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Lymphatic mapping with 99mTc-Evans Blue dye in sheep

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Abstract

Objective

99mTc-Evans Blue (EB) is an agent that contains both radioactive and color signals in a single dose. Earlier studies in animal models have suggested that this agent when compared with the dual-injection technique of radiocolloid/blue dye can successfully discriminate the sentinel lymph node. The aim of this study was to investigate the potential of 99mTc-EB as an agent to map the lymphatic system in an ovine model.

Methods

Doses of 99mTc-EB (23 MBq) containing EB dye (4 mg) were administered intradermally to the limbs of four anesthetized sheep, and they were then imaged over 20–30 min using a gamma camera. The study protocol was repeated using 99mTc-antimony trisulfide colloid (ATC) and Patent Blue V dye. The lymph nodes (popliteal, inguinal, and iliac for hind limbs or prescapular for fore limbs) were identified with a gamma probe during the operative exposure, then dissected and counted in a large volume counter.

Results

Simple and complex (dual) drainage patterns were visible on the scans, and the sentinel node was more radioactive than higher tier nodes in a chain, for both radiotracers. For 99mTc-EB, maximum radioactive uptake was achieved at 3–6 min for popliteal lymph nodes, 12–14 min for iliac nodes, and 13–14 min for prescapular nodes. 99mTc-ATC resulted in maximum radioactive uptake at 4–6 min for popliteal lymph nodes, 13 min for an inguinal node, 13–20 min for iliac nodes, and 18 min for a prescapular node. Following 99mTc-EB injection, 15/15 lymph nodes harvested were all radioactive and blue. For 99mTc-radiocolloid/Patent Blue V injection, 8/14 nodes were radioactive and blue, and 6/14 nodes were radioactive only.

Conclusions

The soluble radiotracer 99mTc-EB appeared to be a useful lymphoscintigraphic agent in sheep, in which radioactive counts from superficial lymphatic channels and lymph nodes were sufficient for planar imaging. In comparison with 99mTc-antimony trisulfide colloid, both tracers discriminated the sentinel lymph node up to 50 min after administration; however, 99mTc-EB had the advantage of providing radioactive (gamma probe) and color signals simultaneously during the operative exposure.

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Authors and Affiliations

  1. Nuclear Medicine Department, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia

    Chris Tsopelas, Max Bellon & Barry E. Chatterton

  2. Department of Breast and Endocrine Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia

    Elaine Bevington, James Kollias & Sabah Shibli

Authors
  1. Chris Tsopelas
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  2. Max Bellon
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  3. Elaine Bevington
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  4. James Kollias
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  5. Sabah Shibli
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  6. Barry E. Chatterton
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Correspondence to Chris Tsopelas.

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Tsopelas, C., Bellon, M., Bevington, E. et al. Lymphatic mapping with 99mTc-Evans Blue dye in sheep. Ann Nucl Med 22, 777–785 (2008). https://doi.org/10.1007/s12149-008-0171-y

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  • DOI: https://doi.org/10.1007/s12149-008-0171-y

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