Gallium-67-citrate imaging in nuclear oncology

Gallium-67-citrate is one of the most useful radiopharmaceuticals to detect tumors, stage extent of the disease, monitor response to treatment and distinguish recurrent disease from post-treatment changes. Gallium is likewise very sensitive to detect and locate infections and inflammatory foci. This application is extremely important in the management of immunocompromised cancer patients. Image interpretation should be tempered with full knowledge of the patients clinical condition, anatomic alterations due to prior surgery and correct timing of image acquisition. Early imaging at 4-6 h is useful to detect gastrointestinal infections, whereas 24 h imaging is used to evaluate chest infections. Although gallium-67 is a non-specific agent, the identification of the etiology of the inflammation may be improved by adequate clinical and laboratory information as well as correlation with other imaging modalities such as sonography and computerized x-ray tomography (CT). High dose (10 mCi) gallium-67 single photon emission computed tomography (SPECT) imaging with image co-registration is important for accurate uptake localization.