Biomedical research with cyclotron produced radionuclides

Progress is reported on: metabolic and tumor localization in man and animals; radiodrug development; dosimetry for internally deposited isotopes; and radioactive material transfer system. Based on experience with /sup 13/N-glutamate in osteogenic sarcoma and Ewing's sarcoma, we conclude that (a) the /sup 13/N label enters tumor tissue rapidly at a rate similar to that at which activity leaves the blood, suggesting that the labeled glutamate itself is being transported into the tumor rather than some labeled metabolite; (b) uptake in the tumor is related to its metabolic activity, but factors such as blood flow are also important; (c) changes in the glutamate scan accurately reflect the response of osteogenic sarcoma to pre-operative chemotherapy as measured by conventional means, and that it is desirable to extend this experience to other types of tumors. /sup 13/N-Glutamate (and other /sup 13/N-labeled compounds) afford several advantages over conventional tumor imaging agents, such as rapid blood clearance and localization, low radiation exposure and the possibility of obtaining accurate, three-dimensional quantitative images via positron emission tomography. It is doubtful that these advantages will justify the routine use of /sup 13/N-glutamate to detect tumors or to monitor therapy except in clinical situations where conventional techniques are unsatisfactory. The value of /sup 1/3N-glutamate is as a tool to assess the metabolic requirement of neoplastic tissue in cancer patients in-vivo. (PCS

Maximal safe dose of I-131 after failure of standard fixed dose therapy in patients with differentiated thyroid carcinoma

OBJECTIVE: The maximal safe dose (MSD) on the basis of bone marrow irradiation levels allows the delivery of a large amount of I-131 to thyroid cancer tissue. The efficacy of MSD therapy in differentiated metastatic thyroid cancers that persisted after conventional fixed dose therapy is investigated. METHODS: Forty-seven differentiated thyroid carcinoma patients with non-responsive residual disease despite repetitive fixed dose I-131 therapy were enrolled in this study. Their postoperative pathologies were 43 papillary carcinomas and 4 follicular carcinomas. The MSD was calculated with the Memorial Sloan-Kettering Cancer Center protocol using serial blood samples. The MSDs were administered at intervals of 6 months. Treatment responses were evaluated using I-131 whole-body scans and serum thyroglobulin measurements. RESULTS: The mean calculated MSD was 12.5 +/- 2.1 GBq (339.6 +/- 57.5 mCi). Of the 46 patients, 7 (14.9%) showed complete remission, 15 (31.9%) partial remission, 19 (40.4%) stable disease, and 6 (12.8%) disease progression. Of the patients who showed complete or partial remission, 15 (65%) showed response after the first MSD session and 6 (26%) showed response after the second session. Twenty-nine patients (62%) experienced transient cytopenia after therapy, but three did not recover to the baseline level. CONCLUSIONS: The maximal safe dose provides an effective means of treatment in patients who failed to respond adequately to conventional fixed dose therapy. I-131 MSD therapy can be considered in patients who fail fixed dose therapy