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In Vivo Detection of Apoptosis in an Intracardiac Tumor

L. Hofstra, MD, PhD; E. A. Dumont, MD; P. W. L. Thimister, MD, PhD; G. A. K. Heidendal, MD, PhD; A. P. DeBruine, MD, PhD; T. W. O. Elenbaas, MD; H. H. Boersma, PharmD; W. L. van Heerde, PhD; C. P. M. Reutelingsperger, PhD
JAMA. 2001;285(14):1841-1842. doi:10.1001/jama.285.14.1841.
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To the Editor: We previously demonstrated in vivo imaging of cell death in the myocardia of patients with acute myocardial infarction using technetium Tc 99m–labeled annexin-V (99mTc-p-annexin-V [Apomate], Theseus Imaging, Cambridge, Mass) and nuclear imaging.1 Because high proliferation and apoptotic indices have been reported in rapidly growing malignant tumors,2 information about the extent of apoptosis in the tumor may also provide insight into the tumor's biology and prognosis.

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Figure 1. Imaging Studies of the Heart
Graphic Jump Location

A, Echocardiogram of the heart in short-axis orientation shows a large tumor in the left ventricle originating from the lateral area (white arrow). B, Thallium perfusion scintigraphy shows the perfused myocardium of the left ventricle in a short-axis orientation. C, Increased uptake of technetium Tc 99m-p-annexin-V can be seen (black arrows) within the contour of the left ventricle on short-axis single-photon emission computed tomographic imaging, using a similar orientation as the perfusion scintigram.

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Figure 2. Immunohistochemical Analysis of the Tumor Specimen
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A, Immunostaining for annexin-V shows binding of annexin-V to the plasma membrane of tumor cells (brown staining, arrows). B, Corresponding section stained with CM1 antibody specific for activated caspase-3 shows extensive binding to the cytosol of cells, which colocalize with annexin-V–positive cells in A (brown staining, arrows). C, Double staining with annexin-V antibody (brown staining) and CM1 antibody (red staining) shows specific binding of annexin-V of the plasma membrane of cells with activated caspase-3 in the cytosol.

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