TY - JOUR
T1 - Intradermal lymphoscintigraphy at rest and after exercise
T2 - A new technique for the functional assessment of the lymphatic system in patients with lymphoedema
AU - Tartaglione, Girolamo
AU - Pagan, Marco
AU - Morese, Roberto
AU - Cappellini, Giancarlo Antonini
AU - Zappalà, Albina Rita
AU - Sebastiani, Claudia
AU - Paone, Giuseppe
AU - Bernabucci, Valerio
AU - Bartoletti, Roberto
AU - Marchetti, Paolo
AU - Marzola, Maria Cristina
AU - Naji, Meeran
AU - Rubello, Domenico
PY - 2010/6
Y1 - 2010/6
N2 - AIM: The aim of this study was to evaluate the effect of implementing a new technique, intradermal injection lymphoscintigraphy, at rest and after muscular exercise on the functional assessment of the lymphatic system in a group of patients with delayed or absent lymph drainage. Methods: We selected 44 patients (32 women and 12 men; 15 of 44 with upper limb and 29 of 44 with lower limb lymphoedema). Thirty of 44 patients had bilateral limb lymphoedema and 14 of 44 had unilateral disease; 14 contralateral normal limbs were used as controls. Twenty-three patients had secondary lymphoedema after lymphadenectomy and the remaining 21 had idiopathic lymphoedema. Each of the 44 patients was injected with 50MBq (0.3-0.4ml) of Tc-albumin-nanocolloid, which was administered intradermally at the first interdigital space of the affected limb. Two planar static scans were performed using a low-energy general-purpose collimator (acquisition matrix 128×128, anterior and posterior views for 5min), and in which drainage was slow or absent, patients were asked to walk or exercise for 2min. A postexercise scan was then performed to monitor and record the tracer pathway and the tracer appearance time (TAT) in the inguinal or axillary lymph nodes. Results: The postexercise scans showed that (i) 21 limbs (15 lower and six upper limbs) had accelerated tracer drainage and tracer uptake in the inguinal and/or axillary lymph nodes. Two-thirds of these showed lymph stagnation points; (ii) 27 limbs had collateral lymph drainage pathways; (iii) in 11 limbs, there was lymph drainage into the deeper lymphatic channels, with unusual uptake in the popliteal or antecubital lymph nodes; (iv) six limbs had dermal backflow; (v) three limbs did not show lymph drainage (TAT=not applicable). TAT=15±3min, ranging from 12 to 32min in limbs with lymphoedema versus 5±2min, ranging from 1 to 12min in the contralateral normal limbs (P
AB - AIM: The aim of this study was to evaluate the effect of implementing a new technique, intradermal injection lymphoscintigraphy, at rest and after muscular exercise on the functional assessment of the lymphatic system in a group of patients with delayed or absent lymph drainage. Methods: We selected 44 patients (32 women and 12 men; 15 of 44 with upper limb and 29 of 44 with lower limb lymphoedema). Thirty of 44 patients had bilateral limb lymphoedema and 14 of 44 had unilateral disease; 14 contralateral normal limbs were used as controls. Twenty-three patients had secondary lymphoedema after lymphadenectomy and the remaining 21 had idiopathic lymphoedema. Each of the 44 patients was injected with 50MBq (0.3-0.4ml) of Tc-albumin-nanocolloid, which was administered intradermally at the first interdigital space of the affected limb. Two planar static scans were performed using a low-energy general-purpose collimator (acquisition matrix 128×128, anterior and posterior views for 5min), and in which drainage was slow or absent, patients were asked to walk or exercise for 2min. A postexercise scan was then performed to monitor and record the tracer pathway and the tracer appearance time (TAT) in the inguinal or axillary lymph nodes. Results: The postexercise scans showed that (i) 21 limbs (15 lower and six upper limbs) had accelerated tracer drainage and tracer uptake in the inguinal and/or axillary lymph nodes. Two-thirds of these showed lymph stagnation points; (ii) 27 limbs had collateral lymph drainage pathways; (iii) in 11 limbs, there was lymph drainage into the deeper lymphatic channels, with unusual uptake in the popliteal or antecubital lymph nodes; (iv) six limbs had dermal backflow; (v) three limbs did not show lymph drainage (TAT=not applicable). TAT=15±3min, ranging from 12 to 32min in limbs with lymphoedema versus 5±2min, ranging from 1 to 12min in the contralateral normal limbs (P
KW - Tc-nanocolloid
KW - Exercise
KW - Intradermal injections
KW - Limbs
KW - Lymphoedema
KW - Rest
KW - Scintigraphy
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U2 - 10.1097/MNM.0b013e328338277d
DO - 10.1097/MNM.0b013e328338277d
M3 - Article
C2 - 20215978
AN - SCOPUS:77951766995
VL - 31
SP - 547
EP - 551
JO - Nuclear Medicine Communications
JF - Nuclear Medicine Communications
SN - 0143-3636
IS - 6
ER -