Photoscanning Localization of Tumor, Utilizing Chlormerodrin Mercury 197

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Abstract
Methods of detecting carcinomatous change and the spread of metastatic disease are always being sought. Recently, during a routine evaluation of mercury 197 chlormerodrin as a brain and renal scanning agent, we found mercury 197 concentrated in carcinomatous tissue in all areas of the body (1, 2). Since this initial discovery we have studied a large number of tumors, both benign and malignant, to further evaluate this phenomenon. Tissue counts and radiophotoscans of the involved areas were performed with our clinical radiophotoscanning devices. This communication will present the results of this clinical research and describe future applications of the technic. Methodology Picker Nuclear Magnascanners Model 2806B were utilized. During the last portion of the study a 5 × 2-in. sodium iodide crystal was substituted for the 3 × 2-in. crystal. A lead 19-hole collimator was employed in all large organ scanning. For all studies utilizing mercury 197 a window of 60 to 90 kev was used. In vitro tissue counts were performed with a 2 × 2-in. sodium iodide crystal and pulse-height analyzer. Cancer Detection with Mercury 197 Neohydrin In the beginning of this study, we scanned areas suspected of carcinomatous change at various times during a seventy-two-hour period. We found, in the majority of cases, the twenty-four-hour post-dose scan was most acceptable for the following reasons : (a) the blood background at twenty-four hours had been reduced to a minimum and (b), for reasons still being investigated, the carcinoma cell retained the most radioactive mercury 197, therefore making a good target-to-nontarget ratio. In tumors proximating areas which normally concentrate mercury, thin lead shielding was placed over the normal area. Case Reports Case I: A 63-year-old white woman in whom a carcinoma was removed from the left breast about five years prior to admittance. Hormone therapy, hypophysectomy, and chemotherapy had been administered. On admission the clinical and laboratory diagnosis was diffuse carcinomatosis. A skeletal survey revealed an extensive primary osteoblastic process involving the entire skeleton. The right humerus showed a combination osteoblastic-osteolytic lesion involving mainly the head of the humerus. Alkaline phosphatase was 9.1 units (normal in this laboratory 0.3 to 2.8 units). The scan showed concentration of mercury 197 in the head of the humerus (Fig. 1). Case II: A 79-year-old colored woman with squamous-cell carcinoma in the floor of the mouth, proved by biopsy. Radiation therapy was administered, but the tumor progressed, with involvement of the lower gum and adjacent structures. Clinically, a large ulceration of the floor of the mouth involved the tongue, lower gum, and the cervical lymph nodes. Scanning disclosed an increased concentration of mercury 197 Neohydrin in the region of the tumor and cervical lymph nodes (Fig. 2). Results Areas of tumefaction in the eye were quite small.

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