Lymphoscintigraphy

What is Lymphoscintigraphy?

Lymphoscintigraphy is a imaging technique used in diagnosis of lymphedema, or lymphatic spread from different types of cancer. Primary lymphedema occurs without obvious cause and can present at different stages. Secondary lymphedema is a fairly common condition in people with or being treated for breast, prostate, bladder, uterine, skin, or lymphatic cancer. The condition is debilitating through cosmetic abnormalities and other complications that arise.

 In lymphedema the flow of lymph is hindered or blocked. There are no drugs currently available in the U.S. to treat this disorder. One treatment that seems promising is Complete Decongestive Physiotherapy. The treatment and presentation are discussed in the Prevention, Etiology, and Treatment of Lymphedema link. The diagnosis and follow-up of the treatment are both greatly aided by lymphoscintigraphy. This technique involves dosing the patient with a radiopharmaceutical that will be taken up in the lymphatic system and then imaging the distribution with a gamma-camera. Images, such as the above and to the right, are of great clinical value, despite the poor resolution. These images are so important because the flow of the lymph can be traced which gives great insight to the condition of the vessels.

The agents used and the technique are briefly discussed below. For more information on this subject refer to the links below.

Agents

NOTE: Agents must have a particle size of <50nm or they will stay at the site of injection.

Imaging Technique

The following technique was taken from the Case Study #2 link below. This technique may vary for the other scans such as melanoma, other examples involving different types of scans can be viewed in case study #2 link.
  • Evaluation of extremity lymphedema -
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    Links to other sites on the Web

      Description of the Chemistry and Agent Used
    Case Study #1 (H. Lee Moffit Cancer Center and Research Institute)
    Description of the Technique (Victoria Hospital)
    Description of Lymphedema (Lymphedema Association of Australia)
    Case Study #2 (Harvard)
    Images of different Radiopharmaceutical scans (University of Kentucky)
    Intraoperative Lymphatic Mapping (University of Texas)
    Etiology, Prevention, and Treatment of Lymphedema (Lerner Lymphedema Services)
    Dextran Lymphoscintigraphy (Mahidol University)


    A Typical Gamma Camera

    
    

    This page was created by chadp@lex.infi.net and jmdurh1@pop.uky.edu

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