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Gallium-67 Distribution in a Man with a Decrease in Both Transferrin and Hepatic Gallium-67 Concentration

Department of Nuclear Medicine, University of Connecticut Health Center, Farmington, Connecticut

Correspondence: For reprints contact: Ronald E. Weiner, PhD, Department of Nuclear Medicine, MC 2935, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030.

ABSTRACT

A patient with reduced transferrin concentration had a ⁶⁷Ga scintigram that showed uptake in a peritoneal abscess, pericarditis and pleural effusion but only faint liver uptake. Gallium 67 activity was measured in liver, lung, muscle and plasma samples obtained at autopsy. The percent injected dose/kg for liver and plasma samples was considerably lower than previously reported while that in muscle and lung tissues values were comparable to prior data. In this patient, sites on transferrin available to bind ⁶⁷Ga were reduced from the normal 40 µM to 5.2 µM; this in turn increased the concentration of radiogallate from 1% to 7%. This elevated free activity increased ⁶⁷Ga excretion and reduced the amount of ⁶⁷Ga*transferrin species. These results and those of previous studies suggest that liver uptake is slower than abscess uptake and more sensitive to concentration of ⁶⁷Ga*transferrin. Iron status is an important facet of the interpretation of ⁶⁷Ga scintigrams.