Pulmonary oil deposition in patients subjected to lymphography: Detection by thoracic photoscan and sputum examination.
During clinical trials of intralymphatic therapy with radioiodinated ethiodized oil (Lipiodol Ultra-Fluid; Ethiodol) [LUF-I(131)] for malignant disease involving lymph nodes, significant pulmonary deposition of radioactive material was demonstrated by thoracic scan in each of five cases treated. Radioactivity was detected in sputum obtained from two cases. Induced sputum specimens were subsequently obtained from patients undergoing lymphography. Fat demonstrated in sputum was confirmed as Lipiodol in one of six patients tested. Sputum examination and use of tracer doses of LUF-I(131) plus photoscanning are suggested as sensitive methods of assessing the incidence of oil deposition in the lungs of patients undergoing lymphography. Despite limitation of the volume of oil injected, monitoring of the infusion, and absence of radiographic evidence of contrast medium in the lungs, some degree of pulmonary oil deposition appears to be an inevitable result of lymphography. Further study of lung dosimetry is being undertaken by the authors before clinical usage of endolymphatic radioisotope therapy is expanded.