Quantitative lymphoscintigraphy using 99Tcm human serum albumin in patients with previously treated uterine cancer

Abstract

To evaluate the clinical usefulness of lymphoscintigraphy using 99Tcm human serum albumin (99Tc-HSA) in assessing lymphoedema in the lower extremities, lymphoscintigraphy was performed by subcutaneous injection of 7.4 MBq of 99Tcm-HSA in 26 patients with uterine cancer, previously treated by operation (OP) and/or radiation therapy (RT), and in five controls. Radioactivity at the injection site in the lower extremities was counted for 3 min at 10 min (A) and at 3 h (B) after injection, and clearance of 99Tcm-HSA was defined as (1-(B)/(A)) x 100(%). Clearance in controls was 46.8 +/- 3.9%, which was significantly more than those in the other treatment groups. Clearances in patients treated with both OP and RT were less than those in patients treated with either OP or RT alone (30.1 +/- 11.4 vs. 41.9 +/- 8.9, 43.7 +/- 9.6%, respectively; p less than 0.01). The clearance in legs with lymphoedema was less than those without lymphoedema in patients treated with both OP and RT (16.6 +/- 7.7 vs. 34.9 +/- 9.3%; p less than 0.01) and in patients treated with RT (33.1 +/- 7.4 vs. 48.0 +/- 5.6%; p less than 0.01). There was a significant difference between clearance in controls and clearance in non-oedematous patients' legs treated with OP and RT (p less than 0.01). In patients treated with RT alone, radiation dose was closely correlated with 99Tcm-HSA clearance and with the development of lymphoedema. These data suggest that lymphoscintigraphy using 99Tcm-HSA is useful in evaluating lymphoedema and that radiation dose is one of the factors in the development of lymphoedema.