Prediction of myocutaneous adverse side effect due to intra-arterial chemotherapy by intra-arterial 99mTc-macroaggregated albumin administration in patients with bone and soft-tissue tumors

フォーマット:

論文

責任表示:

Taki, Junichi ; Sumiya, Hisashi ; Higuchi, Takahiro ; Tsuchiya, Hiroyuki ; Takazawa, Kotaro ; Tomita, Katsuro ; Tonami, Norihisa

言語:

英語

出版情報:

THE SOCIETY OF NUCLEAR MEDICINE INC, 2002-11-01

著者名:

Taki, Junichi

Sumiya, Hisashi

Higuchi, Takahiro

Tsuchiya, Hiroyuki

Takazawa, Kotaro

Tomita, Katsuro

Tonami, Norihisa

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掲載情報:

Journal of Nuclear Medicine

ISSN:

0161-5505      

巻:

43

通号:

11

開始ページ:

1452

終了ページ:

1456

バージョン:

publisher

概要:

金沢大学大学院医学系研究科<br />In malignant bone and soft-tissue tumors, intra-arterial chemotherapy and limb-saving surgery have become popular. Myocutaneous inflammatory change and necrosis are the major local side effects of intra-arterial che … motherapy. 99mTc-macroaggregated albumin (MAA) imaging with intra-arterial tracer administration was performed to evaluate drug distribution, and the ability of 99mTc-MAA imaging to predict local side effects was assessed. Methods: In 24 patients, 42 99mTc-MAA images were obtained with tracer injection through an intra-arterial catheter that was inserted into the proximal portion of the tumor-feeding artery. Abnormal uptake other than by tumor was assessed visually and quantitatively. Results: In visual analysis, abnormal 99mTc-MAA accumulation was observed in 21 of 42 images. In the first consecutive 13 of these 21 images, intra-arterial chemotherapy with cisplatin, doxorubicin, and caffeine was administered, and myocutaneous inflammation or necrosis in the area corresponding to the abnormal 99mTc-MAA uptake was observed in 11. In contrast, none of the 21 images without abnormal 99mTc-MAA uptake demonstrated any local adverse effect from intra-arterial chemotherapy. In the last consecutive 8 images with abnormal 99mTc-MAA uptake, intra-arterial chemotherapy was initiated with only cisplatin, and doxorubicin and caffeine administration was changed to the intravenous route. In all 8 of these images, no local adverse effects from chemotherapy were observed. Overall, the sensitivity, specificity, and accuracy of 99mTc-MAA imaging for the detection of myocutaneous damage were 100% (11/11), 91% (21/23), and 94% (32/34), respectively, and positive and negative predictive values were 85% (11/13) and 100% (21/21), respectively. In quantitative analysis, when the diagnostic threshold of the uptake ratio was set at 2.5, sensitivity, specificity, and accuracy for the detection of myocutaneous complications were 91% (10/11), 96% (22/ 23), and 94% (32/34), respectively, and positive and negative predictive values were 91% (10/11) and 96% (22/23), respectively. Conclusion: 99mTc-MAA imaging with intra-arterial infusion before intra-arterial chemotherapy for bone and soft-tissue tumors can facilitate prediction of local myocutaneous adverse effects due to chemotherapy. 続きを見る

URL:

http://hdl.handle.net/2297/2795