake on routine whole body imaging. A significant proportion of these patients, after therapy doses of 131I, may demonstrate positive 131I uptake with a subsequent fall in serum Tg, implying a therapeutic effect. Attempts to identify such patients by increasing the dose of the diagnostic 131I tracer may lead to inhibition of subsequent uptake after the therapy dose, an effect referred to as 'stunning' and associated with a reduction in therapeutic effect. 123I is a short half-life gamma-emitter, thought to be unlikely to cause stunning, which may thus be more suitable than 131I for diagnostic imaging of thyroid cancer., Design and Patients: The efficacy of the 123I radionuclide was determined in a longitudinal study of 12 patients who were selected only because they showed elevated serum Tg and a negative diagnostic 131I whole body study prior to therapy with 131I., Results: There was almost complete concordance in uptake between 123I diagnostic imaging and the final scans carried out after 131I therapy (hereafter known as therapy studies) in 11 out of 12 patients at their first evaluation, in each of four patients receiving 123I at their second evaluation and in a single patient receiving 123I at a third evaluation. One patient had a positive 123I study but a negative 131I therapy study: following therapy Tg declined from 5.5 pg/l to undetectable levels, implying a therapeutic effect, and suggesting that the negative uptake was not the result of stunning. Two negative diagnostic 123I studies were followed by negative therapy studies, and thus there were no false negatives. 123I correctly identified disease in the nine patients with metastases in the lungs, mediastinum and bone at the first evaluation, in all four patients at the second evaluation and in the single patient at the third evaluation. At the end of the study, patients had received up to three 131I therapy doses, Tg had risen in four patients, fallen in eight and become undetectable in one patient., Conclusions: 123I is highly sensitive in diagnosing local recurrence and metastatic disease, and produces scintigraphic images which concord well with uptake following 131I therapy. It is proposed that 123I imaging, in combination with serum Tg measurements, should replace 131I tracer imaging as an indicator of the potential efficacy of 131I therapy. Stunning, with its detrimental effects on 131I therapy, may thus be avoided. The possibility of false negative images due to the stunning phenomenon must always be borne in mind if there is a discrepancy between positive 131I imaging studies and a surprisingly negative subsequent 131I therapy scan.
- Published
- 2001
- Full Text
- View/download PDF
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