Developmental steps for radionuclide hysterosalpingography

Detection of Tc-99m labelled albumin particles in the Fallopian tubes after intraperitoneal deposition

OBJECTIVE

To study the Fallopian tube uptake of intra-abdominal albumin particles.

STUDY DESIGN

Six healthy women volunteered for ultrasound guided deposition of Tc-99m labelled albumin particles into the pouch of Douglas, before undergoing sterilisation by salpingectomy.

RESULTS

On gamma camera images radioactivity spread evenly over the parietal peritoneum. Autoradiography of the Fallopian tubes showed radioactive "hot spots" on the inner tubal surface. A rapid increase in blood radioactivity stabilised after 2-3 h while radioactivity remained high in the peritoneal cavity. Cervical mucus showed a significant radioactivity.

CONCLUSION

Autoradiography strongly indicated that Tc-99m labelled particles deposited into the pouch of Douglas were transported to the Fallopian tubes. The small uptake of radioactivity identified in blood was most likely due to a rapid diffusion of free Tc-99m pertechnetate from the peritoneal cavity. The radioactivity identified in cervical mucus could be pertechnetate or labelled albumin particles or a combination of both. Future development of the present technique may be used for fertility investigation.

Radioactivity in cervical mucus after intraperitoneal deposition of Tc-99m labelled albumin particles before and after sterilisation

OBJECTIVE

To study the transport of radiolabelled albumin particles from the pouch of Douglas to cervical mucus.

STUDY DESIGN

A prospective randomised study, including 10 healthy women, undergoing laparoscopic sterilization. A solution of human serum albumin particles, labelled with Technetium 99(m) (Tc-99(m)) was injected into the pouch of Douglas, either before or after sterilisation.

RESULTS

Gamma camera images showed gradual spread to the entire peritoneal cavity. Blood samples, showed increasing levels of radioactivity. Measurement of radioactivity in cervical mucus showed significant activity both in women sterilized before and after the deposition.

CONCLUSION

The study showed evidence of transport of radioactivity from the pouch of Douglas to cervical mucus. The transport seemed to consist of free activity since no radionuclide labelled particles could be detected in cervical mucus. The transport was probably haematogenous or lymphatic and not intraluminal through the fallopian tube. Further studies utilizing particles comparable in size to fertilized ova are required to design methods for evaluating the transport from the fallopian tube to the uterine cavity.