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An integrated approach to biodistribution radiation absorbed dose estimates

Noz ME; Kramer EL; Maguire GQ Jr; McGee SA; Sanger JJ
An integrated approach to existing methods of extracting biodistribution data, pharmacokinetics and radiation absorbed dose estimates from serial scintigraphic images is described. This approach employs a single computer-generated user interface to reformat planar scans into a standard file type, align conjugate (anterior and posterior) images, draw regions of interest (ROIs) over selected organs and lesions and generate count data for anterior and posterior views and calculated geometric means. Using standard correction methods, the fraction injected activity is obtained for all ROIs and total body. This methodology has been applied to the analysis of indium-III-labelled breast-cancer-directed antibodies and technetium-90m-labelled CEA-specific antibody fragments in non-small-cell lung cancer. It is anticipated that this approach will be useful for evaluating the dosimetry of other radiolabelled monoclonal antibodies, as well as other radiopharmaceuticals
PMID: 8382614
ISSN: 0340-6997
CID: 8227

Graphical interface for medical image processing

Noz ME; Maguire GQ Jr; Birnbaum BA; Sanger JJ; Kramer EL; Chapnick JV; Kaminer EA
We have developed a graphical interface which allows users of varying levels of computer experience and proficiency to manipulate medical image-processing data with 'point-and-click' ease. The power which had formerly been associated with protocols and shell scripts has been combined with the flexibility and 'user-friendliness' of buttons and dialog boxes
PMID: 8320536
ISSN: 0148-5598
CID: 25912

Anomalous origin of the left coronary artery. Use of thallium perfusion scans in the evaluation of successful revascularization [Case Report]

Fernandes J; Rutkowski M; Sanger JJ
Thallium imaging was performed on a 2-month-old infant with a left coronary artery originating from the pulmonary artery. Imaging was performed before and after corrective surgery, which involved creating a new left coronary osteum from the ascending aorta. The radionuclide study documented successful revascularization postoperatively
PMID: 1611786
ISSN: 0363-9762
CID: 13661

ICRF-187 permits longer treatment with doxorubicin in women with breast cancer [published erratum appears in J Clin Oncol 1992 May;10(5):867]

Speyer JL; Green MD; Zeleniuch-Jacquotte A; Wernz JC; Rey M; Sanger J; Kramer E; Ferrans V; Hochster H; Meyers M; et al
PURPOSE: To test potential protection by ICRF-187 against cumulative doxorubicin-dose-related cardiac toxicity, we conducted a randomized clinical trial in 150 women with advanced breast cancer. PATIENTS AND METHODS: Patients received fluorouracil (5FU) 500 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 500 mg/m2 every 21 days intravenously (IV) (control regimen, 74 patients), or the same regimen preceded by ICRF-187 1,000 mg/m2 IV (experimental regimen, 76 patients). RESULTS: We previously reported that ICRF-187 in this dose and schedule provides cardiac protection and does not substantially alter the noncardiac toxicity or antitumor efficacy of the control regimen. In this updated analysis of the entire patient cohort, we provide additional support for these findings and demonstrate that patients in the ICRF-187 group received more cycles (median, 11) and higher cumulative doses (median, 500 mg/m2) of doxorubicin than patients in the control group (median, nine cycles, P less than .01; and 441 mg/m2, P less than .05). Twenty-six patients in the ICRF-187 group received doxorubicin doses of at least 700 mg/m2, and among them, 11 patients received 1,000 mg/m2 or more. Only three patients in the control group received doxorubicin doses of 700 mg/m2; the maximum dose administered to one patient in this group was 950 mg/m2. ICRF-187 cardiac protection was demonstrated by difference in incidence of clinical congestive heart failure (CHF; two patients in the ICRF-187 group v 20 in the control group; P less than .0001) and by differences in resting left ventricular ejection fraction (LVEF) determined by multigated radionuclide (MUGA) scan from baselines and that required patient removal from study (five patients in the ICRF-187 group had a decrease in LVEF to less than 0.45 or a decrease from the baseline LVEF of 0.20 or more v 32 in the control group; P less than .000001). Among the 30 patients who had an assessable endomyocardial biopsy at cumulative doxorubicin 450 mg/m2, none of 16 in the ICRF-187 group and six of 14 in the control group had a score of 2 (P less than .05). ICRF-187 cardiac protection was observed in patients with and without prior chest-wall radiation or other risk factors for developing doxorubicin cardiac toxicity. CONCLUSION: By protecting against cumulative doxorubicin-induced cardiac toxicity, ICRF-187 permits significantly greater doses of doxorubicin to be administered to patients with greater safety
PMID: 1727913
ISSN: 0732-183x
CID: 13730

Radionuclide quantitation of renal function

Sanger JJ; Kramer EL
Quantitation of renal function may be performed with a variety of radiopharmaceuticals which reflect slightly different renal functions. Plasma sampling techniques and imaging techniques have been used to derive absolute measurements of renal function. The addition of imaging permits the determination of relative or 'split' function. Time-activity curves from renal studies provide other quantitative parameters of function reflecting arterial supply, renal cortical function, and patency of the renal collecting system. Quantitative radionuclide studies of the kidneys provide comprehensive, reproducible, and objective assessments of renal function
PMID: 1509629
ISSN: 0171-1091
CID: 13763

Hepatic hemangiomas: diagnosis with fusion of MR, CT, and Tc-99m-labeled red blood cell SPECT images

Birnbaum BA; Noz ME; Chapnick J; Sanger JJ; Megibow AJ; Maguire GQ Jr; Weinreb JC; Kaminer EM; Kramer EL
A method of image analysis was developed for correlation of hemangiomas detected at computed tomography (CT) and/or magnetic resonance (MR) imaging with increased blood pool activity evident at single photon emission CT (SPECT) performed after labeling of red blood cells with technetium-99m. Image analysis was performed in 20 patients with 35 known hepatic hemangiomas. After section thickness and pixel sizes of the different studies were matched, intrinsic landmarks were chosen to identify anatomically corresponding locations. Regions of interest (ROIs) drawn on the CT and/or MR images were translated, rotated, and reprojected to match the areas of interest on the corresponding SPECT images by means of a two-dimensional polynomial-based warping algorithm. Analysis of ROIs on 30 SPECT-MR and 20 SPECT-CT pairs of registered images provided absolute confirmation that 34 suspected hemangiomas identified on SPECT images correlated exactly with lesions seen on CT and/or MR images. Accuracy of fusion was within an average of 1.5 pixels +/- 0.8 (+/- 1 standard deviation). The technique enabled diagnostic confirmation of hemangiomas as small as 1.0 cm and proved useful for evaluating lesions located adjacent to intrahepatic vessels
PMID: 1924790
ISSN: 0033-8419
CID: 13849

GRAPHICS APPLIED TO MEDICAL IMAGE REGISTRATION

Maguire, GQ; Noz, ME; Rusinek, H; Jaeger, J; Kramer, EL; Sanger, JJ; Smith, G
ISI:A1991FA95100004
ISSN: 0272-1716
CID: 32223

A prospective randomized trial of ICRF-187 for prevention of cumulative doxorubicin-induced cardiac toxicity in women with breast cancer

Speyer JL; Green MD; Sanger J; Zeleniuch-Jacquotte A; Kramer E; Rey M; Wernz JC; Blum RH; Hochester H; Meyers M; et al
PMID: 2125531
ISSN: 0305-7372
CID: 15688

Detection of thoracic infections by nuclear medicine techniques in the acquired immunodeficiency syndrome

Kramer EL; Sanger JJ
The challenge of the acquired immunodeficiency syndrome (AIDS) for nuclear medicine has been the early detection of related intrathoracic opportunistic infections, inflammatory conditions, and neoplasms. Gallium-67 citrate scanning has proved a sensitive test not only for Pneumocystis carinii pneumonia but for many of the other opportunistic infections and malignancies, including mycobacterial infections and lymphoma. Patterns and intensity of gallium uptake may suggest more specific diagnoses. Indium-111-labeled white blood cells may also be a valuable diagnostic tool in the AIDS patient
PMID: 2685873
ISSN: 0033-8389
CID: 25915

CT-SPECT fusion to correlate radiolabeled monoclonal antibody uptake with abdominal CT findings

Kramer EL; Noz ME; Sanger JJ; Megibow AJ; Maguire GQ
To enhance the information provided by computed tomography (CT) and single photon emission computed tomography (SPECT) performed with radiolabeled, anti-carcinoembryonic antigen monoclonal antibody (MoAb), the authors performed fusion of these types of images from eight subjects with suspected colorectal adenocarcinoma. Section thickness and pixel size of the two studies were matched, coordinates of corresponding points from each study were identified, and CT sections were translated, rotated, and reprojected to match the corresponding SPECT scans. The CT-SPECT fusion enabled identification of anatomic sites of tumor-specific MoAb accumulation in four cases, showed non-specific MoAb accumulation in two, and helped confirm information only suggested by the two studies separately in one
PMID: 2788895
ISSN: 0033-8419
CID: 25913