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

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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 chemotherapy. 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.

Original languageEnglish
Pages (from-to)1452-1456
Number of pages5
JournalJournal of Nuclear Medicine
Volume43
Issue number11
Publication statusPublished - Nov 1 2002
Externally publishedYes

Fingerprint

Albumins
Bone and Bones
Drug Therapy
Neoplasms
Caffeine
Doxorubicin
Cisplatin
Necrosis
Intra-Arterial Injections
Sensitivity and Specificity
Intra Arterial Infusions
Catheters
Extremities
Arteries
Inflammation
Pharmaceutical Preparations

Keywords

  • Tc-macroaggregated albumin
  • Drug distribution
  • Intra-arterial chemotherapy
  • Myocutaneous inflammatory change

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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. / Taki, Junichi; Sumiya, Hisashi; Higuchi, Takahiro; Tsuchiya, Hiroyuki; Takazawa, Koutaro; Tomita, Katsuro; Tonami, Norihisa.

In: Journal of Nuclear Medicine, Vol. 43, No. 11, 01.11.2002, p. 1452-1456.

Research output: Contribution to journalArticle

Taki, Junichi ; Sumiya, Hisashi ; Higuchi, Takahiro ; Tsuchiya, Hiroyuki ; Takazawa, Koutaro ; Tomita, Katsuro ; Tonami, Norihisa. / 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. In: Journal of Nuclear Medicine. 2002 ; Vol. 43, No. 11. pp. 1452-1456.
@article{6a87de5b6ca44e37a578c40df5c5d6f5,
title = "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",
abstract = "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 chemotherapy. 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.",
keywords = "Tc-macroaggregated albumin, Drug distribution, Intra-arterial chemotherapy, Myocutaneous inflammatory change",
author = "Junichi Taki and Hisashi Sumiya and Takahiro Higuchi and Hiroyuki Tsuchiya and Koutaro Takazawa and Katsuro Tomita and Norihisa Tonami",
year = "2002",
month = "11",
day = "1",
language = "English",
volume = "43",
pages = "1452--1456",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "11",

}

TY - JOUR

T1 - 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

AU - Taki, Junichi

AU - Sumiya, Hisashi

AU - Higuchi, Takahiro

AU - Tsuchiya, Hiroyuki

AU - Takazawa, Koutaro

AU - Tomita, Katsuro

AU - Tonami, Norihisa

PY - 2002/11/1

Y1 - 2002/11/1

N2 - 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 chemotherapy. 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.

AB - 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 chemotherapy. 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.

KW - Tc-macroaggregated albumin

KW - Drug distribution

KW - Intra-arterial chemotherapy

KW - Myocutaneous inflammatory change

UR - http://www.scopus.com/inward/record.url?scp=0036840171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036840171&partnerID=8YFLogxK

M3 - Article

C2 - 12411547

AN - SCOPUS:0036840171

VL - 43

SP - 1452

EP - 1456

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

SN - 0161-5505

IS - 11

ER -