Lymphatics Radiopharmacy

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What are the two tracers that are primarily used in lymphatics?

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  • Tc99m Tilmanocept (Lymphoseek)

  • Tc99m Sulfur Colloid

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What tracer is more commonly used?

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  • Tc99m Tilmanocept

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23 Terms

1
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What are the two tracers that are primarily used in lymphatics?

  • Tc99m Tilmanocept (Lymphoseek)

  • Tc99m Sulfur Colloid

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What tracer is more commonly used?

  • Tc99m Tilmanocept

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What is the form of the Tc99m Sulfur Colloid

  • particles

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Where does the sulfur colloid get taken up? (MOL)

  • phagocytosis

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What molecules are used with tilmanocept?

  • Mannose molecules

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What size are the molecules for tilmanocept?

  • about 7 nanometers

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Where does the tilmanocept bind?

  • receptor protein called CD-206

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Where is the CD-206 found?

  • macrophages

  • dendritic cells

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what is telmanocept diluted with?

  • sodium chloride

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Does localization of tilmanocept occur fast or slow?

fast

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how long can the tilmanocept remain in the lymph nodes?

30 hours

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Sulfur Colloid Particle size

ranges from 0.1-1 microm, mean size of 3 microm

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Indications for sulfur colloid use:

  • sentinel node localization

  • lymphoscintigraphy - evaluate for lymphedema

  • lymphatic leak

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Filter that can be applied for sulfur colloid

  • 0.1 or 0.2 micron filter to eliminate larger particles

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What is in a sulfur colloid kit?`

  • sodium thiosulfate anhydrous

  • edetate disodium

  • bovine gelatin

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What is is Vial A for sulfor colloid kit?

  • hydrochloric acid solution

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What is in Vial B for a sulfur colloid kit?

  • aqueous solution of sodium biphosphate anhydrous

  • sodium hydroxide

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The preparation steps for a sulfur colloid kit:

  • maximum of 500mCi in 1-3 mL of sodium pertechnetate added to kit

  • add 1.5 mL of Vial A to kit

  • Place kit in boiling water bath to fully cover liquid in the vial - boil for 5 minutes

  • cool for 3 minutes

  • add 1.5 mL of vial B to the kit

  • BUD: 6 hours

  • After reconstruction it can be filtered

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what is the BUD for sulfur colloid?

6 hours

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Lymphoseek

Tc99m Tilmanocept

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How quick does localization occur with Lymphoseek

within 10 minutes

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recommended dose of lymphoseek

0.5 mCi

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