       Document 0568
 DOCN  M9610568
 TI    The role of gallium and labeled leukocyte scintigraphy in the AIDS
       patient.
 DT    9601
 AU    Palestro CJ; Goldsmith SJ; Division of Nuclear Medicine, Long Island
       Jewish Medical Center,; New Hyde Park, New York, NY, USA.
 SO    Q J Nucl Med. 1995 Sep;39(3):221-30. Unique Identifier : AIDSLINE
       MED/96033591
 AB    Because AIDS patients frequently present with minimal symptomatology,
       radionuclide imaging with its ability to survey the entire body, is
       especially valuable. Gallium-67 citrate, the most commonly performed
       radionuclide study for localizing infection in these patients, is most
       useful for detecting opportunistic infections, especially in the thorax.
       A negative gallium scan, particularly when the chest X-ray is
       unremarkable, rules strongly against pulmonary disease. A negative
       gallium scan in a patient with an abnormal chest X-ray and Kaposi's
       sarcoma, suggests that the patient's respiratory distress is related to
       the neoplasm. Diffuse pulmonary parenchymal uptake of gallium in the HIV
       (+) patient is most often associated with PCP. While there are other
       causes of diffuse pulmonary uptake, the more intense or heterogeneous
       the uptake, the more likely the patient is to have PCP. Focal pulmonary
       uptake is usually associated with bacterial pneumonia although PCP may
       occasionally present in this fashion. Lymph node uptake of gallium is
       usually associated with Mycobacterium avium complex, tuberculosis, or
       lymphoma. When corresponding abnormalities are present on thallium
       scintigraphy lymphoma is likely. Gallium positive, thallium negative,
       studies suggest mycobacterial disease. Labeled leukocyte imaging is not
       useful for detecting opportunistic infections probably because of the
       inflammatory response incited by these organisms. Leukocyte imaging is,
       however, more sensitive for detecting bacterial pneumonia. In the
       abdomen, gallium imaging is most useful for identifying lymphadenopathy,
       while labeled leukocyte imaging is superior for detecting
       AIDS-associated colitides. In summary, radionuclide studies are valuable
       diagnostic modalities in AIDS. Their success can be maximized by
       tailoring the study to the individual's needs.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIONUCLIDE  IMAGING
       AIDS-Related Opportunistic Infections/*RADIONUCLIDE IMAGING
       Citrates/*DIAGNOSTIC USE  Gallium Radioisotopes/*DIAGNOSTIC USE  Human
       *Leukocytes  Lung Diseases/COMPLICATIONS/*RADIONUCLIDE IMAGING
       Neoplasms/COMPLICATIONS/*RADIONUCLIDE IMAGING  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

