Linda M. Thorson

18F-FDG labelling of human leukocytes

Radiolabelled leukocytes are useful for the imaging of inflammation and infection, and 18F-fluorodeoxyglucose (18F-FDG) is known to concentrate in metabolically active cells. We evaluated the feasibility of leukocyte labelling with 18F-FDG using ACD and heparin anticoagulants at 20°C and 37°C, with and without gentle mixing during incubation. With leukocytes (WBC) harvested from 20 ml blood, studies were performed using 18F-FDG in concentrations of 3.7-74 MBq (0.1-2.0 mCi). 18F-FDG WBC stability in platelet-poor plasma was assessed at 1-4 h. Satisfactory labelling efficiency was achieved with incubation in heparin-saline at 37°C for 30 min (62.7±1.6%), and was further enhanced by mixing during incubation (78.1±3.9%). Cell labelling was predominantly of granulocytes (78.5±1.4%). 18F-FDG WBC was relatively stable in platelet-poor plasma for up to 4 h, and no cell staining was observed in viability studies using trypan blue. These results indicate the feasibility of leukocyte labelling with 18F-FDG, providing an approach that may be useful in PET imaging of inflammation and infection.

Biodistribution of Radiolabeled Adenosylcobalamin in Patients Diagnosed With Various Malignancies

OBJECTIVE To study the biodistribution of a vitamin B12 analog, indium In 111-labeled diethylenetriaminepentaacetate adenosylcobalamin (In 111 DAC), in patients recently diagnosed as having primary or recurrent malignancy. PATIENTS AND METHODS Thirty patients (14 women and 16 men) with radiographically or clinically diagnosed breast, lung, colon, sarcomatous, thyroid, or central nervous system malignancies were studied prior to definitive surgery or biopsy. A maximum of 650 microCi (2.2 microg) of In 111 DAC was administered intravenously. Vitamin B12 and folate levels were determined prior to injection. Serum clearance and urinary and stool excretion of the tracer were measured. Images were routinely obtained at 0.5, 3 to 5, and 20 to 24 hours after injection. Biodistribution of In 111 DAC was determined by computer analysis of regions of interest. RESULTS Serum T1/2 clearance was 7 minutes. Average urinary and stool excretion of the injected dose over 24 hours was 26.1% and 0.4%, respectively. The greatest focal uptake of In 111 DAC occurred in the liver and spleen, followed by the nasal cavity and salivary and lacrimal glands. The average tumor uptake of the injected dose was 2% at 30 minutes and 1.5% at 24 hours. High-grade primary and metastatic breast, lung, colon, thyroid, and sarcomatous malignancies were all imaged at 3 to 5 hours after injection. Central nervous system tumors and advanced metastatic prostate cancer were best identified at 24 hours. Mammographically occult, palpable, and nonpalpable breast cancers were delineated by In 111 DAC. Low-grade malignancies as well as early skeletal metastatic disease were not effectively imaged by the vitamin B12 tracer. Patients with elevated baseline vitamin B12 or those concurrently taking corticosteroids appeared to have optimal visualization of their malignancies. CONCLUSION Vitamin B12 may be a useful vehicle for delivering diagnostic and therapeutic agents to various malignancies. Further evaluation of cobalamin analogs and their interaction with transport proteins and cellular receptors within malignant tissue and infection is warranted.

Biodistribution and dosimetry of [18F]fluorodeoxyglucose labelled leukocytes in normal human subjects

This study was performed in order to assess [18F]fluorodeoxyglucose white blood cell (18F-FDG WBC) dosimetry in normal human subjects. Using previously reported methods, mixed cell suspensions of autologous leukocytes were prepared from four normal volunteers. Leukocytes were labelled in heparin-saline by incubation with 18F-FDG at 37°C for 20 min. After washing and resuspension, 18F-FDG WBCs (225-315 MBq) were administered by intravenous injection. Whole-body imaging was performed at 0.5, 1, 2, 4 and 6 h using a GE Varicam with 511 keV collimation. Blood samples were obtained at corresponding times as well as fractionated urinary collection. Whole-body anterior and posterior images were used for calculation of organ dosimetry. Uptake of 18F-FDG WBCs occurred predominantly within the reticulo-endothelial system. Plasma activity, urinary excretion (9.9±2.3% at 6 h), and brain uptake (1.7±0.4%) were consistent with partial elution of 18F-FDG. Positron emission tomography imaging performed at5-6 h after injection yielded good quality images of reticulo-endothelial uptake. Whole-body and organ dosimetry for 18F-FDG WBCs in doses of 225-250 MBq are comparable with reported results for conventional doses of 111In oxine labelled leukocytes. Further studies of 18F-FDG WBC as an agent for positron emission tomography imaging of inflammatory disease appear warranted.

Evaluation of Macroaggregated Albumin Particle Sizes for Use in Pulmonary Shunt Patient Studies

OBJECTIVE To assess commercial macroaggregated albumin (MAA) reagent kits for compliance with particle-size parameters needed for proper clinical evaluation of pulmonary shunts (right-to-left). DESIGN Comparative trial. SETTING Nuclear pharmacy (laboratory setting). PATIENTS AND OTHER PARTICIPANTS Not applicable. INTERVENTIONS Minimally, 90% of the particles contained within an MAA reagent kit should be within the 10 to 90 microns range with minimal variation in particle size distribution and as few small particles (i.e., < 10 microns) as possible. Five separate vials from five commercial brands of MAA reagent kits were obtained, and 500 to 517 particles were analyzed for each sample. An additional study was performed on one of the MAA reagent kit brands, using five vials from each of five different lot numbers to determine the variability between lots. MAIN OUTCOME MEASURES Long axis (maximum, micron), short axis (minimum, micron), and the area (micron 2) of each MAA particle. RESULTS One MAA brand had the lowest percentage of unacceptable MAA particle sizes and maintained consistent particle sizes between vials. However, the same MAA reagent kit brand showed that only two of five lots had a low percentage of MAA particle sizes below the 10-micron limit. CONCLUSION Particle sizes varied among the five different brands of MAA reagent kits, as did different lots of the best-performing kit. This variability in particle sizes may affect the accuracy and reproducibility of pulmonary shunt patient studies.

In vitro evaluation of neutrophil viability after exposure to a hypotonic medium

Separation techniques for radiolabelled leukocytes have inherent problems with contaminants (e.g. platelets and erythrocytes). Hypotonic lysis methods can eliminate the erythrocytes, but the question of neutrophil viability after an exposure to a hypotonic solution (i.e. sterile water) remains. Ficoll/ hypaque two-density gradient separation was performed on donor whole blood to obtain a pure neutrophil suspension. A timed sequence of water exposure was done for 5-100 s on the neutrophil preparations. The viability of these preparations was evaluated using flow cytometry and chemotaxis. The trypan blue staining method was used to document cell death. With water exposures ranging up to 100 s, 2.04 +/- 1.80% neutrophils exhibited cellular degradation by flow cytometry, and all samples demonstrated viable neutrophils by chemotaxis and trypan blue staining. The hypotonic medium exposure times for leukocyte separations should be less than 30 s for neutrophils to retain their viability by these in vitro techniques.