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Lymphoscintigraphy with Tc-99m-labeled dextran.

Current agents for lymphoscintigraphy have limitations because of slow migration of the colloidal tracers from the injection site and the unknown effect of phagocytosis on the removal of the labeled particles. The usefulness of Tc-99m dextran (TcDx) with a molecular weight of 110,000 has been tested for lymphoscintigraphy. Computer-assisted dynamic imaging and serial blood sampling in 13 dog experiments demonstrated that the tracer cleared only by lymph drainage from an interstitial injection site. Following interdigital injection of 1.0 ml (0.5-5.0 mCi), TcDx reached the knee or elbow lymph nodes in 12.4 +/- 6.5 (1 s.d.) sec, and the inguinal or axillary lymph nodes in 98.0 +/- 42.3 sec. It cleared from the injection site with a half-time of 31.5 min. In a dog with surgically induced lymphedema, tracer migration was markedly delayed in the edematous leg and the radionuclide lymphoscintigram resembled the contrast lymphangiogram. Initial studies in man yielded high-quality radionuclide lymphograms of the leg, and the pelvic and paraaortic lymph nodes. We conclude that TcDx is very promising for lymphoscintigraphy.