The clinical application of radioactive colloidal gold Au-198 in pelvic lymphoscanning

Choe, S J; Kim, M S; Suh, C S

Abstract

It is important to know the possible cancer dissemination upon pelvic lymphnodes not only for thedetermination of the therapeutic plan of the cancer of the uterine cervix and other pelvic neoplasm but also fordetermination of their prognosis. The radioactive pelvic lymphnode scanning has been practised to detect thepossible metastatic malignancy involving pelvic lymphnode. When an intradermal or subcutaneous injection ofradioactive colloidal gold-198 is made it flows through the lymphatic channels to the ragional lymphnodes. Thelocalization of the colloidal particle in the lymphnodes depends on the lymphnode integrity and the patency of thelymphatic channels. The flow of the colloid through the lymphatics may be blocked or slowed by lymphnodes that areinvaded or replaced by tumor tissue. In order to investigate the diagnostic potential of the slowing of the flow of the colloidal particle in the lymphatic channel, the authors measured the disappearing rate of theradioactivity injected into the inter-digital soft tissue of patient's feet and it was found that there isconsiderable delaying in hte clearing of the radioactivity from the injected site in the case of those who showedabnormal pelvic lymphnodes scanning. The authors found that more than 85% of injected radioactivity remaining atthe site of injection 24 hours after injection should be considered to be abnormal, and the difference more than15% in the remaining rate of radioactivity between the right and left foot indicated some abnormality in thepelvic lymphnodes. Therefore the authors advocated the radioactivity disappearing test could be practised as acoscreening test with routine pelvic lymphoscanning or be performed as a independent screeening test to detect apossible malignant involvement of the pelvic lymphnodes.