Mediastinal lymphoscintigraphy in ovarian cancer using intraperitoneal autologous technetium-99m-labelled erythrocytes

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Abstract
99Tcm-labeled autologous erythrocytes (2.0 ml and 2.0 mCi) were administered i.p. to 15 patients with ovarian cancer. Anterior abdominal images were then collected for up to 6 h to evaluate both the dynamics of i.p. tracer distribution and the potential for visualizing internal mammary lymph nodes as correlated with the presence of diaphragmatic tumor. Dispersion of red cells closely resembled that seen during i.p. contrast studies; the distribution patterns were heterogeneous, remained constant with time, and were intimately related to bowel peristalsis. Visualization of internal mammary lymph nodes indicated patency of diaphragmatic lymphatics; non-visualized nodes correlated with the presence of diaphragmatic tumor. The test had a sensitivity of 0.80 and a specificity of 0.90 for defining disease. Use of 99Tcm-red blood cells is suggested as a diagnostic test for diaphragmatic involvement by ovarian cancer and as a method for monitoring the effects of therapy.