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Results for “Lymphoscintigraphy”

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At least 19 recordsLinked to original sources

PubMed1989

Lymphoscintigraphy to confirm the clinical diagnosis of lymphedema.

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 of 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.

Adolescent↗

PubMed1986

Lymphoscintigraphy in lymphedema: an aid to microsurgery.

The role of lymphoscintigraphy, performed with 99mTc-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 patients 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.

Adolescent↗

PubMed1986

A comparative evaluation of lymphoscintigraphy versus lymphangiography and computerized tomography scanning in diagnosis of lymph node metastases in advanced bladder cancer.

The potential of lymphoscintigraphy to detect lymph node metastases compared to lymphangiography and computerized tomography scanning was evaluated in 26 patients who underwent radical cystectomy for invasive bladder cancer. Four-view images of the abdominoperineal area were taken 90 to 120 minutes after 99mtechnetium-rhenium sulfide was injected into 2 interdigital spaces in each foot. Results of lymphoscintigraphy interpretation correlated with surgical and histological findings: a correct diagnosis was made in 61.5 per cent of the patients, while 23.1 per cent had false positive and 15.4 per cent had false negative results. Although computerized tomography was the most accurate method to detect lymph node metastases (correct diagnosis in 73.1 per cent of the patients) no significant difference was found among the 3 diagnostic methods. False positive interpretation of lymphoscintigraphy was twice as common as that of the radiological studies (23 versus 11.5 per cent). The possibilities that may cause image variation interpreted as a false positive result are discussed. Because lymphoscintigraphy is an easier and less time-consuming study than lymphangiography, the former method is suggested to be an additional and sometimes (for example if short-term followup studies are required) preferred modality to evaluate the extent of lymph node involvement in cases of invasive bladder cancer.

Aged↗

PubMed1991

[Retrosternal lymph node metastases in breast cancer: lymphoscintigraphy and magnetic resonance tomography].

In 21 patients with breast cancer (pT1-4, N0, M0) internal mammary lymphoscintigraphy and magnetic resonance imaging (MRI) were performed to evaluate retrosternal lymph node metastases. In 6 patients normal findings of lymphoscintigraphy were confirmed by MRI. In the 15 patients with focal defects seen by lymphoscintigraphy no lymph nodes were found by MRI in 5 in the corresponding area, 5 showed normal-sized lymph nodes (less than 1 cm) and 5 enlarged lymph nodes indicating metastatic infiltration. In addition to internal mammary lymphoscintigraphy MRI may offer the possibility to improve TNM staging in patients with breast cancer.

Adult↗

PubMed1988

Lymphedema: evaluation of qualitative and quantitative lymphoscintigraphy in 238 patients.

Lymphoscintigraphy was performed in 128 patients with primary lymphedema, in 91 patients with secondary lymphedema, and in 19 healthy volunteers. A total of 457 extremities were examined. Technetium-99m-labeled human serum albumin was injected subcutaneously, and passive muscular exercise was standardized to reduce the variability of lymphatic function. The scintigrams were analyzed for visualization of lymph vessels and lymph nodes, dilatation of lymphatic vessels, existence of collateral vessels, and dermal backflow. With this qualitative interpretation alone, the diagnosis of lymphedema was established in 216 of 308 extremities (70.1%). Quantitative parameters derived from clearance data showed abnormal lymphatic function in all 308 extremities. Whereas qualitative lymphoscintigraphy allows the characterization of lymphatic morphology, quantitative lymphoscintigraphy is very accurate in detection of incipient lymphedema.

Adolescent↗

PubMed1992

[Phase III trial of 99mTc-rhenium colloid for lymphoscintigraphy].

A multicenter study was carried out on 191 patients (196 examinations) with lymphatic system disorders to evaluate the efficacy and safety of 99mTc-rhenium Colloid, a tracer for lymphoscintigraphy (TCK-17). Local pain and swelling occurred at the site of injection in 79.6% and 5.1% of patients, respectively, and 2 patients experienced mild fever. The accuracy was calculated on the basis of the results obtained by other diagnostic methods. Lymphoscintigraphy using TCK-17 was sensitive diagnostic procedures, but low specificity. The efficacy was classified into five grades: "Excellent", "Good", "Moderate", "Equivocal", and "Poor". 67.3% of all examination were evaluated as "Excellent" or "Good". This study revealed TCK-17 was a useful radiopharmaceutical for lymphoscintigraphy because of its safety and effectiveness.

Adult↗

PubMed1992

Lymphoscintigraphy in healthy dogs and dogs with experimentally created thoracic duct abnormalities.

Lymphoscintigraphic evaluation of the thoracic duct (TD) was performed in 10 healthy and 12 dogs with experimentally created TD abnormalities (6 dogs with TD lacerations and 6 dogs with cranial vena ligations). Complete imaging took 4 hours and caused no adverse effects or complications. Lymphoscintigraphy of healthy dogs failed to image the TD; however, background activity in the abdomen and thorax, and radioactivity in the kidneys, bladder, liver, and heart were noticed. Lacerations and transections of the TD were experimentally created in 6 dogs to ascertain whether TD rupture could be detected with lymphoscintigraphy. Lymphoscintigraphy was performed within 48 hours of creating the TD defect. There was no significant difference in the scintigraphic pattern of healthy dogs and those with experimentally created TD defects. Ligation of the cranial vena cava was performed in 6 dogs; 3 dogs developed chylothorax. In those 3 dogs, diffuse radioactivity was imaged in the thorax and was compatible with thoracic lymphangiectasia. In one of these dogs, linear activity consistent with the TD and localized regions of radioactivity cranial to the heart (compatible with the mediastinal lymph nodes) were noticed. Lymphoscintigraphic findings in these dogs correlated with lymphangiographic findings.

Animals↗

PubMed1987

[Value of exploring the deep lymphatic system of the lower limbs using lymphoscintigraphy. Preliminary study of 18 patients with arteritis].

Lymphoscintigraphy of lower limbs generally involves bilateral subcutaneous injection of a radioactive colloid into the first or second interdigital space: only the superficial internal saphenous pathway is visualized in this way (superficial lymphoscintigraphy: SL). However, the external saphenous and deep pathways can be explored by an external retromalleolar injection as demonstrated in radiology. Isotopic exploration of the external saphenous pathway and deep lymphatics (deep lymphoscintigraphy: DL) was carried out in 18 patients with arteritis also investigated by SL. The study forms part of a prospective trial of edema developing after femoro-popliteal shunts. The deep lymphatics are correctly and easily visualized, and in about 20% of cases there exist anomalies of distribution of superficial or deep lymphatic flow, morphologic anomalies developing postoperatively in one pathway only, or in both pathways. DL is a simple, reliable method of investigation of deep lymphatics, and complete exploration of lymphatics of lower limbs should include both SL and DL.

Aged↗

PubMed1990

Progress in the assessment of lymphatic spread in rectal cancer. Rectal endoscopic lymphoscintigraphy.

Rectal endoscopic lymphoscintigraphy was performed in 10 control subjects and in a series of 85 patients with adenocarcinoma of the rectum as a prospective study to evaluate lymphatic drainage of the rectum and lymphatic spread in rectal cancer. Complete cranial drainage was demonstrated in all control subjects, and internal iliac nodes were also visible in 50 percent of cases. Results were correlated with histologic node examination in all patients operated upon for rectal cancer. Rectal endoscopic lymphoscintigraphy was assessed for sensitivity (85 percent), specificity (68 percent), overall accuracy (76 percent), positive predictive value (71 percent), and negative predictive value (83 percent). False-negative and false-positive results are discussed. Rectal endoscopic lymphoscintigraphy represents the only method currently available for evaluation of lymphatic spread in rectal cancer.

Adenocarcinoma↗

PubMed1988

Use of lymphoscintigraphy in chyluria.

The roentgenographic procedure of choice in delineating lymphatic channels has been lymphangiography. Recently, radionuclide lymphoscintigraphy has been used to outline lymphatics in patients with various lymphatic disorders. We present and compare the results of lymphangiography and lymphoscintigraphy in 2 patients with chyluria. Since the results of lymphoscintigraphy correlated with lymphangiography, the application of this less invasive technique in the diagnosis and management of chyluria may be warranted.

Adult↗

PubMed1992

Lymphoscintigraphy in vulvar cancer: a pilot study.

This pilot study was undertaken to correlate the patterns of lymphatic drainage demonstrated by vulvar lymphoscintigraphy with the clinical and pathologic findings of the inguino-femoral lymph nodes in patients with vulvar cancer. Ten patients were studied with the radionuclide Technetium-antimony trisulfide colloid (Tc 99m ASC) using a perilesional technique. Images were obtained at 2-4 hr postinjection. Four of the six patients with central lesions or lesions that crossed the midline had bilateral groin uptake, and two had unilateral uptake to the side on which the lesion was predominantly located. Three of these patients, each with suspicious groin nodes bilaterally, had metastatic nodal disease, two unilateral and one bilateral, in whom the uptake was bilateral and unilateral, respectively. Three of the four patients with unilateral lesions had ipsilateral groin drainage only and one had no drainage. Three underwent a bilateral lymphadenectomy and none had metastasis. The pattern of Tc 99m ASC uptake was not predictive of metastatic nodal disease. In two of the three patients with unilateral groin recurrence the side of recurrence was the same as that demonstrated on lymphoscintigraphy, and in the third case there was bilateral drainage. Further data are needed to determine the role of lymphoscintigraphy in the management of vulvar cancer.

Aged↗

PubMed1985

Abdominal lymphoscintigraphy: an effective substitute for lymphography?

Abdominal lymphoscintigraphy is a quick, easy, cheap and relatively non-invasive technique. In our study it appeared to be as accurate as lymphography, giving a positive correlation in 25 out of 32 patients (78%). In 11% of cases the lymphoscintigram detected an abnormality of lymph node function before macroscopic morphological change was seen in the lymphogram, indicating that in some instances lymphoscintigraphy is more sensitive than lymphography. The reason for this is unknown, although possible mechanisms are discussed and these are the subject of current further study. We believe this to be the first report of lymphoscintigraphy being more sensitive than lymphography for detecting lymph node disease.

Abdomen↗

PubMed1991

Quantitative lymphoscintigraphy using 99Tcm human serum albumin in patients with previously treated uterine cancer.

To evaluate the clinical usefulness of lymphoscintigraphy using 99Tcm human serum albumin (99Tc-HSA) in assessing lymphoedema in the lower extremities, lymphoscintigraphy was performed by subcutaneous injection of 7.4 MBq of 99Tcm-HSA in 26 patients with uterine cancer, previously treated by operation (OP) and/or radiation therapy (RT), and in five controls. Radioactivity at the injection site in the lower extremities was counted for 3 min at 10 min (A) and at 3 h (B) after injection, and clearance of 99Tcm-HSA was defined as (1-(B)/(A)) x 100(%). Clearance in controls was 46.8 +/- 3.9%, which was significantly more than those in the other treatment groups. Clearances in patients treated with both OP and RT were less than those in patients treated with either OP or RT alone (30.1 +/- 11.4 vs. 41.9 +/- 8.9, 43.7 +/- 9.6%, respectively; p less than 0.01). The clearance in legs with lymphoedema was less than those without lymphoedema in patients treated with both OP and RT (16.6 +/- 7.7 vs. 34.9 +/- 9.3%; p less than 0.01) and in patients treated with RT (33.1 +/- 7.4 vs. 48.0 +/- 5.6%; p less than 0.01). There was a significant difference between clearance in controls and clearance in non-oedematous patients' legs treated with OP and RT (p less than 0.01). In patients treated with RT alone, radiation dose was closely correlated with 99Tcm-HSA clearance and with the development of lymphoedema. These data suggest that lymphoscintigraphy using 99Tcm-HSA is useful in evaluating lymphoedema and that radiation dose is one of the factors in the development of lymphoedema.

Adult↗

PubMed1992

[Evaluation of the internal mammary nodes by lymphoscintigraphy and ultrasonography in patients with breast cancer].

The efficacy of lymphoscintigraphy and ultrasonography was evaluated in the detection of internal mammary lymph node (IMN) metastases in patients with breast cancer. On histological examination of IMN, 10 patients had metastases (positive group) and 47 did not (negative group). On lymphoscintigraphy, lack of uptake in the parasternal region of the affected side was classified as abnormal. The frequency of this abnormal finding was not significantly different between both groups. On sonography, the thickness of the sonolucent internal mammary area was measured. The thickness of the affected side was 6 mm or more in two patients of the positive group and only one of the negative group. A thickness of over 6 mm on the affected side was statistically significant (p less than 0.05). The difference in thickness between the affected side and the healthy side was 3 mm or more in four patients of the positive group, and was less than 3 mm in all patients of the negative group. A difference in thickness of more than 3 mm between the two sides was extremely significant (p less than 0.001). In conclusion, sonography is valuable in detecting IMN metastases, while lymphoscintigraphy is not useful. Sonography is recommended as an efficient diagnostic modality for IMN metastases.

Adult↗

PubMed1990

Lymphoscintigraphy for melanoma: is it always predictive for lymphatic basin mapping?

Therapeutic decision making in treating patients with melanoma is difficult, with very few investigative tools and a lack of treatment options. Surgical extirpation remains the best method for cure and supports discussion in favor of prophylactic regional node dissection for subgroups of patients with stage I disease. In melanoma of the trunk or head and neck, lymphoscintigraphy has reliably provided guidance for resecting the regional lymphatics draining the involved site. This article describes a patient with a melanoma of the posterior neck, with metachronous metastases to the right and left posterior cervical triangles. Lymphoscintigraphy performed in the context of clinically negative nodal regions did not show drainage to either cervical nodal chain. Several explanations are presented, although a false-negative lymphoscintigraphic finding is the only plausible explanation. To our knowledge, this dilemma has not been previously reported, and raises the question of the infallibility of lymphoscintigraphy in predicting lymphatic basin mapping.

Drainage↗

PubMed1987

Utility of lymphoscintigraphy in directing surgical therapy for melanomas of the head, neck, and upper thorax.

Lymphoscintigraphy with technetium99m antimony sulfur colloid or technetium99m human serum albumin helped direct the surgical management of 24 patients who had melanomas of the head, neck, and upper thorax. Eighteen (75%) patients had documented lymphatic flow to other than a single adjacent predictable lymph nodal group. Nineteen patients underwent lymphadenectomy. Availability of the scan altered surgical management in nine patients (47%) who required resection of nodes in addition to resection of adjacent nodes. The discovery of metastatic disease in one patient was clearly attributable to lymphoscintigraphy. This demonstrates the unpredictable lymphatic anatomy of this region and suggests that preoperative lymphoscintigraphy may be useful in directing the surgical management of cutaneous melanomas in which lymph node dissection is planned.

Adult↗

PubMed1985

Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels.

To quantitate visual findings in lymphoscintigraphy with 99mTc-labeled stannous sulfur colloids, a numeric index of transport kinetics was designed by combining visual assessment of five criteria: temporal and spatial distribution of the radionuclide, appearance time of lymph nodes, and graded visualization of lymph nodes and vessels. For assessment, scores were used ranging from 0 to 9. Thus, the resulting transport index (TI) ranged from 0 (normal) to 45 (pathological). TI in healthy extremities was less than 10. Lymphoscintigraphy was performed routinely in healthy lower extremities to ensure normal drainage before transplantation. In 122 investigations of upper and lower extremities, TI was found to be very sensitive (97.4%). Specificity was 90.3%. An interobserver study in 179 investigations revealed a high correlation (r = 0.96). A total of 23 patients underwent autologous lymphatic transplantation. The average decrease of TI was 5.9: 31.1 before and 25.2 after transplantation. This decrease of TI was correlated with a marked decrease of the volumes of the extremities (from 3423 ml to 2580 ml). Changes in TI and volume were significant (p less than 0.05). This method of evaluation has proved to be very sensitive, reproducible, and able to measure the transport capacity of only two or three transplanted lymph collectors.

Adult↗

PubMed1987

Endoscopic lymphoscintigraphy. A new tool for target surgery of rectal cancer.

To define the "in vivo" lymphatic drainage from the rectum and the anal canal, 79 subjects (normal controls and patients with rectal cancer) underwent endoscopic rectal lymphoscintigraphy. This method consists of endoscopically injecting a radiolabelled colloid into the rectal and anal submucosa. The diffusion of the tracer, which is drained preferentially by the lymphatic vessels, was determined by means of a computerized gamma camera. Our results suggest a different pattern of lymphatic drainage from the rectum as compared to traditional anatomical studies. Moreover, analysis of our data yields a new hypothesis about the lymphatic spread of rectal cancer. Therefore, lymphoscintigraphy could be employed in the preoperative assessment of "N" staging of these neoplasms. This should provide better selection of patients for different surgical approaches and for adjuvant therapy. The results of 2 years of experience and possible future applications of this technique are discussed.

Anal Canal↗