Continuous intraoperative external monitoring of perfusate leak using iodine-131 human serum albumin during isolated perfusion of the liver and limbs.
Regional isolated perfusion using tumor necrosis factor (TNF) shows significant promise for treatment of cancer which is limited to limbs or organs. The high toxicity of TNF requires very sensitive real time monitoring of leakage in order to avoid serious patient complications. Human serum albumin labeled with iodine-131 is used with an externally mounted and collimated NaI(Tl) detector to track the leakage of blood from the isolated perfusion blood circuit into the general systemic vascular space. Blood activity levels measured using the monitor demonstrated a very good correlation with blood serum samples taken concurrently with external monitoring. External monitoring can reduce the risks of perfusion leakage intraoperatively with the precision necessary to safely perform isolated perfusion using TNF.
Barker
W C
WC
Nuclear Medicine Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
Andrich
M P
MP
Alexander
H R
HR
Fraker
D L
DL
D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy; D005121:Extremities; D006801:Humans; D007371:Interferon-gamma / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008545:Melanoma / Q000628:therapy*; D008558:Melphalan / Q000008:administration & dosage; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods; D012509:Sarcoma / Q000628:therapy*; D012711:Serum Albumin, Radio-Iodinated; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage* / Q000009:adverse effects
D012711:Serum Albumin, Radio-Iodinated; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; D008558:Melphalan