Sentinel lymph node mapping of the colon and stomach using lymphoseek in a pig model

Ann Surg Oncol. 2004 Jul;11(7):674-81. doi: 10.1245/ASO.2004.06.007.


Background: Lymphoseek is a radiopharmaceutical designed for sentinel lymph node (SLN) mapping. The purpose of this study was to compare Lymphoseek colon and gastric pharmacokinetics with filtered [(99m)Tc]sulfur colloid (fTcSC).

Methods: Eight anesthetized pigs received an endoscopic injection of Lymphoseek or fTcSC in the stomach and colon. Scintigraphy was obtained of both administration sites at 15-minute intervals up to 3 hours after injection, after which all SLNs were identified by a handheld gamma probe through a laparotomy incision. Isosulfan blue was administered at the injection site 5 minutes before SLN mapping. The percentage of injected dose (%ID) was measured for all harvested nodes, and the clearance half-life (T(c)) was calculated for all injection sites.

Results: The mean Lymphoseek clearance for colon (T(c), 2.56 +/- 1.04 hours) and gastric (T(c), 3.83 +/- 1.18 hours) injection sites was statistically faster (P =.030) compared with fTcSC (colon T(c), 14.98 +/- 3.41 hours; stomach T(c), 14.52 +/- 4.08 hours). After 3 hours, Lymphoseek exhibited a mean SLN %ID of 1.32% +/- 1.71% in the colon and 2.04% +/- 2.12% in the stomach; this was not statistically different from fTcSC (colon,.63% +/-.39%; stomach, 2.35% +/- 2.90%). SLN uptake of Lymphoseek was significantly different from second-echelon node %ID for the colon (P =.011) and gastric (P =.029) injection sites. All SLNs exceeded 10 times background, and there was no discordance between isosulfan blue and Lymphoseek or fTcSC.

Conclusions: Three hours after colon stomach administration, Lymphoseek demonstrated rapid injection site clearance, detectable SLN uptake, and low second-echelon node uptake.

MeSH terms

  • Animals
  • Colon / diagnostic imaging
  • Colonic Neoplasms / diagnostic imaging*
  • Colonic Neoplasms / pathology*
  • Dextrans / pharmacokinetics*
  • Disease Models, Animal
  • Female
  • Lymphatic Metastasis / diagnostic imaging*
  • Mannans / pharmacokinetics*
  • Organotechnetium Compounds / pharmacokinetics*
  • Pentetic Acid / pharmacokinetics*
  • Radionuclide Imaging
  • Sentinel Lymph Node Biopsy / methods
  • Stomach / diagnostic imaging
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology*
  • Swine
  • Technetium Tc 99m Pentetate / analogs & derivatives
  • Tissue Distribution


  • Dextrans
  • Mannans
  • Organotechnetium Compounds
  • technetium-diethylenetriaminepentaacetic acid-mannosyl-dextran
  • Pentetic Acid
  • Technetium Tc 99m Pentetate