Gallium scan

Last updated

Gallium-67 scan
Synonyms Gallium imaging
ICD-10-PCS C?1?LZZ (planar) C?2?LZZ (tomographic)
ICD-9-CM 92.18
OPS-301 code 3-70c
MedlinePlus 003450

A gallium scan is a type of nuclear medicine test that uses either a gallium-67 (67Ga) or gallium-68 (68Ga) radiopharmaceutical to obtain images of a specific type of tissue, or disease state of tissue. Gallium salts like gallium citrate and gallium nitrate may be used. The form of salt is not important, since it is the freely dissolved gallium ion Ga3+ which is active. [1] Both 67Ga and 68Ga salts have similar uptake mechanisms. [2] Gallium can also be used in other forms, for example 68Ga-PSMA is used for cancer imaging. The gamma emission of gallium-67 is imaged by a gamma camera, while the positron emission of gallium-68 is imaged by positron emission tomography (PET).

Contents

Gallium salts are taken up by tumors, inflammation, and both acute and chronic infection, [3] [4] allowing these pathological processes to be imaged. Gallium is particularly useful in imaging osteomyelitis that involves the spine, and in imaging older and chronic infections that may be the cause of a fever of unknown origin. [5] [6]

Gallium-68 DOTA scans are increasingly replacing octreotide scans (a type of indium-111 scan using octreotide as a somatostatin receptor ligand). The gallium-68 is bound to an octreotide derivative chemical such as DOTATOC and the positrons it emits are imaged by PET-CT scan. Such scans are useful in locating neuroendocrine tumors and pancreatic cancer. [7] [8]

Gallium citrate scan

Gallium scan showing panda (A) and lambda (B) patterns, considered specific for sarcoidosis in the absence of histological confirmation Gallium 67 Scan (Diagnosis of Sarcoidosis).png
Gallium scan showing panda (A) and lambda (B) patterns, considered specific for sarcoidosis in the absence of histological confirmation

In the past, the gallium scan was the gold standard for lymphoma staging, until it was replaced by positron emission tomography (PET) using fludeoxyglucose (FDG). [9] [10] Gallium imaging is still used to image inflammation and chronic infections, and it still sometimes locates unsuspected tumors as it is taken up by many kinds of cancer cells in amounts that exceed those of normal tissues. Thus, an increased uptake of gallium-67 may indicate a new or old infection, an inflammatory focus from any cause, or a cancerous tumor.

It has been suggested that gallium imaging may become an obsolete technique, with indium leukocyte imaging and technetium antigranulocyte antibodies replacing it as a detection mechanism for infections. For detection of tumors, especially lymphomas, gallium imaging is still in use, but may be replaced by fludeoxyglucose PET imaging in the future. [11]

In infections, the gallium scan has an advantage over indium leukocyte imaging in imaging osteomyelitis (bone infection) of the spine, lung infections and inflammation, and for chronic infections. In part this is because gallium binds to neutrophil membranes, even after neutrophil death. Indium leukocyte imaging is better for acute infections (where neutrophils are still rapidly and actively localizing to the infection), and also for osteomyelitis that does not involve the spine, and for abdominal and pelvic infections. Both the gallium scan and indium leukocyte imaging may be used to image fever of unknown origin (elevated temperature without an explanation). However, the indium leukocyte scan will image only the 25% of such cases which are caused by acute infections, while gallium will also localize to other sources of fever, such as chronic infections and tumors. [12] [13]

Mechanism

The body generally handles Ga3+ as though it were ferric iron (Fe-III), and thus the free isotope ion is bound (and concentrates) in areas of inflammation, such as an infection site, and also areas of rapid cell division. [14] Gallium (III) (Ga3+) binds to transferrin, leukocyte lactoferrin, bacterial siderophores, inflammatory proteins, and cell-membranes in neutrophils, both living and dead. [15]

Lactoferrin is contained within leukocytes. Gallium may bind to lactoferrin and be transported to sites of inflammation, or binds to lactoferrin released during bacterial phagocytosis at infection sites (and remains due to binding with macrophage receptors). [16] Gallium-67 also attaches to the siderophore molecules of bacteria themselves, and for this reason can be used in leukopenic patients with bacterial infection (here it attaches directly to bacterial proteins, and leukocytes are not needed). [17] Uptake is thought to be associated with a range of tumour properties including transferring receptors, anaerobic tumor metabolism and tumor perfusion and vascular permeability. [18] [19]

Common indications

Note that all of these conditions are also seen in PET scans using the gallium-68.

Technique

The main (67Ga) technique uses scintigraphy to produce two-dimensional images. After the tracer has been injected, images are typically taken by a gamma camera at 24, 48, and in some cases, 72, and 96 hours later. [23] [24] Each set of images takes 30–60 minutes, depending on the size of the area being imaged. The resulting image will have bright areas that collected large amounts of tracer, because inflammation is present or rapid cell division is occurring. Single-photon emission computed tomography (SPECT) images may also be acquired. In some imaging centers, SPECT images may be combined with computed tomography (CT) scan using either fusion software or SPECT/CT hybrid cameras to superimpose both physiological image-information from the gallium scan, and anatomical information from the CT scan.

A common injection dose is around 150 megabecquerels. [25] Imaging should not usually be sooner than 24 hours as high background at this time produces false negatives. Forty-eight-hour whole body images are appropriate. Delayed imaging can be obtained even 1 week or longer after injection if bowel is confounding. SPECT can be performed as needed. Oral laxatives or enemas can be given before imaging to reduce bowel activity and reduce dose to large bowel; however, the usefulness of bowel preparation is controversial. [24]

10% to 25% of the dose of gallium-67 is excreted within 24 hours after injection (the majority of which is excreted through the kidneys). After 24 hours the principal excretory pathway is colon. [24] The "target organ" (organ that receives the largest radiation dose in the average scan) is the colon (large bowel). [23]

In a normal scan, uptake of gallium is seen in wide range of locations which do not indicate a positive finding. These typically include soft tissues, liver, and bone. Other sites of localisation can be nasopharyngeal and lacrimal glands, breasts (particularly in lactation or pregnancy), normally healing wounds, kidneys, bladder and colon. [26]

Gallium PSMA scan

CT scan (left) and gallium PSMA PET scan (right) of patient with prostate cancer metastases in the bones Gallium PSMA PET scan.png
CT scan (left) and gallium PSMA PET scan (right) of patient with prostate cancer metastases in the bones

The positron emitting isotope, 68Ga, can be used to target prostate-specific membrane antigen (PSMA), a protein which is present in prostate cancer cells. The technique has been shown to improve detection of metastatic disease compared to MRI or CT scans. [27]

In December 2020, the U.S. Food and Drug Administration (FDA) approved 68Ga PSMA-11 for medical use in the United States. [28] [29] It is indicated for positron emission tomography (PET) of prostate specific membrane antigen (PSMA) positive lesions in men with prostate cancer. [30] [29] It is manufactured by the UCLA Biomedical Cyclotron Facility. [29] The FDA approved 68Ga PSMA-11 based on evidence from two clinical trials (Trial 1/NCT0336847 identical to NCT02919111 and Trial 2/NCT02940262 identical to NCT02918357) of male participants with prostate cancer. [29] Some participants were recently diagnosed with the prostate cancer. [29] Other participants were treated before, but there was suspicion that the cancer was spreading because of rising prostate specific antigen or PSA. [29] The trials were conducted at two sites in the United States. [29]

The FDA considers 68Ga PSMA-11 to be a first-in-class medication. [31]

Common indications

Gallium PSMA scanning is recommended primarily in cases of biochemical recurrence of prostate cancer, particularly for patients with low PSA values, and in patients with high risk disease where metastases are considered likely. [32] [33]

Technique

An intravenous administration of 1.8–2.2 megabecquerels of 68Ga PSMA-11 per kilogram of bodyweight is recommended. Imaging should commence approximately 60 minutes after administration with an acquisition from mid-thigh to the base of the skull. [32] [34]

Gallium DOTA scans

68Ga DOTA conjugated peptides (including 68Ga DOTA-TATE, DOTA-TOC and DOTA-NOC) are used in positron emission tomography (PET) imaging of neuroendocrine tumours (NETs). The scan is similar to the SPECT octreotide scan in that an octreotide-based somatostatin analogue (such as edotreotide) is used as the radioligand, and there are similar indications and uses as ocreotide scans, however image quality is significantly improved. [35] Somatostatin receptors are overexpressed in many NETs, so that the 68Ga DOTA conjugated peptide is preferentially taken up in these locations, and visualised on the scan. [36] As well as diagnosis and staging of NETs, 68Ga DOTA conjugated peptide imaging may be used for planning and dosimetry in preparation for lutetium-177 or yttrium-90 DOTA therapy. [37] [38]

In June 2016, Netspot (kit for the preparation of gallium Ga-68 dotatate injection) was approved for medical use in the United States. [39] [40]

In August 2019, 68Ga edotreotide injection (68Ga DOTATOC) was approved for medical use in the United States for use with PET imaging for the localization of somatostatin receptor positive neuroendocrine tumors (NETs) in adults and children. [41] [42] [43]

The U.S. Food and Drug Administration (FDA) approved 68Ga edotreotide (DOTATOC) based on evidence from three clinical trials (Trial 1/NCT#1619865, Trial 2/NCT#1869725, Trial 3/NCT#2441062) of 334 known or suspected neuro-endocrine tumors. [42] The trials were conducted in the United States. [42]

Gallium (68Ga) oxodotreotide was approved for medical use in Canada as Netspot in July 2019, [44] and as Netvision in May 2022. [45]

The combination germanium (68Ge) chloride / gallium (68Ga) chloride was approved for medical use in the European Union in August 2024. [46]

Radiochemistry of gallium-67

Gallium-67 citrate is produced by a cyclotron. Charged particle bombardment of enriched Zn-68 is used to produce gallium-67. The gallium-67 is then complexed with citric acid to form gallium citrate. The half-life of gallium-67 is 78 hours. [47] It decays by electron capture, then emits de-excitation gamma rays that are detected by a gamma camera. Primary emission is at 93 keV (39% abundance), followed by 185 keV (21%) and 300 keV (17%). [48] : 64  For imaging, multiple gamma camera energy windows are used, typically centred around 93 and 184 keV or 93, 184, and 296 keV. [24]

Radiochemistry of gallium-68

Gallium-68, which has a 68 minutes half-life, is produced in a gallium-68 generator by decay of germanium-68 with a 271 day half-life or by the irradiation of zinc-68 through a low energy cyclotron. Use of a generator means a supply of 68Ga can be produced easily with minimal infrastructure, for example at sites without a cyclotron, commonly used to produce other PET isotopes. It decays by positron emission and electron capture into zinc-68. [49] Maximum energy of positron emission is at 1.9 MeV. [48] : 65 

Related Research Articles

A radioligand is a microscopic particle which consists of a therapeutic radioactive isotope and the cell-targeting compound - the ligand. The ligand is the target binding site, it may be on the surface of the targeted cancer cell for therapeutic purposes. Radioisotopes can occur naturally or be synthesized and produced in a cyclotron/nuclear reactor. The different types of radioisotopes include Y-90, H-3, C-11, Lu-177, Ac-225, Ra-223, In-111, I-131, I-125, etc. Thus, radioligands must be produced in special nuclear reactors for the radioisotope to remain stable. Radioligands can be used to analyze/characterize receptors, to perform binding assays, to help in diagnostic imaging, and to provide targeted cancer therapy. Radiation is a novel method of treating cancer and is effective in short distances along with being unique/personalizable and causing minimal harm to normal surrounding cells. Furthermore, radioligand binding can provide information about receptor-ligand interactions in vitro and in vivo. Choosing the right radioligand for the desired application is important. The radioligand must be radiochemically pure, stable, and demonstrate a high degree of selectivity, and high affinity for their target.

Natural gallium (31Ga) consists of a mixture of two stable isotopes: gallium-69 and gallium-71. Twenty-nine radioisotopes are known, all synthetic, with atomic masses ranging from 60 to 89; along with three nuclear isomers, 64mGa, 72mGa and 74mGa. Most of the isotopes with atomic mass numbers below 69 decay to isotopes of zinc, while most of the isotopes with masses above 71 decay to isotopes of germanium. Among them, the most commercially important radioisotopes are gallium-67 and gallium-68.

<span class="mw-page-title-main">Neuroendocrine tumor</span> Tumors of the endocrine and nervous systems

Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. They most commonly occur in the intestine, where they are often called carcinoid tumors, but they are also found in the pancreas, lung, and the rest of the body.

<span class="mw-page-title-main">Glutamate carboxypeptidase II</span> Enzyme

TAH molecule, also known as N-acetyl-L-aspartyl-L-glutamate peptidase I, NAAG peptidase, or prostate-specific membrane antigen (PSMA) is an enzyme that in humans is encoded by the FOLH1 gene. Human GCPII contains 750 amino acids and weighs approximately 84 kDa.

Copper-64 (64Cu) is a positron and beta emitting isotope of copper, with applications for molecular radiotherapy and positron emission tomography. Its unusually long half-life (12.7-hours) for a positron-emitting isotope makes it increasingly useful when attached to various ligands, for PET and PET-CT scanning.

<span class="mw-page-title-main">Octreotide scan</span> Type of medical imaging

An octreotide scan is a type of SPECT scintigraphy used to find carcinoid, pancreatic neuroendocrine tumors, and to localize sarcoidosis. It is also called somatostatin receptor scintigraphy (SRS). Octreotide, a drug similar to somatostatin, is radiolabeled with indium-111, and is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to tumor cells that have receptors for somatostatin. A gamma camera detects the radioactive octreotide, and makes pictures showing where the tumor cells are in the body, typically by a SPECT technique. A technetium-99m based radiopharmaceutical kit is also available.

Indium-111 (111In) is a radioactive isotope of indium (In). It decays by electron capture to stable cadmium-111 with a half-life of 2.8 days. Indium-111 chloride (111InCl) solution is produced by proton irradiation of a cadmium target in a cyclotron, as recommended by International Atomic Energy Agency (IAEA). The former method is more commonly used as it results in a high level of radionuclide purity.

A germanium-68/gallium-68 generator is a device used to extract the positron-emitting isotope 68Ga of gallium from a source of decaying germanium-68. The parent isotope 68Ge has a half-life of 271 days and can be easily utilized for in-hospital production of generator produced 68Ga. Its decay product gallium-68 is extracted and used for certain positron emission tomography nuclear medicine diagnostic procedures, where the radioisotope's relatively short half-life and emission of positrons for creation of 3-dimensional PET scans, are useful.

<span class="mw-page-title-main">DOTA-TATE</span> Eight amino-acid long peptide covalently bonded to a DOTA chelator

DOTA-TATE is an eight amino acid long peptide, with a covalently bonded DOTA bifunctional chelator.

Advanced Accelerator Applications is a France-based pharmaceutical group, specialized in the field of nuclear medicine. The group operates in all three segments of nuclear medicine to diagnose and treat serious conditions in the fields of oncology, neurology, cardiology, infectious and inflammatory diseases.

Fluciclovine (<sup>18</sup>F) Chemical compound

Fluciclovine (18F), also known as anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid, and sold under the brand name Axumin, is a diagnostic agent used for positron emission tomography (PET) imaging in men with suspected prostate cancer recurrence based on elevated prostate specific antigen (PSA) levels.

Sandip Basu is an Indian physician of Nuclear Medicine and the Head, Nuclear Medicine Academic Program at the Radiation Medicine Centre. He is also the Dean-Academic (Health-Sciences), BARC at Homi Bhabha National Institute and is known for his services and research in Nuclear Medicine, particularly on Positron emission tomography diagnostics and Targeted Radionuclide Therapy in Cancer. The Council of Scientific and Industrial Research, the apex agency of the Government of India for scientific research, awarded him the Shanti Swarup Bhatnagar Prize for Science and Technology, one of the highest Indian science awards for his contributions to Nuclear Medicine in 2012.

A PSMA scan is a nuclear medicine imaging technique used in the diagnosis and staging of prostate cancer. It is carried out by injection of a radiopharmaceutical with a positron or gamma emitting radionuclide and a prostate-specific membrane antigen (PSMA) targeting ligand. After injection, imaging of positron emitters such as gallium-68 (68Ga), copper-64 (64Cu), and fluorine-18 (18F) is carried out with a positron emission tomography (PET) scanner. For gamma emitters such as technetium-99m (99mTc) and indium-111 (111In) single-photon emission computed tomography (SPECT) imaging is performed with a gamma camera.

<span class="mw-page-title-main">Peptide receptor radionuclide therapy</span> Type of radiotherapy

Peptide receptor radionuclide therapy (PRRT) is a type of radionuclide therapy, using a radiopharmaceutical that targets peptide receptors to deliver localised treatment, typically for neuroendocrine tumours (NETs).

<span class="mw-page-title-main">Piflufolastat F-18</span> Chemical compound

Piflufolastat F-18, sold under the brand name Pylarify among others, is a radioactive diagnostic agent used for positron emission tomography (PET) imaging. It is given by intravenous injection.

Gallium (<sup>68</sup>Ga) gozetotide Radiopharmaceutical medication

Gallium (68Ga) gozetotide or Gallium (68Ga) PSMA-11 sold under the brand name Illuccix among others, is a radiopharmaceutical made of 68Ga conjugated to prostate-specific membrane antigen (PSMA) targeting ligand, Glu-Urea-Lys(Ahx)-HBED-CC, used for imaging prostate cancer by positron emission tomography (PET). The PSMA targeting ligand specifically directs the radiolabeled imaging agent towards the prostate cancerous lesions in men.

<span class="mw-page-title-main">Somatostatin receptor antagonist</span> Class of chemical compounds

Somatostatin receptor antagonists are a class of chemical compounds that work by imitating the structure of the neuropeptide somatostatin. The somatostatin receptors are G protein-coupled receptors. Somatostatin receptor subtypes in humans are sstr1, 2A, 2 B, 3, 4 and 5. While normally expressed in the gastrointestinal (GI) tract, pancreas, hypothalamus, and central nervous system (CNS), they are expressed in different types of tumours. The predominant subtype in cancer cells is the ssrt2 subtype, which is expressed in neuroblastomas, meningiomas, medulloblastomas, breast carcinomas, lymphomas, renal cell carcinomas, paragangliomas, small cell lung carcinomas and hepatocellular carcinomas.

<span class="mw-page-title-main">Somatostatin inhibitor</span> Class of pharmaceuticals

Somatostatin receptor antagonists are a class of chemical compounds that work by imitating the structure of the neuropeptide somatostatin, which is an endogenous hormone found in the human body. The somatostatin receptors are G protein-coupled receptors. Somatostatin receptor subtypes in humans include sstr1, 2A, 2 B, 3, 4, and 5. While normally expressed in the gastrointestinal (GI) tract, pancreas, hypothalamus, and central nervous system (CNS), they are expressed in different types of tumours. The predominant subtype in cancer cells is the ssrt2 subtype, which is expressed in neuroblastomas, meningiomas, medulloblastomas, breast carcinomas, lymphomas, renal cell carcinomas, paragangliomas, small cell lung carcinomas, and hepatocellular carcinomas.

Flotufolastat F-18, sold under the brand name Posluma, is a radioactive diagnostic agent for use with positron emission tomography (PET) imaging for prostate cancer. The active ingredient is flotufolastat F-18 gallium.

References

  1. ↑ Treves ST (2014). Pediatric nuclear medicine and molecular imaging (4th ed.). Springer. p. 480. ISBN   9781461495512.
  2. ↑ Jain SK (2017). Imaging Infections: From Bench to Bedside. Springer. p. 34. ISBN   9783319545929. Archived from the original on 21 February 2022. Retrieved 23 June 2017.
  3. ↑ Verberne SJ and O. P. P. Temmerman (2017). 12 - Imaging of prosthetic joint infections Archived 21 February 2022 at the Wayback Machine - Arts, J.J. Chris. Management of Periprosthetic Joint Infections (PJIs). J. Geurts, Woodhead Publishing: 259-285.
  4. ↑ Verberne SJ, Raijmakers PG, Temmerman O (2016). "The Accuracy of Imaging Techniques in the Assessment of Periprosthetic Hip Infection: A Systematic Review and Meta-Analysis". The Journal of Bone and Joint Surgery. American Volume. 98 (19): 1638–1645. doi:10.2106/jbjs.15.00898. PMID   27707850. S2CID   9202184. Archived from the original on 16 December 2016. Retrieved 18 December 2016.
  5. ↑ Termaat MF, Raijmakers PG, Scholten HJ, Bakker FC, Patka P, Haarman HJ (November 2005). "The accuracy of diagnostic imaging for the assessment of chronic osteomyelitis: a systematic review and meta-analysis". The Journal of Bone and Joint Surgery. American Volume. 87 (11): 2464–71. doi:10.2106/JBJS.D.02691 (inactive 11 November 2024). PMID   16264122. S2CID   26280068.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  6. ↑ Becker W (October 1995). "The contribution of nuclear medicine to the patient with infection". European Journal of Nuclear Medicine. 22 (10): 1195–1211. doi:10.1007/BF00800606. PMID   8542906. S2CID   19293222.
  7. ↑ Hofman M, Kong G, Neels O, Eu P, Hong E, Hicks R (2012). "High management impact of Ga-68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours". Journal of Medical Imaging and Radiation Oncology. 56 (1): 40–47. doi: 10.1111/j.1754-9485.2011.02327.x . PMID   22339744. S2CID   21843609.
  8. ↑ Scott, A, Howe J (2018). "Management of Small Bowel Neuroendocrine Tumors". Journal of Oncology Practice. 14 (8): 471–482. doi:10.1200/JOP.18.00135. PMC   6091496 . PMID   30096273.{{cite journal}}: CS1 maint: overridden setting (link)
  9. ↑ Bryan RN (2010). Introduction to the science of medical imaging. Cambridge: Cambridge University Press. p. 200. ISBN   9780521747622. Archived from the original on 21 February 2017. Retrieved 20 February 2017.
  10. ↑ Bleeker-Rovers CP, Vos FJ, van der Graaf WT, Oyen WJ (16 June 2011). "Nuclear Medicine Imaging of Infection in Cancer Patients (With Emphasis on FDG-PET)". The Oncologist. 16 (7): 980–991. doi:10.1634/theoncologist.2010-0421. PMC   3228133 . PMID   21680576.
  11. ↑ Ziessman HA, O'Malley JP, Thrall JH (2013). Nuclear Medicine: The Requisites E-Book. Elsevier Health Sciences. p. 281. ISBN   978-0323112925.
  12. ↑ Palestro CJ (April 1994). "The current role of gallium imaging in infection". Seminars in Nuclear Medicine. 24 (2): 128–141. doi:10.1016/S0001-2998(05)80227-2. PMID   8023169.
  13. ↑ Shields TW, LoCicero J, Reed CE, Feins RH (2009). General Thoracic Surgery. Lippincott Williams & Wilkins. p. 2106. ISBN   9780781779821.
  14. ↑ Love C, Palestro CJ (June 2004). "Radionuclide imaging of infection". Journal of Nuclear Medicine Technology. 32 (2): 47–57, quiz 58–9. PMID   15175400. Archived from the original on 7 November 2016. Retrieved 20 February 2017.
  15. ↑ Tsan MF (January 1985). "Mechanism of gallium-67 accumulation in inflammatory lesions". Journal of Nuclear Medicine. 26 (1): 88–92. PMID   3880816.
  16. ↑ Greenberg AM, Prein J (2007). Craniomaxillofacial reconstructive and corrective bone surgery principles of internal fixation using AO/ASIF technique. New York: Springer. p. 79. ISBN   9780387224275.
  17. ↑ Weiner R (1996). "The mechanism of 67Ga localization in malignant disease". Nuclear Medicine and Biology. 23 (6): 745–751. doi:10.1016/0969-8051(96)00119-9. PMID   8940716.
  18. ↑ Biersack HJ, Freeman LM (2007). Clinical nuclear medicine. Berlin: Springer. p. 324. ISBN   978-3-540-28026-2.
  19. ↑ Hoffer P (1980). "Gallium: mechanisms". Journal of Nuclear Medicine. 21 (3): 282–5. PMID   6988551. Archived from the original on 7 July 2022. Retrieved 20 February 2017.
  20. ↑ "Gallium scan". MedlinePlus. Archived from the original on 14 September 2017. Retrieved 14 September 2017.
  21. ↑ "ACR–SPR Practice Parameter for the Performance of Scintigraphy for Inflammation and Infection" (PDF). American College of Radiology. 2014. Archived from the original (PDF) on 16 October 2015. Retrieved 14 September 2017.
  22. ↑ "Lung gallium scan". MedlinePlus. Archived from the original on 14 September 2017. Retrieved 14 September 2017.
  23. 1 2 Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. (2 September 2003). "67Ga Scintigraphy Procedure Guidelines for Tumour Imaging" (PDF). EANM. Archived (PDF) from the original on 26 October 2020. Retrieved 14 September 2017.
  24. 1 2 3 4 "Society of Nuclear Medicine Procedure Guideline for Gallium Scintigraphy in Inflammation" (PDF). SNMMI. 2 June 2004. Archived (PDF) from the original on 21 October 2016. Retrieved 7 September 2016.
  25. ↑ "Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources" (PDF). Administration of Radioactive Substances Advisory Committee. January 2016. Archived (PDF) from the original on 24 September 2016. Retrieved 7 September 2016.
  26. ↑ Palestro CJ (2012). "SPECT and PET in the Assessment of Bone Infections". In Fogelman I, Gnanasegaran G, van der Wall H (eds.). Radionuclide and hybrid bone imaging. Berlin: Springer. pp. 523–559. doi:10.1007/978-3-642-02400-9_20. ISBN   978-3-642-02399-6.
  27. ↑ Maurer T, Eiber M, Schwaiger M, Gschwend JE (23 February 2016). "Current use of PSMA–PET in prostate cancer management". Nature Reviews Urology. 13 (4): 226–235. doi:10.1038/nrurol.2016.26. PMID   26902337. S2CID   2448922.
  28. ↑ "Drug Approval Package: Gallium Ga 68 PSMA-11". U.S. Food and Drug Administration (FDA). 16 December 2020. Archived from the original on 26 January 2021. Retrieved 25 December 2020.
  29. 1 2 3 4 5 6 7 "Drug Trials Snapshot: Ga 68 PSMA-11". U.S. Food and Drug Administration (FDA). 1 December 2020. Archived from the original on 10 December 2020. Retrieved 11 December 2020.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  30. ↑ "GALLIUM GA 68 PSMA-11 Labeling-Package Insert" (PDF). Drugs@FDA. University of California, Los Angeles. 17 November 2021. Archived (PDF) from the original on 13 May 2022. Retrieved 18 March 2022.
  31. ↑ "New Drug Therapy Approvals 2020". U.S. Food and Drug Administration (FDA). 31 December 2020. Archived from the original on 18 January 2021. Retrieved 17 January 2021.
  32. 1 2 Fendler WP, Eiber M, Beheshti M, Bomanji J, Ceci F, Cho S, et al. (10 March 2017). "68Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0". European Journal of Nuclear Medicine and Molecular Imaging. 44 (6): 1014–1024. doi:10.1007/s00259-017-3670-z. PMID   28283702. S2CID   5882407.
  33. ↑ Rai BP, Baum RP, Patel A, Hughes R, Alonzi R, Lane T, et al. (September 2016). "The Role of Positron Emission Tomography With 68Gallium (Ga)-Labeled Prostate-specific Membrane Antigen (PSMA) in the Management of Patients With Organ-confined and Locally Advanced Prostate Cancer Prior to Radical Treatment and After Radical Prostatectomy". Urology. 95: 11–15. doi:10.1016/j.urology.2015.12.048. PMID   26790588.
  34. ↑ Afaq A, Batura D, Bomanji J (14 February 2017). "New frontiers in prostate cancer imaging: clinical utility of prostate-specific membrane antigen positron emission tomography". International Urology and Nephrology. 49 (5): 803–810. doi:10.1007/s11255-017-1541-y. PMID   28197764. S2CID   3902900.
  35. ↑ Mojtahedi A, Thamake S, Tworowska I, Ranganathan D, Delpassand ES (15 August 2014). "The value of 68Ga-DOTATATE PET/CT in diagnosis and management of neuroendocrine tumors compared to current FDA approved imaging modalities: a review of literature". American Journal of Nuclear Medicine and Molecular Imaging. 4 (5): 426–434. ISSN   2160-8407. PMC   4138137 . PMID   25143861.
  36. ↑ Virgolini I, Ambrosini V, Bomanji JB, Baum RP, Fanti S, Gabriel M, et al. (2 July 2010). "Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE" (PDF). European Journal of Nuclear Medicine and Molecular Imaging. 37 (10): 2004–2010. doi:10.1007/s00259-010-1512-3. PMID   20596866. S2CID   11469889. Archived (PDF) from the original on 17 May 2017. Retrieved 6 October 2017.
  37. ↑ Kam BL, Teunissen JJ, Krenning EP, de Herder WW, Khan S, van Vliet EI, et al. (3 March 2012). "Lutetium-labelled peptides for therapy of neuroendocrine tumours". European Journal of Nuclear Medicine and Molecular Imaging. 39 (S1): 103–112. doi:10.1007/s00259-011-2039-y. PMC   3304065 . PMID   22388631.
  38. ↑ Taïeb D, Garrigue P, Bardiès M, Abdullah AE, Pacak K (October 2015). "Application and Dosimetric Requirements for Gallium-68–labeled Somatostatin Analogues in Targeted Radionuclide Therapy for Gastroenteropancreatic Neuroendocrine Tumors". PET Clinics. 10 (4): 477–486. doi:10.1016/j.cpet.2015.06.001. PMC   4617555 . PMID   26384594.
  39. ↑ "Netspot (kit for the preparation of gallium Ga 68 dotatate injection)". U.S. Food and Drug Administration (FDA). 21 June 2016. Archived from the original on 31 March 2021. Retrieved 18 October 2020.
  40. ↑ "Netspot- 68ga-dotatate kit". DailyMed. 23 October 2019. Archived from the original on 22 September 2020. Retrieved 18 October 2020.
  41. ↑ "GA-68-DOTATOC- edotreotide gallium ga-68 injection, solution". DailyMed. 3 September 2019. Archived from the original on 7 July 2022. Retrieved 17 March 2020.
  42. 1 2 3 "Drug Trials Snapshots: Ga-68-DOTATOC". U.S. Food and Drug Administration (FDA). 21 August 2019. Archived from the original on 13 December 2019. Retrieved 17 March 2020.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  43. ↑ "Drug Approval Package: Gallium Dotatoc GA 68". U.S. Food and Drug Administration (FDA). 23 September 2019. Archived from the original on 6 April 2021. Retrieved 18 October 2020.
  44. ↑ "Summary Basis of Decision (SBD) for Netspot". Health Canada . 23 October 2014. Archived from the original on 31 May 2022. Retrieved 29 May 2022.
  45. ↑ "Summary Basis of Decision - NETVision". Health Canada. 26 May 2022. Archived from the original on 7 July 2022. Retrieved 7 July 2022.
  46. ↑ "GalliaPharm EPAR". European Medicines Agency (EMA). 1 August 2024. Retrieved 26 August 2024.
  47. ↑ IAEA (2009). Cyclotron produced radionuclides: physical characteristics and production methods (PDF). Vienna: International Atomic Energy Agency. p. 116. ISBN   9789201069085. Archived (PDF) from the original on 9 March 2017. Retrieved 7 September 2016.
  48. 1 2 Delacroix D, Guerre JP, Leblanc P, Hickman C (2002). Radionuclide and Radiation Protection Data Handbook (2nd ed.). Ashford: Nuclear Technology Publishing. ISBN   978-1870965873.
  49. ↑ Bé MM, Chisté V, Mougeot X, Chechev V, Kondev F, Nichols AL, et al. (2013). Monographie BIPM: Table of radionuclides Vol. 7. Paris: Bureau International des Poids et Mesures. p. 33. ISBN   9789282222485. Archived from the original on 23 August 2017. Retrieved 14 September 2017.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.