A dual beam study with isotopic X- and gamma-rays for in vivo lymph pool assay

Abstract

Dual beam absorptiometry utilizes differential absorption of X- and gamma rays of differing energy to determine an absorber's component ratio. This principle has been applied to diverse physical and biological problems. Our method, using the 22 and 88 keV emissions from 109Cd, resolves the lean and non-lean mammalian tissue fractions. Accuracy of 1%, and reproducibility of 1–2% is attainable in in vitro measurements. Techniques have been developed to apply this system to the more complicated applications involved in human studies. A scanning device capable of measuring limbs has been developed. Mathematical treatment provides an integrated value of lean fraction over the scanned area. Lymphedema is a painful malady in which blockage of lymph flow causes swelling and distension of the extremities. Compressive therapy is the preferred medical treatment. There has been no accurate quantitative index of the efficacy of this therapy. Our research program uses dual beam analysis as a unique quantitative measure of the lymph transport. Lymph pool change is equated to change in the lean. Five measurements are made on subjects undergoing a two week regimen of compressive therapy. These absorptiometric results are analyzed for correlation to other indices of treatment effect. Data shows a progressive decrease in the lean tissue component over the treatment period. Changes seen vary with the individual and the severity of involvement. This study showed that the largest transport rate occurs in the first treatment days. Absorptiometry accurately monitors total adipose mass, total non-adipose mass, extremely cross section, and change in lymph pooling.