skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Lymphoscintigraphy (LS) in lymphedema (LE) of the extremities

Abstract

Twenty-two patients with primary and secondary LE and one with lipedema had LS using 0.4-0.6 mCi of Tc-99mSb2Sb3 subcutaneous at the second interdigital space. Three had excisional surgery, in four patients lympho-venous anastomosis (LVA) was attempted following LS. Results are presented in this paper. This study concludes that LS is a noninvasive method without side effects that visualizes the pattern of the lymphatic system in LE. If lymph channels were seen, LVA could be performed. LS seems adequate for patient selection and follow-up after LVA. It differentiated LE from lipedema. Image patterns or quantitative studies could not differentiate between primary and secondary LE.

Authors:
; ; ; ; ; ;
Publication Date:
Research Org.:
Mayo Clinic/Foundation, Rochester, MN
OSTI Identifier:
5961109
Report Number(s):
CONF-850611-
Journal ID: CODEN: JNMEA; TRN: 87-039261
Resource Type:
Conference
Resource Relation:
Journal Name: J. Nucl. Med.; (United States); Journal Volume: 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 59 BASIC BIOLOGICAL SCIENCES; EDEMA; DIAGNOSIS; LIMBS; LYMPHATIC SYSTEM; SCINTISCANNING; DIAGNOSTIC USES; LYMPH NODES; LYMPH VESSELS; PATIENTS; SIDE EFFECTS; SUBCUTANEOUS INJECTION; SURGERY; TECHNETIUM 99; TISSUE DISTRIBUTION; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; BODY AREAS; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISTRIBUTION; HOURS LIVING RADIOISOTOPES; INJECTION; INTAKE; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; NUCLEI; ODD-EVEN NUCLEI; PATHOLOGICAL CHANGES; RADIOISOTOPE SCANNING; RADIOISOTOPES; SYMPTOMS; TECHNETIUM ISOTOPES; USES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics; 550901 - Pathology- Tracer Techniques

Citation Formats

Gloviczki, P., Vaqueiro, M., Fisher, J., Schirger, A., Dewanjee, M.K., Hollier, L.H., and Wahner, H.W. Lymphoscintigraphy (LS) in lymphedema (LE) of the extremities. United States: N. p., 1985. Web.
Gloviczki, P., Vaqueiro, M., Fisher, J., Schirger, A., Dewanjee, M.K., Hollier, L.H., & Wahner, H.W. Lymphoscintigraphy (LS) in lymphedema (LE) of the extremities. United States.
Gloviczki, P., Vaqueiro, M., Fisher, J., Schirger, A., Dewanjee, M.K., Hollier, L.H., and Wahner, H.W. 1985. "Lymphoscintigraphy (LS) in lymphedema (LE) of the extremities". United States. doi:.
@article{osti_5961109,
title = {Lymphoscintigraphy (LS) in lymphedema (LE) of the extremities},
author = {Gloviczki, P. and Vaqueiro, M. and Fisher, J. and Schirger, A. and Dewanjee, M.K. and Hollier, L.H. and Wahner, H.W.},
abstractNote = {Twenty-two patients with primary and secondary LE and one with lipedema had LS using 0.4-0.6 mCi of Tc-99mSb2Sb3 subcutaneous at the second interdigital space. Three had excisional surgery, in four patients lympho-venous anastomosis (LVA) was attempted following LS. Results are presented in this paper. This study concludes that LS is a noninvasive method without side effects that visualizes the pattern of the lymphatic system in LE. If lymph channels were seen, LVA could be performed. LS seems adequate for patient selection and follow-up after LVA. It differentiated LE from lipedema. Image patterns or quantitative studies could not differentiate between primary and secondary LE.},
doi = {},
journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 26:5,
place = {United States},
year = 1985,
month = 5
}

Conference:
Other availability
Please see Document Availability for additional information on obtaining the full-text document. Library patrons may search WorldCat to identify libraries that hold this conference proceeding.

Save / Share:
  • The role of lymphoscintigraphy, performed with /sup 99m/Tc-labeled antimony sulfur colloid, in the diagnosis of lymphedema and as a test for selection of patients for microvascular operation was evaluated in 32 patients with primary and secondary lymphedema and four patients with other causes of leg edema. Lymphoscintigraphy clearly demonstrated if edema was of lymphatic origin. Five different image patterns were identified; abnormal image patterns could not be predicted from clinical history or physical findings. Quantitative evaluation of removal of the radioactive colloid from the injection site and appearance in lymph node sites and liver was of limited usefulness. Nine patientsmore » underwent various surgical procedures before or after lymphoscintigraphy. Lympho-venous anastomoses were possible only in patients who had patent lymph channels visible on lymphoscintigrams. Based on initial experience, lymphoscintigraphy seems to be useful to select patients for microvascular operation.« less
  • Confirmation of the diagnosis of lymphedema often requires lymphangiography, a procedure that is painful for the patient and technically demanding. Radioisotope lymphoscintigraphy is a relatively new technique that uses technetium 99 m antimony trisulfide colloid to produce a diagnostic image similar to a lymphangiogram. The procedure requires a single subcutaneous injection in the involved extremity, and images are obtained 3 hours later. It is technically easy to perform, produces minimal discomfort for the patient, and has no adverse effects. We have recently used radioisotope lymphoscintigraphy to evaluate 17 patients with extremity edema. These patients initially had a presumed diagnosis ofmore » lymphedema involving the upper or lower extremity. Lymphoscintigraphy confirmed the diagnosis of lymphedema in 12 (70.6%) patients. In five of the 17 patients (29.4%) the clinical impression of lymphedema was not supported by lymphoscintigraphy, leading to alternative diagnoses such as lipomatosis, venous insufficiency (two patients), congestive heart failure, and disuse edema. In all patients with secondary lymphedema the lymphatic system in the involved extremity could be partially visualized. Conversely, three of four patients with primary lymphedema had no ascent of the tracer from the foot and no lymphatic channels could be visualized. Lymphoscintigraphy is relatively easy to perform, safe, minimally invasive, and not uncomfortable for the patient. It is useful in differentiating lymphedema from other causes of extremity edema, allowing institution of appropriate therapy.« less
  • Contrast lymphangiography has been the traditional radiographic method for imaging the lymphatic system of the lower extremities. Because of the difficulty in performing the procedure and its potential side effects, radionuclide lymphangiography is a safe and reliable alternative. Technetium-99m labeled to antimony trisulfide colloid was used in nine patients presenting with lymphedema of the lower extremities. The procedure was relatively simple to perform, and no adverse effects were noted.
  • Twelve patients with primary lymphedema of the lower limb were examined with computed tomography (CT). A characteristic honeycomb pattern of the subcutaneous compartment was seen in 10 of these patients. CT scans in nine other patients with swollen leg secondary to chronic venous disease or lipedema did not show this characteristic pattern. CT may be helpful in the differential diagnosis of a swollen leg, thus obviating venography or lymphangiography.