Interstitial lymphoscintigraphy for diagnosis of lymphocele.
A patient with the development of a post-surgical mass in the thigh, at the site of surgery, is described. Lymphoscintigraphy was important in solving the clinical dilemma.
Cysts↗
SEARCH · Search PubMed
Results for “Lymphoscintigraphy”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Tc-99m human serum albumin lymphoscintigraphy in lymphedema of the lower extremities.
Edema of the lower extremities is a difficult clinical problem. It can be due to stasis, obstruction of the lymphatic channels, increased production of lymph beyond the drainage capacity of the lymphatic vessels. It is often difficult to differentiate between these varieties. Lymphoscintigraphy was performed on 164 patients complaining of swelling of the lower extremities and on 5 volunteers. All patients were injected with 1 mCi of Tc-99m human serum albumin (HSA) intradermally in the medial web of the dorsum of each foot. Data were acquired dynamically for both inguinal regions for 45 minutes, and static images of the legs, thighs, and pelvis were taken at 90 minutes. Time activity curves were generated for the equal regions of inguinal nodes on both inguinal sides. The following patterns were recognized: normal (5 volunteers and 57 patients), enhanced (17 patients), stasis with mild obstruction (70 patients), and marked stasis with obstruction (20 patients).
Adult↗
Combined transmission-emission imaging in lymphoscintigraphy.
A modification of standard lymphoscintigraphic imaging is described that incorporates the use of a two-headed camera with flood source to provide combined whole-body transmission-emission images of lymphatic drainage in a patient with malignant melanoma. The most common imaging technique for lymphoscintigraphy uses single-head gamma cameras with or without skin markers. The authors performed both techniques on their patient, and believe that the modification may provide a clearer image for lymphoscintigraphic interpretation.
Humans↗
Technetium-99m antimony sulphide colloid lymphoscintigraphy of the prostate by direct transrectal injection.
Laterality of prostatic lymphatic drainage was successfully assessed in nine patients with prostatic carcinoma after direct unilateral transrectal injections of 99Tcm-antimony sulphide colloid by Franzen needle. Pelvic lymphatic drainage was equally divided between ipsilateral, contralateral and bilateral patterns. The frequent observation of radiocolloid migration to contralateral lymph node groups in patients with prostate carcinoma, including those with primary disease localized clinically to a single lobe of the prostate, indicates the potential for contralateral pelvic lymph node metastases in this population. This finding may be important in determining the appropriate surgical staging and treatment of patients with prostate carcinoma. The clinical applicability of lymphoscintigraphy in the evaluation of metastatic spread and in lymph node biopsy planning requires further study.
Administration, Rectal↗
Lymphoscintigraphy in lymphedema of the lower limbs using 99mTc HSA.
Edema of the lower limbs is a difficult clinical problem. Edema could be due to stasis, obstruction of the lymphatic channels, or increased production of lymph beyond the drainage capacity of the lymphatic vessels. Sometimes it is difficult to differentiate among these varieties. Lymphoscintigraphy was performed in 164 patients complaining of swelling of the lower limbs, 2 women patients with lymphedema of the upper limbs following radical mastectomy, and 5 volunteers. All patients were injected with 1 mCi of 99mTc human serum albumin intradermally in the medial web on the dorsum of each foot. Data were acquired dynamically for both inguinal regions for forty-five minutes with a gamma camera interfaced with a computer. Static images were taken at ninety minutes for both legs and thighs and for the pelvis. Time activity curves were generated for the equal regions of inguinal nodes on both inguinal sides. The following patterns were recognized: normal pattern in 5 volunteers and in 57 patients, enhanced flow pattern in 17 patients, stasis with mild obstruction in 72 patients, and marked stasis with obstruction in 20 patients.
Adolescent↗
The importance of the subfascial lymphatics in the diagnosis of lower limb edema: investigations with semiquantitative lymphoscintigraphy.
A new method of semiquantitative lymphoscintigraphy for the evaluation of lower limb edema is characterized by (1) the evaluation of both the epifascial and subfascial system in order to assess type and stage of the edema, (2) the use of high-resolution digital whole-body imaging to facilitate the calculation of functional parameters, and (3) the use of active, standardized ergometry for reproducibility. The appearance time of 99mTc-labeled human albumin nanocolloid in inguinal lymph nodes after injection and the percent uptake of colloid into lymph nodes at 40 and 120 min after injection served as functional parameters. Patients with edema of the lower limb were compared with normal subjects. In patients with primary lymphedema the two lymphatic compartments are functionally compromised. Early and advanced stages of postthrombotic syndromes can be distinguished by characteristic lymphoscintigraphic patterns in epifascial and subfascial lymphatic compartments. These results indicate that only the separate evaluation of both the epifascial and subfascial compartments allows an accurate functional assessment of the lymphatics in lower limb edema.
Adolescent↗
[99mTc-DTPA-HSA lymphoscintigraphy in lymphedema of the lower extremities: diagnostic significance of dynamic study and muscular exercise].
The efficacy of lymphoscintigraphy was evaluated in 25 cases to clarify the diagnostic significance of dynamic study and muscular exercise in the diagnosis of lymphedema. 99mTc-diethylene triamine pentaacetic acid-human serum albumin (DTPA-HSA) was injected subcutaneously, and dynamic imaging was performed in 18 cases. Thirteen patients were asked to walk for 3 minutes. Qualitative evaluation of static images had sensitivity of 90% and specificity of 97%. Diagnostic criteria including qualitative evaluation of dynamic images were less specific (sensitivity 95%, specificity 76%). Interpretation of static images obtained at one hour after injection in the patients without muscular exercise had sensitivity of 89% and specificity of 67%, whereas sensitivity was 92% and specificity was 100% in the patients with muscular exercise. Lympho-scintigraphy was reliable in diagnosis of lymphedema. Dynamic study was limited usefulness because of some false-positive cases. Muscular exercise accelerated migration of the tracer in normal extremities, and improved positive predictive value.
Adolescent↗
Lymphoscintigraphy using (99m)Tc filtered sulfur colloid in chylothorax: a case report.
OBJECTIVE: A 66-y-old man was diagnosed with esophageal carcinoma and underwent a right thoracotomy and esophagectomy. Postoperatively, a recurring right pleural effusion developed. Because an attempt at lymphangiography failed, lymphoscintigraphy was suggested. Because of the inability to obtain radiolabeled albumin, dextran, or nanocolloid, we used filtered sulfur colloid. (0.1 um). The study confirmed the diagnosis of chylothorax.
Aged↗
Whole-body lymphoscintigraphy using transmission scans.
OBJECTIVE: Our objective was to show the advantages of performing whole-body lymphoscintigraphy using transmission sources. This technique should decrease scanning time, help locate the sentinel lymph node, and decrease radiation exposure to the technologist. METHODS: Twenty patients with proven melanoma received 18.5 MBq (0.5 mCi) filtered (0.22 microm) (99m)Tc-sulfur colloid in a 0.2-mL volume, administered as multiple intradermal or subcutaneous injections around the known melanoma lesion or scar. All 20 patients underwent serial static imaging immediately after the injection, along with whole-body scanning after the static imaging. The static emission images were acquired for 5 min and the transmission images for 1 min using a 256 x 256 matrix. The whole-body transmission scans were acquired after the whole-body emission scans. The transmission scans were obtained with the same parameters as the emission scans, with the addition of placement of a (57)Co sheet source on one of the detectors of the large-field-of-view dual-head camera. The planar static axial images (transmission, emission) were compared with the whole-body images (transmission, emission) to determine whether the same number of lymph nodes was visualized with each technique. Posterior outlines were obtained through computer manipulation of anterior transmission images. RESULTS: In all 20 patients, the number of lymph nodes seen on the static images was the same as that seen on the whole-body emission and transmission images. The whole-body emission and transmission scanning time was an average of 30 min less than the time required to acquire the serial static images. CONCLUSION: The anatomic location of the sentinel lymph node is seen more easily on whole-body images, both anterior transmission and posterior transmission, than on planar static images. Whole-body emission and transmission imaging decreased scanning time and thus improved patient comfort and throughput. Technologists received less radiation exposure when handling the (57)Co source only twice during whole-body imaging, as opposed to several times during static imaging.
Humans↗
[Lymphoscintigraphy in oncology--the role in the preoperative diagnosis].
Lymphoscintigraphy is the nuclear medicine procedure, which visualize the distribution of radiolabelled particles in the lymph vessels and lymph nodes. The sentinel node concept presumes that the first lymph node to receive drainage from a tumour will show the metastasis if there has been lymphatic tumour spread. Detection of metastatic involvement of lymph nodes is essential for management and prognostic evaluation in cancer patients. Sentinel lymph node biopsy, radioguided intraoperative lymph node detection widely increased the role of lymphatic mapping in oncology. This article provides a brief history of the sentinel lymph node concept, discusses radiopharmaceuticals, equipment and techniques in lymphatic mapping mainly in melanoma and breast cancer.
Breast Neoplasms↗
99mTc-HSA lymphoscintigraphy and leg edema following arterial reconstruction.
Twelve patients with peripheral arterial occlusive disease were evaluated prospectively in an effort to further investigate the etiology of pedal and lower leg edema that occurs following revascularization (e.g., aorto-iliac or femoropopliteal bypass). Serum total protein, albumin, blood urea nitrogen, and creatinine levels were measured (in addition to peripheral venous pressure), and lymphoscintigraphy of the lower leg was performed. These parameters were assessed just prior to surgery, four weeks postoperatively, and again at follow-up. The serum levels obtained four weeks after surgery and on subsequent follow-ups were significantly higher than the preoperative values. Preoperative peripheral venous pressure was not significantly different from that obtained after surgery. There was no correlation between these pressure measurements and the degree of edema (Grades I to IV correspond to increasing degrees of severity). For both the supine and upright positions, lymphoscintigraphic counts in the inguinal region were significantly higher after surgery. However, the relative increase was dependent upon the severity of edema. The postoperative lymphoscintigraphic count in the upright position was 77 +/- 33 CPS in patients with Grades I and II edema (n = 6) and 20.6 +/- 16.2 CPS in patients with Grades III and IV edema (n = 10) (p less than 0.01). Thus, a lesser degree of postoperative pedal and lower leg edema was associated with higher lymphoscintigraphic counts. We conclude that major contributors to the development of lower extremity edema following arterial reconstruction are failed capillary hydrostatic pressure and interrupted lymphatic drainage.
Aged↗
Lymphoscintigraphy and lymphedema of the lower extremities.
Lymphoscintigraphy, using technetium-99m-labeled sulphur microcolloid, was employed to study the flow and transport of lymph in the lower extremities of 39 consecutive patients in whom lymphedema of one or both legs was suspected clinically. Time-activity curves of four segments of each leg were evaluated for lymph capacity, flow and soft-tissue uptake, and compared with the results from film scintigraphy. Curve analysis provided quantitative evaluation of the extent of hypoplasia or aplasia in primary lymphedema and of lymphatic obstruction in secondary lymphedema, and is particularly suited to assess the involvement of lymphatics in chronic venous disease. Film scintigraphy, on the other hand, is preferable in cases in which the pattern of activity distribution in the affected extremity is diagnostic, such as in dermal back flow, traumatic lymphocele, or megalymphatics. Venography is most informative in cases of suspected underlying venous disease, but the role of lymphangiography, which shows only part of the lymphatic system and requires incision of the edematous tissues, is considered questionable.
Adult↗
[The lymphatics of the esophagus--evaluation of endoscopic RI-lymphoscintigraphy with SPECT].
For the studies of the esophageal lymphatics, endoscopic RI-lymphoscintigraphy was performed in 23 cases of esophageal cancer, 3 cases of lung cancer and 5 cases of gastric cancer. 99mTc-Rhenium colloid was endoscopically injected into the submucosal layer of the esophagus near the tumor and the images of the lymph flow were obtained after about 3 hours. Single photon emission computerized tomography (SPECT) was used to acquire the three-dimensional images of the esophageal lymph flow on 19 patients. RI-uptake of all dissected lymph nodes was also counted after the operation. The results were shown as follows. 1. Whole neck, thoracic and abdominal lymph nodes could be imaged in any cases injected at any parts of the thoracic esophagus. But the lymph flow in the upper third of the esophagus tended to move mainly upward, and the lymph flow in the lower third tended to move mainly downward. 2. The block of intra-mural lymph vessels by the tumor had very important roles upon the esophageal lymph flow. 3. The removal of upper mediastinal lymph nodes and intraabdominal lymph nodes as well as paraesophageal lymph nodes seemed to be very important for curative resection of carcinoma of the esophagus.
Aged↗
Lymphoscintigraphy.
Lymphoscintigraphy is rapidly gaining favor as a noninvasive technique to assess lymphatic structure and function. The following essay summarizes the historical background and provides a synopsis of personal experience with radiolabeled (99mTc) human serum albumin (HSA) using this technique.
Breast Neoplasms↗
Lymph drainage originating from the lower esophagus and gastric cardia as measured by radioisotope uptake in the regional lymph nodes following lymphoscintigraphy.
Lymph drainage originating from the lower esophagus and gastric cardia was determined using uptake of radioisotope (RI) in the regional lymph nodes in 19 patients with primary cancer at these sites. On the day prior to operation, 99m Tc colloid solution was injected submucosally in the distal esophagus or gastric cardia during endoscopy. The regional lymph nodes were removed at operation and RI uptake of individual nodes was measured in a well-type scintillation counter. Uptake was expressed as the amount per nodal weight. After radioactive colloid was injected into the lower esophagus, high RI uptake was common in both the mid-mediastinal and abdominal nodes, suggesting that lymph originating from the lower esophagus drains in both a superior and inferior direction. On the other hand, after radioactive colloid was injected into the gastric cardia, high RI uptake was never demonstrated in mediastinal lymph nodes suggesting that direct mediastinal lymph flow from the gastric cardia is rare. These results support clinical observations on the distribution of lymph nodal metastases in patients with lower esophageal and gastric cardia malignancies. As a diagnostic tool for lymph nodal metastases, however, lymphoscintigraphy is unreliable.
Abdomen↗
Lymphoscintigraphy in patients with lymphedema. A new approach using intradermal injections of technetium-99m human serum albumin.
Forty cases were examined by a new lymphoscintigraphic approach using intradermal injections of Tc-99m human serum albumin (HSA). Thirty-three patients had lymphedema due to the metastases of a malignant tumor and/or the dissection of lymph nodes. The others were control patients without lymphedema. With the assistance of a computer, sequential images and time-activity curves of tracer activity in the lymph nodes and the soft tissue were obtained at 30 minutes after injection. An image of the axillary or inguinal lymph nodes was identified 2-6 minutes after injection in control cases. Four main abnormal findings, the delayed appearance of radioactivity and interruption of the lymphatic system, the collateral pathways, and the retrograde lymphatic flow were observed clearly, as was the nonvisualization of the lymph nodes. These abnormalities were observed in a high percentage of patients with moderate lymphedema, as compared with a low percentage of patients with slight lymphedema. The collateral pathways could not be observed in patients with severe lymphedema. Imaging with Tc-99m HSA was considered to be more useful than other techniques, including radiocolloid lymphoscintigraphy, for examining patients with lymphedema.
Adult↗
Dynamic lymphoscintigraphy with Tc-99m human serum albumin.
Dynamic studies of the lymphatic systems of 26 cases, of which 4 were healthy volunteers, were performed using an intradermal injection of Tc-99m human serum albumin (Tc-99m HSA). With the assistance of a computer, sequential images and time-activity curves of lymphatic vessels and/or lymph nodes were obtained for a period of 30 min after the injection from the cases who took no physical exercise. The image of the axillary or inguinal lymph nodes was identified 2-4 min after injection in cases with a normal lymphatic flow. The delayed appearance of radionuclide, the collateral pathways and the obstruction of the lymphatic system were clearly observed in patients with a flow disorder. The clearance rate at the injection site of Tc-99m HSA was approximately twice as fast as that of Tc-99m rhenium sulfide colloid. The high pressure in the dense connective tissue caused by intradermal injection and the high specific radioactivity of Tc-99m HSA were thought to be important factors for obtaining excellent dynamic lymphoscintigraphy.
Adult↗
Endobronchial lymphoscintigraphy (EBLS). New diagnostic modality.
A safe, simple method of visualizing deep intrathoracic lymph nodes and determining regional tracheobronchial lymphatic drainage with colloidal radionuclides has been developed. The tracer is injected submucosally via a bronchoscope and lymph node scanning is performed at least 2 hours later. The technique was developed and tested in seven canine experiments. Endobronchial lymphoscintigraphy (EBLS) has been performed in 43 patients undergoing routine bronchoscopic examination. 99mTc phytate, 198Au colloid, and 99mTc antimony sulfide have been used; the last appears to have been the most satisfactory. The primary lymphatic drainage from selected sites of the tracheobronchial tree could be determined. Up to five lymph nodes have been visualized, with an average of 2.1 lymph nodes seen in those patients with lymph node visualization. Four patterns of lymphatic drainage were seen; ipsilateral ascending, contralateral ascending, descending, and no spread of injected colloid. In some cases cervical and celiac lymph nodes were seen. In combination with conventional diagnostic methods, EBLS in many cases clarified the extent and nature of underlying disease.
Aged↗