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. 1982 Jan;37(1):11–18. doi: 10.1136/thx.37.1.11

Gallium-67 in the evaluation of sarcoidosis: correlations with serum angiotensin-converting enzyme and bronchoalveolar lavage.

D Beaumont, J Y Herry, M Sapene, P Bourguet, J J Larzul, B de Labarthe
PMCID: PMC459238  PMID: 6280330

Abstract

Gallium-67 (67Ga) scanning was assessed for its usefulness in the evaluation and follow-up of 54 patients with sarcoidosis, both treated and untreated. Scans were repeated in 23 subjects. Serum levels of angiotensin-converting enzyme (ACE) were determined concurrently in all 54 patients and bronchoalveolar lavage was performed in 29 patients. Gallium-67 scan was effective in the detection and assessment of lesions not revealed by traditional methods of investigation, particularly those affecting the mediastinum, spleen, and salivary glands. The scan also enabled fibrotic lesions, which do not show uptake, to be distinguished from granulomatous lesions, which do--an advantage of prognostic interest particularly in patients with pulmonary lesions. Another merit of 67Ga scanning was that it offered a means of following disease progression in each site. In patients showing spontaneous clearing of disease or receiving treatment the scintigraphic method was more sensitive than serum ACE determination. Scan findings showed a rough correlation with serum ACE but not with bronchoalveolar lavage findings. This suggests that the three markers probably reflect different stages of the granulomatous process. On the strength of this study the indications for gallium scanning in sarcoid patients can be defined more clearly than has previously been possible.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bekerman C., Hoffer P. B., Bitran J. D., Gupta R. G. Gallium-67 citrate imaging studies of the lung. Semin Nucl Med. 1980 Jul;10(3):286–301. doi: 10.1016/s0001-2998(80)80007-9. [DOI] [PubMed] [Google Scholar]
  2. Cushman D. W., Cheung H. S. Spectrophotometric assay and properties of the angiotensin-converting enzyme of rabbit lung. Biochem Pharmacol. 1971 Jul;20(7):1637–1648. doi: 10.1016/0006-2952(71)90292-9. [DOI] [PubMed] [Google Scholar]
  3. Dauber J. H., Rossman M. D., Daniele R. P. Bronchoalveolar cell populations in acute sarcoidosis. Observations in smoking and nonsmoking patients. J Lab Clin Med. 1979 Dec;94(6):862–871. [PubMed] [Google Scholar]
  4. DeRemee R. A., Rohrbach M. S. Serum angiotensin-converting enzyme activity in evaluating the clinical course of sarcoidosis. Ann Intern Med. 1980 Mar;92(3):361–365. doi: 10.7326/0003-4819-92-3-361. [DOI] [PubMed] [Google Scholar]
  5. Fogh J., Bertelsen S., Schmidt A. Diagnostic value of 67Ga-scintigraphy in chest surgery. Thorax. 1974 Jan;29(1):26–31. doi: 10.1136/thx.29.1.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Galassi A., Campanini A., Bettini L., Drei G., Pistocchi W. Expériences de scintigraphie pulmonaire avec le gallium. Bronches. 1975 Jul-Aug;25(4):240–255. [PubMed] [Google Scholar]
  7. Grönhagen-Riska C., Kurppa K., Fyhrquist F., Selroos O. Angiotensin-converting enzyme and lysozyme in silicosis and asbestosis. Scand J Respir Dis. 1978 Aug;59(4):228–231. [PubMed] [Google Scholar]
  8. Gupta S. M., Sziklas J. J., Spencer R. P., Rosenberg R. Significance of diffuse pulmonary uptake in radiogallium scans: concise communication. J Nucl Med. 1980 Apr;21(4):328–332. [PubMed] [Google Scholar]
  9. Heshiki A., Schatz S. L., McKusick K. A., Bowersox D. W., Soin J. S., Wagner H. N., Jr Gallium 67 citrate scanning in patients with pulmonary sarcoidosis. Am J Roentgenol Radium Ther Nucl Med. 1974 Dec;122(4):744–749. doi: 10.2214/ajr.122.4.744. [DOI] [PubMed] [Google Scholar]
  10. Israel H. L., Park C. H., Mansfield C. M. Gallium scanning in sarcoidosis. Ann N Y Acad Sci. 1976;278:514–516. doi: 10.1111/j.1749-6632.1976.tb47063.x. [DOI] [PubMed] [Google Scholar]
  11. Kinoshita F., Ushio T., Maekawa A., Ariwa R., Kubo A. Scintiscanning of pulmonary diseases with 67Ga-citrate. J Nucl Med. 1974 Apr;15(4):227–233. [PubMed] [Google Scholar]
  12. Larzul J. J., Le Treut A., Couliou H., Beaumont D., Delaval P., Sapene M., de Labarthe B. Taux sérique de l'enzyme de conversion de l'angiotensine dans la sarcoïdose. Essai de corrélation avec l'activité clinique de la maladie. Nouv Presse Med. 1981 Feb 28;10(9):675–678. [PubMed] [Google Scholar]
  13. Le Treut A., Couliou H., Delbary M., Larzul J. J., De Labarthe B., Le Gall J. Y. Le dosage de l'enzyme de conversion de l'angiotensine I par méthode spectrophotométrique. Clin Chim Acta. 1979 Oct 15;98(1-2):1–4. doi: 10.1016/0009-8981(79)90158-x. [DOI] [PubMed] [Google Scholar]
  14. Lieberman J. Elevation of serum angiotensin-converting-enzyme (ACE) level in sarcoidosis. Am J Med. 1975 Sep;59(3):365–372. doi: 10.1016/0002-9343(75)90395-2. [DOI] [PubMed] [Google Scholar]
  15. Line B. R., Fulmer J. D., Reynolds H. Y., Roberts W. C., Jones A. E., Harris E. K., Crystal R. G. Gallium-67 citrate scanning in the staging of idiopathic pulmonary fibrosis: Correlation and physiologic and morphologic features and bronchoalveolar lavage. Am Rev Respir Dis. 1978 Aug;118(2):355–365. doi: 10.1164/arrd.1978.118.2.355. [DOI] [PubMed] [Google Scholar]
  16. McKusick K. A., Soin J. S., Ghiladi A., Wagner H. N. Gallium 67 accumulation in pulmonary sarcoidosis. JAMA. 1973 Feb 5;223(6):688–688. [PubMed] [Google Scholar]
  17. Mishkin F. S., Maynard W. P. Lacrimal gland accumulation of 67Ga. J Nucl Med. 1974 Jul;15(7):630–631. [PubMed] [Google Scholar]
  18. Mishkin F. S., Tanaka T. T., Niden A. H. Abnormal gallium scan patterns of the salivary gland in pulmonary sarcoidosis. Ann Intern Med. 1978 Dec;89(6):933–934. doi: 10.7326/0003-4819-89-6-933. [DOI] [PubMed] [Google Scholar]
  19. Mitchell D. N., Scadding J. G. Sarcoidosis. Am Rev Respir Dis. 1974 Dec;110(6):774–802. doi: 10.1164/arrd.1974.110.6P1.774. [DOI] [PubMed] [Google Scholar]
  20. NIH conference. Pulmonary sarcoidosis: a disease characterized and perpetuated by activated lung T-lymphocytes. Ann Intern Med. 1981 Jan;94(1):73–94. doi: 10.7326/0003-4819-94-1-73. [DOI] [PubMed] [Google Scholar]
  21. Nelson B., Hayes R. L., Edwards C. L., Kniseley R. M., Andrews G. A. Distribution of gallium in human tissues after intravenous administration. J Nucl Med. 1972 Jan;13(1):92–100. [PubMed] [Google Scholar]
  22. Niden A. H., Mishkin F. S., Khurana M. M. 67Gallium citrate lung scans in interstitial lung disease. Chest. 1976 Feb;69(2 Suppl):266–268. doi: 10.1378/chest.69.2_supplement.266. [DOI] [PubMed] [Google Scholar]
  23. Nosal A., Schleissner L. A., Mishkin F. S., Lieberman J. Angiotensin-I-converting enzyme and gallium scan in noninvasive evaluation of sarcoidosis. Ann Intern Med. 1979 Mar;90(3):328–331. doi: 10.7326/0003-4819-90-3-328. [DOI] [PubMed] [Google Scholar]
  24. Reynolds H. Y., Fulmer J. D., Kazmierowski J. A., Roberts W. C., Frank M. M., Crystal R. G. Analysis of cellular and protein content of broncho-alveolar lavage fluid from patients with idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonitis. J Clin Invest. 1977 Jan;59(1):165–175. doi: 10.1172/JCI108615. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Schermuly W., Behrend H., Pöhls P. H. Die 67Ga-Szintigraphie bei der Sarkoidose. Rofo. 1975 Jan;122(1):54–62. doi: 10.1055/s-0029-1230021. [DOI] [PubMed] [Google Scholar]
  26. Siemsen J. K., Grebe S. F., Sargent E. N., Wentz D. Gallium-67 scintigraphy of pulmonary diseases as a complement to radiography. Radiology. 1976 Feb;118(2):371–375. doi: 10.1148/118.2.371. [DOI] [PubMed] [Google Scholar]
  27. Siemsen J. K., Grebe S. F., Waxman A. D. The use of gallium-67 in pulmonary disorders. Semin Nucl Med. 1978 Jul;8(3):235–249. doi: 10.1016/s0001-2998(78)80031-2. [DOI] [PubMed] [Google Scholar]
  28. Siemsen J. K., Sargent E. N., Grebe S. F., Winsor D. W., Wentz D., Jacobson G. Pulmonary concentration of Ga67 in pneumoconiosis. Am J Roentgenol Radium Ther Nucl Med. 1974 Apr;120(4):815–820. doi: 10.2214/ajr.120.4.815. [DOI] [PubMed] [Google Scholar]
  29. Tsan M. F., Chen W. Y., Scheffel U., Wagner H. N., Jr Studies on gallium accumulation in inflammatory lesions: I. Gallium uptake by human polymorphonuclear leukocytes. J Nucl Med. 1978 Jan;19(1):36–43. [PubMed] [Google Scholar]
  30. Weiner R., Hoffer P. B., Thakur M. L. Lactoferrin: its role as a Ga-67-binding protein in polymorphonuclear leukocytes. J Nucl Med. 1981 Jan;22(1):32–37. [PubMed] [Google Scholar]

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