Dual-phase (99m)Tc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism: correlation with clinical or pathological variables

PURPOSE

The purpose of this study was to assess the relationship between (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT.

METHODS

Dual-phase (99m)Tc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent (99m)Tc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing (99m)Tc-MIBI scintigraphy and (99m)Tc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy were evaluated using ROC analysis.

RESULTS

Among 244 patients, 174 (71.31 %) patients with 181 foci had a positive (99m)Tc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the (99m)Tc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69 %) patients had a negative (99m)Tc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive (9m)Tc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, (99m)Tc-MDP bone scintigraphy showed positive finding in 80 (51.61 %) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥ 150 ng/L were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.96 cm and 163.85 ng/L, respectively.

CONCLUSIONS

The utility of delayed neck and thorax SPECT/CT over dual-phase (99m)Tc-MIBI planar scintigraphy is that it can identify and locate a parathyroid tumor in about more than 70 % of patients in PHPT and provide the assistance for surgical planning. These studies also suggest that (99m)Tc-MIBI scintigraphy and (99m)Tc-MDP bone scintigraphy are closely correlated with tumor diameter and PTH; which may show negative results when tumor diameter is small and serum PTH level is low.

Graves' disease in an adolescent with dual congenital ectopia and no orthotopic thyroid gland identified by Tc-99m-pertechnetate SPET/CT imaging

This is the first case of Graves' disease in an adolescent with lingual and prelaryngeal dual congenital ectopia and no orthotopic thyroid gland identified by technetium-99m-pertechnetate (99mTcO-4) SPET/CT imaging in a 15 years old boy. After 8 weeks treatment with methimazole, Graves' disease subsided. Fine needle aspiration cytology of the mass revealed the normal colloid and normal follicular cells without an atypia or lymphoid elements, suggesting a benign ectopic thyroid gland. In conclusion, there is no report in the literature with DETT lingual and prelaryngeal absence of orthotopic thyroid tissue and Graves' disease as in our case. This case also highlights the potential ascendancy of 99mTcO-4 SPET/CT in diagnosing the DETT.

Ab initio chemical kinetic study on the reactions of ClO with C2H2 and C2H4

The mechanisms for the reactions of ClO with C(2)H(2) and C(2)H(4) have been investigated at the CCSD(T)/CBS level of theory. The results show that in both systems, the interaction between the Cl atom of the ClO radical and the triple and double bonds of C(2)H(2) and C(2)H(4) forms prereaction van der Waals complexes with the O-Cl bond pointing perpendicularly toward the π-bonds, both with 2.1 kcal/mol binding energies. The mechanism is similar to those of the HO-C(2)H(2)/C(2)H(4) systems. The rate constants for the low energy channels have been predicted by statistical theory. For the reaction of ClO and C(2)H(2), the main channels are the production of CH(2)CO + Cl (k(1a)) and CHCO + HCl (k(1b)), with k(1a) = 1.19 × 10(-15)T(1.18) exp(-5814/T) and k(1b) = 6.94 × 10(-21) × T(2.60) exp(-6587/T) cm(3) molecule(-1) s(-1). For the ClO + C(2)H(4) reaction, the main pathway leads to C(2)H(4)O + Cl (k(2a)) with the predicted rate constant k(2a) = 2.13 × 10(-17)T(1.52) exp(-3849/T) in the temperature range of 300-3000 K. These rate constants are pressure-independent below 100 atm.

Ab initio study of the ClO + NH2 reaction: prediction of the total rate constant and product branching ratios

The mechanism for ClO + NH2 has been investigated by ab initio molecular orbital and transition-state theory calculations. The species involved have been optimized at the B3LYP/6-311+G(3df,2p) level and their energies have been refined by single-point calculations with the modified Gaussian-2 method, G2M(CC2). Ten stable isomers have been located and a detailed potential energy diagram is provided. The rate constants and branching ratios for the low-lying energy channel products including HCl + HNO, Cl + NH2O, and HOCl + 3NH (X(3)Sigma(-)) are calculated. The result shows that formation of HCl + HNO is dominant below 1000 K; over 1000 K, Cl + NH2O products become dominant. However, the formation of HOCl + 3NH (X(3)Sigma(-)) is unimportant below 1500 K. The pressure-independent individual and total rate constants can be expressed as k1(HCl + HNO) = 4.7 x 10(-8)(T(-1.08)) exp(-129/T), k(2)(Cl + NH2O) = 1.7 x 10(-9)(T(-0.62)) exp(-24/T), k3(HOCl + NH) = 4.8 x 10(-29)(T5.11) exp(-1035/T), and k(total) = 5.0 x 10(-9)(T(-0.67)) exp(-1.2/T), respectively, with units of cm(3) molecule(-1) s(-1), in the temperature range of 200-2500 K.

Ab Initio Study on the Oxidation of NCN by O (3P): Prediction of the Total Rate Constant and Product Branching Ratios

The reaction of NCN with O is relevant to the formation of prompt NO according to the new mechanism, CH+N2-->cyclic-C(H)NN- -->HNCN-->H+NCN. The reaction has been investigated by ab initio molecular orbital and transition state theory calculations. The mechanisms for formation of possible product channels involved in the singlet and triplet potential energy surfaces have been predicted at the highest level of the modified GAUSSIAN-2 (G2M) method, G2M (CC1). The barrierless association/dissociation processes on the singlet surface were also examined with the third-order Rayleigh-Schrödinger perturbation (CASPT3) and the multireference configuration interaction methods including Davidson's correction for higher excitations (MRCI+Q) at the CASPT3(6,6)/6-311+G(3df)//UB3LYP/6-311G(d) and MRCI+Q(6,6)/6-311+G(3df)//UB3LYP/6-311G(d) levels. The rate constants for the low-energy channels producing CO+N2, CN+NO, and N(4S)+NCO have been calculated in the temperature range of 200-3000 K. The results show that the formation of CN+NO is dominant and its branching ratio is over 99% in the whole temperature range; no pressure dependence was noted at pressures below 100 atm. The total rate constant can be expressed by: kt=4.23x10(-11) T0.15 exp(17/T) cm3 molecule(-1) s(-1).

Experimental and theoretical investigation of rate coefficients of the reaction S(P3)+OCS in the temperature range of 298–985K

The reaction S(3P)+OCS in Ar was investigated over the pressure range of 50-710 Torr and the temperature range of 298-985 K with the laser photolysis technique. S atoms were generated by photolysis of OCS with light at 248 nm from a KrF excimer laser; their concentration was monitored via resonance fluorescence excited by atomic emission of S produced from microwave-discharged SO2. At pressures less than 250 Torr, our measurements give k(298 K)=(2.7+/-0.5)x10(-15) cm3 molecule-1 s-1, in satisfactory agreement with a previous report by Klemm and Davis [J. Phys. Chem. 78, 1137 (1974)]. New data determined for 407-985 K connect rate coefficients reported previously for T>or=860 and T<or=478 K and show a non-Arrhenius behavior. Combining our results with data reported at high temperatures, we derived an expression k(T)=(6.1+/-0.3)x10(-18) T1.97+/-0.24 exp[-(1560+/-170)/T] cm3 molecule-1 s-1 for 298<or=TK<or=1680. At 298 K and P>or=500 Torr, the reaction rate was enhanced. Theoretical calculations at the G2M(CC2) level, using geometries optimized with the B3LYP6-311+G(3df) method, yield energies of transition states and products relative to those of the reactants. Rate coefficients predicted with multichannel Rice-Ramsperger-Kassel-Marcus (RRKM) calculations agree satisfactorily with experimental observations. According to our calculations, the singlet channel involving formation of SSCO followed by direct dissociation into S2(a 1Deltag)+CO dominates below 2000 K; SSCO is formed via intersystem crossing from the triplet surface. At low temperature and under high pressure the stabilization of OCS2, formed via isomerization of SSCO, becomes important; its formation and further reaction with S atoms partially account for the observed increase in the rate coefficient under such conditions.

Preparation, in vitro and in vivo evaluation of 99mTc-Annexin B1: A novel radioligand for apoptosis imaging

To develop a radiopharmaceutical for apoptosis imaging, Annexin B1, a new Ca2+-dependent phosphatidylserine (PS)-binding protein, was directly radiolabeled with (99m)Tc. This procedure yields up to 96% of radiochemical purity and higher radiolabeling efficiency. The preparation has been found to be sufficiently stable in vitro. Binding assay with human activated platelets indicated that (99m)Tc-Annexin B1 retained its PS binding activity. Biodistribution in mice revealed that (99m)Tc-Annexin B1 rapidly cleared from the blood and predominantly accumulated in the kidney. The increase in hepatic uptake in anti-Fas antibody treated mice correlated to histologic evidence of fulminant hepatic apoptosis. These data suggest that (99m)Tc-Annexin B1 can be used as a novel radiotracer to detect apoptosis in vivo.

Ab initio Studies of ClOx Reactions: Prediction of the Rate Constants of ClO+NO2 for the Forward and Reverse Processes

The potential-energy surface for the reaction of ClO with NO2 has been constructed at the CCSD(T)/6-311+G(3df)//B3LYP/6-311+G(3df) level of theory. Six ClNO3 isomers are located; these are ClONO2, pc-ClOONO, pt-ClOONO, OClNO2, pt-OClONO, pc-OClONO, with predicted energies relative to the reactants of -25.6, -0.5, 1.0, 1.9, 12.2 and 13.6 kcal mol-1, and heats of formation at 0 K of 7.8, 32.9, 34.4, 35.5, 45.6 and 47.0 kcal mol-1, respectively. Isomerizations among them are also discussed. The rate constants for the low-energy pathways have been computed by statistical theory calculations. For the association reaction producing exclusively ClONO2, the predicted low- and high-pressure-limit rate constants in N2 for the temperature range of 200-600 K can be represented by: (N2)=3.19 x 10-17 T-5.54 exp(-384 K/T) cm6 molecule-2 s-1 and =3.33 x 10-7 T-1.48 exp(-18 K/T) cm3 molecule-1 s-1. The predicted low- and high-pressure-limit rate constants for the decomposition of ClONO2 in N2 at 200-600 K can be expressed, respectively, by =6.08 x 1013 T-6.54 exp(-13813 K/T) cm3 molecule-1 s-1 and =4.59 x 1023 T-2.43 exp(-13437 K/T) s-1. The predicted values compare satisfactorily with available experimental data. The reverse Cl+NO3 reaction was found to be independent of the pressure, giving exclusively ClO+NO2; the predicted rate constant can be expressed as k(Cl+NO3)=1.19 x 10-9 T-0.60 exp(58 K/T) cm3 molecule-1 s-1..

Ab Initio Studies of ClOx Reactions: Prediction of the Rate Constants of ClO+NO for the Forward and Reverse Processes

The mechanisms for ClO+NO and its reverse reactions were investigated by means of ab initio molecular orbital and statistical theory calculations. The species involved were optimized at the B3LYP/6-311 +G(3df) level, and their energies were refined at the CCSD(T)/6-311+ G(3df)//B3LYP/6-311 + G(3df) level. Five isomers and the transition states among them were located. The relative stability of these isomers is ClNO2 > cis-ClONO > trans-ClONO > cis-OClNO>trans-OClNO. The heats of formation of the three most-stable isomers were predicted using isodesmic reactions by different methods. The predicted bimolecular reaction rate constant shows that, below 100 atm, the formation of Cl+NO2 is dominant and pressure-independent. The total rate constant can be expressed as: k(ClO+NO)= 1.43 x 10(-9)T(-083)exp(92/ T) cm3 molecule(-1)s(-1) in the temperature range of 200-1000 K, in close agreement with experimental data. For the reverse reaction, Cl+NO2-->ClNO2 and ClONO (cis and trans isomers), the sum of the predicted rate constants for the formation of the three isomers and their relative yields also reproduce the experimental data well. The predicted total third-order rate constants in the temperature range of 200-1000 K can be represented by: k0(He) = 4.89 x 10(-6)T(-5.85) exp(-796/T) cm6 molecule(-1)s(-1) and k0(N2) =5.72 x 10(-15)T(-5.80) exp(-814/T) cm6 molecule(-1)s(-1). The predicted high- and low-pressure limit decomposition rates of CINO2 in Ar in the temperature range 400-1500 K can be expressed, respectively, by: k-(ClNO2) = 7.25 x 10(19)T(-1.89) exp(-16875/T) s(-1) and kd(ClNO2) = 2.51 x 10(38)T(-6.8) exp(-18409/T) cm3 molecule(-1) s(-1). The value of k0(ClNO2) is also in reasonable agreement with available experimental data.

Ab initio studies of alkyl radical reactions: Combination and disproportionation reactions of CH3 with C2H5, and the decomposition of chemically activated C3H8

This paper reports the first quantitative ab initio prediction of the disproportionation/combination ratio of alkyl+alkyl reactions using CH3+C2H5 as an example. The reaction has been investigated by the modified Gaussian-2 method with variational transition state or Rice-Ramsperger-Kassel-Marcus calculations for several channels producing (1) CH4+CH2CH2, (2) C3H8, (3) CH4CH3CH, (4) H2+CH3CHCH2, (5) H2+CH3CCH3, and (6) C2H6+CH2 by H-abstraction and association/decomposition mechanisms through singlet and triplet potential energy paths. Significantly, the disproportionation reaction (1) producing CH4+C2H4 was found to occur primarily by the lowest energy path via a loose hydrogen-bonding singlet molecular complex, H3CHC2H4, with a 3.5 kcal/mol binding energy and a small decomposition barrier (1.9 kcal/mol), instead of a direct H-abstraction process. Bimolecular reaction rate constants for the formation of the above products have been calculated in the temperature range 300-3000 K. At 1 atm, formation of C3H8 is dominant below 1200 K. Over 1200 K, the disproportionation reaction becomes competitive. The sum of products (3)-(6) accounts for less than 0.3% below 1500 K and it reaches around 1%-4% above 2000 K. The predicted rate constant for the disproportionation reaction with multiple reflections above the complex well, k1=5.04 x T(0.41) exp(429/T) at 200-600 K and k1=1.96 x 10(-20) T(2.45) exp(1470/T) cm3 molecule(-1) s(-1) at 600-3000 K, agrees closely with experimental values. Similarly, the predicted high-pressure rate constants for the combination reaction forming C3H8 and its reverse dissociation reaction in the temperature range 300-3000 K, k2(infinity)=2.41 x 10(-10) T(-0.34) exp(259/T) cm3 molecule(-1) s(-1) and k(-2)(infinity)=8.89 x 10(22) T(-1.67)exp(-46 037/T) s(-1), respectively, are also in good agreement with available experimental data.

Experimental and theoretical investigations of rate coefficients of the reaction S([sup 3]P)+O[sub 2] in the temperature range 298–878 K

Rate coefficients of the reaction S+O(2) with Ar under 50 Torr in the temperature range 298-878 K were determined with the laser photolysis technique. S atoms were generated by photolysis of OCS with a KrF excimer laser at 248 nm; their concentration was monitored via resonance fluorescence excited by atomic emission of S produced from microwave-discharged SO(2). Our measurements show that k(298 K)=(1.92+/-0.29)x10(-12) cm(3) molecule(-1) s(-1), in satisfactory agreement with previous reports. New data determined for 505-878 K show non-Arrhenius behavior; combining our results with data reported at high temperatures, we derive an expression k(T)=(9.02+/-0.27)x10(-19)T(2.11+/-0.15) exp[(730+/-120)/T] cm(3) molecule(-1) s(-1) for 298< or =T< or =3460 K. Theoretical calculations at the G2M (RCC2) level, using geometries optimized with the B3LYP/6-311+G(3df) method, yield energies of transition states and products relative to those of the reactants. Rate coefficients predicted with multichannel RRKM calculations agree satisfactorily with experimental observations; the reaction channel via SOO(1A') dominates at T<500 K, whereas channels involving formation of SOO(3A") followed by isomerization to SO(2) before dissociation, and formation of SOO(1A") followed by direct dissociation, become important at high temperatures, accounting for the observed rapid increase in rate coefficient.

Low-energy paths for the unimolecular decomposition of CH3OH: a G2M/statistical theory study

The potential energy surface (PES) of the CH3OH system has been characterized by ab initio molecular orbital theory calculations at the G2M level of theory. The mechanisms for the decomposition of CH3OH and the related bimolecular reactions, CH3 + OH and 1CH2 + H2O, have been elucidated. The rate constants for these processes have been calculated using variational RRKM theory and compared with available experimental data. The total decomposition rate constants of CH3OH at the high- and low-pressure limits can be represented by k infinity = 1.56 x 10(16) exp(-44,310/T) s-1 and kAr0 = 1.60 x 10(36) T-12.2 exp(-48,140/T) cm3 molecule-1 s-1, respectively, covering the temperature range 1000-3000 K, in reasonable agreement with the experimental values. Our results indicate that the product branching ratios are strongly pressure dependent, with the production of CH3 + OH and 1CH2 + H2O dominant under high (P > 10(3) Torr) and low (P < 1 atm) pressures, respectively. For the bimolecular reaction of CH3 and OH, the total rate constant and the yields of 1CH2 + H2O and H2 + HCOH at lower pressures (P < 5 Torr) could be reasonably accounted for by the theory. For the reaction of 1CH2 with H2O, both the yield of CH3 + OH and the total rate constant could also be satisfactorily predicted theoretically. The production of 3CH2 + H2O by the singlet to triplet surface crossing, predicted to occur at 4.3 kcal mol-1 above the H2C...OH2 van der Waals complex (which lies 82.7 kcal mol-1 above CH3OH), was neglected in our calculations.