Gerald Johnston – författare

In 1970, under the sponsorship of Oak Ridge Associated Univer­ sities (ORAU), a group of clinical investigators formed the Cooper­ ative Group to Study Localization of Radiopharmaceuticals. The first radiopharmaceutical selected for study was 67-Gallium (67-Ga) administered as the citrate. The object of the study was to de­ termine the usefulness of 67-Ga in the diagnosis and treatment of patients with various malignancies. Funding for the project was granted by the U. S. Atomic Energy Commission and the National Cancer Institute, National Institutes of Health (NIH). The Nuclear Medicine Department of the Clinical Center, NIH, agreed to assist ORAU with aspects of this study, particularly with 67-Ga scin­ tigraphy of patients with lymphoma and Hodgkin's disease. Pre­ liminary reports from the ORAU study are in press. Since April 1971, 67-Ga scintigraphy has gained increasing use in the study of cancer patients at the Clinical Center, NIH, where well over 1000 such patients have been examined by this method. This monograph was written to present selected examples from this group of a variety of malignancies seen in this 28-month period. No attempt has been made to correlate this overall experience statistically. Rather, this presentation is to help familiarize the practitioner of Nuclear Medicine with the wide range of usefulness for 67-Ga scintigraphy while making him aware of the variation in scan appearance and watchful of the many pitfalls of 67-Ga scan interpretation. Permission to use these patient studies and x-rays was generously granted by Dr. Paul P.

Breast carcinoma is a dreaded disease. The incidence of breast cancer, which appears to be increasing, is 1 in 1500 women with an annual death rate of 4,000 from this disease in the United States (1). It is a cancer which threatens its victims with mutilation as weIl as early death. Although response to therapy has not been good, improved methods for earlier and more complete diagnosis are providing hope for better results. When a woman presents herself for routine breast examination, what diagnostic procedures are indicated? If a breast mass is present, what diagnostic and therapeutic methods are employed? When the mass proves to be malignant, what then? Should biopsy and mastectomy be a combined procedure? Should a positive biopsy be followed by a complete diagnostic work-up before definitive therapy is undertaken? While some answers may seem obvious and others less obvious, common medical practices vary considerably in response to all of these situations. No easy formula exists. Each patient must be given individual consideration and her* treatment carefully planned to incorporate all the diagnostic findings. Experience to date indicates that some diagnostic and therapeutic procedures have established efficacy while others are not very helpful and still others need more evaluation before their usefulness can be . assessed fully. Traditionally, treatment of breast cancer has been surgical. Through the years poor results from surgery, along with acquisition of knowledge of the lymphatic spread of this malignancy, prompted more and more extensive surgical procedures.