The value of gallium-67 and thallium-201 whole-body and single-photon emission tomography images in dialysis-related beta(2)-microglobulin amyloid

Citation
Tc. Yen et al., The value of gallium-67 and thallium-201 whole-body and single-photon emission tomography images in dialysis-related beta(2)-microglobulin amyloid, EUR J NUCL, 27(1), 2000, pp. 56-61
Citations number
43
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Journal title
EUROPEAN JOURNAL OF NUCLEAR MEDICINE
ISSN journal
0340-6997 → ACNP
Volume
27
Issue
1
Year of publication
2000
Pages
56 - 61
Database
ISI
SICI code
0340-6997(200001)27:1<56:TVOGAT>2.0.ZU;2-A
Abstract
The aim of this study was to investigate the value of gallium-67 and thalli um-201 whole-body and single-photon emission tomography (SPET) images in lo ng-term dialysis patients in whom dialysis-related beta(2)-microglobulin am yloid (beta(2)-MA) was clinically suspected. Twenty-three patients who had received dialysis for at least 10 years were included in the study. A techn etium-99m methylene diphosphonate (MDP) whole-body scan was performed in al l of the patients. If there was any MDP accumulation in the articular and/o r peri-articular region, Ga-67 and Tl-201 whole-body and SPET images were t hen acquired. If any Ga-67 and/or Tl-201 uptake was observed, a CT-guided b iopsy was done. In those patients who had articular and/or peri-articular u ptake of Tc-99m MDP, Ga-67 and/or Tl-201 and who were pathologically proven to have beta(2)-MA, Tc-99m MDP, Ga-67 and Tl-201 whole-body scans and SPET were carried out again, both 3 months and 1 year after initiation of treat ment. This served to evaluate the therapeutic effect and allowed comparison with the clinical findings, Of the 23 patients, eight had abnormal Tc-99m MDP uptake. Among these eight, six had intense (99)mTc MDP, Ga-67 and Tl-20 1 uptake in the articular and peri-articular regions before medication. Thr ee months after the start of treatment, there were very marked decreases in uptake on both the Ga-67 and Tl-201 scans but less obvious changes in upta ke of Tc-99m-MDP. In comparison with the other clinical manifestations such as limitation in range of motion, the more the painful disability improved , the less was the uptake on both Ga-67 and Tl-201 scans, There were virtua lly no differences in uptake pattern between the three scans of each radiop harmaceutical obtained for each patient in both 3 months and 1 year after i nitial of treatment. It is concluded that (99)mTc-MDP whole-body bone scan can both detect active and pre-existing inactive deposits of beta(2)-MA. Ga -67 and Tl-201 scans are helpful to differentiate active from inactive depo sits of beta(2)-MA and to evaluate the therapeutic effect on these patients . SPET images are usually needed to distinguish articular and periarticular lesions from bone lesions.