Establishment of the low invasive test to determine the severity of chylothorax and to localize the leakage site of chyle by three-dimensional thoracic duct scintigraphy

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K10701
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Respiratory surgery
• Research Institution: Tohoku University
• Principal Investigator: Kentaro Takanami 東北大学, 大学病院, 助教 (90447160)
• Project Period (FY): 2016-10-21 – 2020-03-31
• Keywords: 乳糜胸 / 核医学 / 長鎖脂肪酸 / 放射線被曝

Outline of Final Research Achievements

In this study, we improved the examination method of three-dimensional (3D) thoracic duct scintigraphy by the oral administration of the radioisotope-labelled BMIPP and conducted a basic study on healthy subjects. In all cases, the thoracic duct was clearly visible and no adverse events were observed. The results of this study demonstrated the necessity to start scanning at less than 100 minutes after the administration. Compared to the effective dose of 2.8mSv / 111MBq for the intravenous administration of BMIPP, the effective dose associated with thoracic duct scintigraphy was slightly higher at 4.7mSv. Since the exposure dose to the thyroid gland and intestinal tract was relatively high, it was considered that exposure could be reduced by using an iodine block before the test or a laxative after the test. The safety and exposure dose of 3D thoracic duct scintigraphy were confirmed, and the possibility of exposure reduction was clarified.

Free Research Field

放射線診断学

Academic Significance and Societal Importance of the Research Achievements

食道癌や肺癌、胸部大動脈瘤等に対する手術の際のリンパ管（胸管）損傷に伴う乳糜胸は稀だが重篤な合併症であり、保存的に改善しない場合は手術により損傷した胸管の修復、結紮が必要な場合がある。本研究結果から、放射線薬剤BMIPP経口投与による3次元胸管シンチグラフィーを用いることで、安全、低侵襲に胸管の走行を描出することが可能であることが明らかとなった。この検査を応用することで、乳糜胸症例における胸管損傷部位を術前に同定し、手術時間の短縮、予後の改善に資すると考えられる。