Scintigraphic peritoneography in advanced ovarian malignancies: its value for chemotherapeutic distribution studies

It is important to be aware of the position of the transabdominal infusion catheter and of the expected distribution of the chemotherapeutic agent, prior to the administration of intraperitoneal chemotherapeutic agents for metastatic tumour. The intraperitoneal introduction of technetium-99m labelled human serum albumin provides a means of studying fluid distribution, as well as identifying the catheter position. The technique used in this examination, the expected normal pattern of distribution and various pathological findings and pitfalls of the peritoneal scan are discussed on the basis of results in 10 patients, in whom 24 intraperitoneal scintigraphic studies were done. In one of these scans there was inappropriate filling of the lesser sac. In another scan the tip appeared to lie within the lumen of the small bowel. In two other patients inappropriate filling of the large bowel was seen. Only one scan showed a total widespread distribution of the scintigraphic agent throughout the abdominal cavity. In 16 other scans the spread was satisfactory. In three scans certain parts of the abdominal cavity did not show any activity at all. In these last scans computed tomography findings could explain why there was a poor peritoneal distribution of the scintigraphic agent.