Side-to-side symmetry of radioprotein transfer from tissue space to systemic vasculature following subcutaneous injection in normal subjects and patients with breast cancer

Eur J Nucl Med Mol Imaging. 2003 May;30(5):657-61. doi: 10.1007/s00259-003-1135-z. Epub 2003 Mar 22.


Quantitative lymphoscintigraphy can be used for investigation of unilateral lymphatic disease of the limbs, such as breast cancer-related lymphoedema (BCRL). Previous studies have compared lymphatic function in the affected limb with that in the unaffected contralateral limb. This study aims to confirm that the assumption of pre-morbid symmetry, never previously demonstrated, is valid. A dual-isotope technique, with bilateral subcutaneous hand injection of polyclonal human immunoglobulin G (HIgG) labelled with either technetium-99m or indium-111, was performed on a total of 37 subjects. The use of two different labels, one for each limb, enabled comparison not only of the rate of clearance from the injection depot, but also of the rate of appearance in venous blood. Results demonstrate clear symmetry between the two arms with respect to both depot clearance and blood appearance rates, as well as the coupling between these two variables. In unilateral lymphatic disease, results of quantitative lymphoscintigraphy should be expressed in relation to the normal arm rather than to an independent control population.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arm / blood supply*
  • Arm / diagnostic imaging*
  • Breast Neoplasms / complications
  • Breast Neoplasms / diagnostic imaging
  • Epinephrine / administration & dosage*
  • Female
  • Humans
  • Immunoglobulin G / administration & dosage
  • Immunoglobulin G / blood*
  • Indium Radioisotopes / administration & dosage
  • Indium Radioisotopes / blood
  • Indium Radioisotopes / pharmacokinetics
  • Lymphatic System / blood supply
  • Lymphatic System / drug effects
  • Lymphatic System / metabolism
  • Lymphedema / blood*
  • Lymphedema / diagnostic imaging*
  • Lymphedema / metabolism
  • Lymphoscintigraphy
  • Metabolic Clearance Rate
  • Organotechnetium Compounds / administration & dosage
  • Organotechnetium Compounds / blood
  • Radiopharmaceuticals / administration & dosage
  • Radiopharmaceuticals / blood
  • Reproducibility of Results
  • Sensitivity and Specificity


  • Immunoglobulin G
  • Indium Radioisotopes
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Epinephrine