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Title: Altered biodistribution of Ga-67 by intramuscular gold salts

Abstract

The authors observed a deviation from the normal scintigraphic pattern of Ga-67 citrate biodistribution. An 8-year-old black girl with juvenile rheumatoid arthritis, who had been treated with intramuscular injections of gold salts, had a Ga-67 study as part of her workup. The study demonstrated no hepatic uptake, but showed elevated skeletal and renal activity. This characteristic biodistribution of Ga-67 may be due to inhibition of lysosomal enzymes by gold and/or to accumulation of gold in lysosomes. To study these possibilities, the authors reviewed the mechanisms of Ga-67 localization and gold metabolism. Alteration of the Ga-67 citrate scintigraphic pattern due to earlier treatment with gold salts has not been reported previously.

Authors:
;  [1]
  1. (Chicago Osteopathic Medical Center, IL (USA))
Publication Date:
OSTI Identifier:
7244570
Resource Type:
Journal Article
Resource Relation:
Journal Name: Clinical Nuclear Medicine; (USA); Journal Volume: 14:11
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; GALLIUM 67; TISSUE DISTRIBUTION; GOLD; METABOLISM; RHEUMATIC DISEASES; DIAGNOSIS; CHILDREN; CITRATES; LYSOSOMES; SCINTISCANNING; AGE GROUPS; BETA DECAY RADIOISOTOPES; CARBOXYLIC ACID SALTS; CELL CONSTITUENTS; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; DISTRIBUTION; ELECTRON CAPTURE RADIOISOTOPES; ELEMENTS; GALLIUM ISOTOPES; INTERMEDIATE MASS NUCLEI; ISOTOPES; METALS; NUCLEI; ODD-EVEN NUCLEI; ORGANOIDS; RADIOISOTOPE SCANNING; RADIOISOTOPES; SKELETAL DISEASES; TRANSITION ELEMENTS; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Moult, R.G., and Bekerman, C. Altered biodistribution of Ga-67 by intramuscular gold salts. United States: N. p., 1989. Web. doi:10.1097/00003072-198911000-00011.
Moult, R.G., & Bekerman, C. Altered biodistribution of Ga-67 by intramuscular gold salts. United States. doi:10.1097/00003072-198911000-00011.
Moult, R.G., and Bekerman, C. Wed . "Altered biodistribution of Ga-67 by intramuscular gold salts". United States. doi:10.1097/00003072-198911000-00011.
@article{osti_7244570,
title = {Altered biodistribution of Ga-67 by intramuscular gold salts},
author = {Moult, R.G. and Bekerman, C.},
abstractNote = {The authors observed a deviation from the normal scintigraphic pattern of Ga-67 citrate biodistribution. An 8-year-old black girl with juvenile rheumatoid arthritis, who had been treated with intramuscular injections of gold salts, had a Ga-67 study as part of her workup. The study demonstrated no hepatic uptake, but showed elevated skeletal and renal activity. This characteristic biodistribution of Ga-67 may be due to inhibition of lysosomal enzymes by gold and/or to accumulation of gold in lysosomes. To study these possibilities, the authors reviewed the mechanisms of Ga-67 localization and gold metabolism. Alteration of the Ga-67 citrate scintigraphic pattern due to earlier treatment with gold salts has not been reported previously.},
doi = {10.1097/00003072-198911000-00011},
journal = {Clinical Nuclear Medicine; (USA)},
number = ,
volume = 14:11,
place = {United States},
year = {Wed Nov 01 00:00:00 EST 1989},
month = {Wed Nov 01 00:00:00 EST 1989}
}
  • Markedly altered biodistribution of ({sup 67}Ga)citrate was observed in a 66-yr-old hemodialysis patient imaged at 48 hr postinjection. A review of the patient's hospital records revealed toxic serum levels of aluminum, treated with the chelating agent desferoxamine. Based on what is known about the biologic interactions between gallium, aluminum, transferrin, and desferoxamine, we believe that both toxic serum aluminum levels and desferoxamine therapy may cause altered biodistribution on ({sup 67}Ga)citrate scintigraphy.
  • The effect of the intravenous administration of the synthetic siderophore LI-CAM-C on the biodistribution of /sup 67/Ga was investigated. The ligand was found capable of the in vivo complexing with /sup 67/Ga, which hastened the renal clearance of the nuclide. The gallium concentration was decreased in all organs, with the exception of the liver and spleen, where we suggest that hydroxide precipitates interfere with gallium sequestration by LICAM-C. The gallium in abscess tissue was only slightly affected, giving rise to an increase in the /sup 67/Ga abscess-to-soft-tissue concentration ratio when LICAM-C is administered. Dosimetry calculations show that the siderophore decreasesmore » the radiation burden from /sup 67/Ga citrate. The advantage of clinical application of LICAM-C are discussed.« less
  • To investigate the effect of iron deficiency on the biodistribution and tumor uptake of Ga-67 citrate, 20 weanling Sprague-Dawley rats were maintained for 6 to 8 weeks on a low-iron diet. Eighteen littermates were maintained on a normal iron diet and served as controls. Animals received 10 ..mu..Ci Ga-67 citrate, and urine and feces were collected for 48 h. The animals were then killed, tissue samples were obtained, and serum iron and unsaturated iron-binding capacity (UIBC) were measured. The accumulation of Ga-67 in the liver and spleen (% injected dose) was markedly increased in iron-deficient animals and urinary excretion wasmore » reduced. Tumor uptake was not significantly different in iron-deficient and control animals, but tumor-to-blood ratios were elevated (p < 0.001) in the iron-deficient animals because of low blood levels of Ga-67. The liver and spleen accumulation of Ga-67 correlated significantly (p < 0.001) with the UIBC. The results show that iron deficiency alters the distribution of Ga-67 citrate, and suggest that the variable liver-spleen uptake seen in clinical Ga-67 images may be explained, in part, by changes in serum iron and UIBC.« less
  • Gallium-67 citrate studies from four patients who received multiple red blood cell transfusions were reviewed. Increased kidney, bladder, or bone localization was associated with decreased liver and colon activity. The findings suggest altered distribution due to competition with iron for receptor binding. Identification of inflammatory disease in two patients was possible. However, the effect of transfusions on detection of inflammatory or neoplastic diseases requires further evaluation.
  • Gallium-67 citrate studies from four patients who received multiple red blood cell transfusions were reviewed. Increased kidney, bladder or bone localization was associated with decreased liver and colon activity. The findings suggest altered distribution due to competition with iron for receptor binding. Identification of inflammatory disease in two patients was possible. However, the effect of transfusions on detection of inflammatory or neoplastic diseases requires further evaluation.