Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

Dalia, Roberta Maria; Martins, Gláucia Ribeiro P.; Barbosa, Rodolfo Duarte; Lima, Carla Flávia de; Siqueira, Cristiano Ferrari

doi:10.1590/s1516-89132005000700023

Cited by 9 publications

(20 citation statements)

References 2 publications

(1 reference statement)

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“…In ICG lymphography, retained fluid is detectable without background noise because there is no endogenous fluorescence in the near infrared band used for the detection of ICG, thereby increasing the accuracy [8]. In addition, when there is no definite lymphatic flow obstruction or dermal backflow, it is possible to overlook decreased lymphatic flow with qualitative lymphoscintigraphy [9].…”

Section: Discussionmentioning

confidence: 99%

Early Stage Lymphedema in Breast Cancer Patient Detected by Indocyanine Green Lymphography but not by Lymphoscintigraphy: A Case Report

et al. 2019

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Secondary upper extremity lymphedema after lymph node dissection in breast cancer patients is a major complication affecting their quality of life. As lymphatic function is compromised before symptoms develop in most cases, early diagnosis and intervention before symptomatic manifestation is known to prevent severe progression of lymphedema. In this case report, we present a patient with secondary lymphedema, whose disease could be diagnosed at an early stage using indocyanine green (ICG) lymphography. The patient had mild edema of the left upper extremity that regressed with elevation, had normal lymph vessel distribution without dermal backflow pattern in lymphoscintigraphy. Her symptom improved after early prescription of complex decongestive physiotherapy. We conclude that ICG lymphography could be an effective diagnostic tool in addition to other imaging methods, for early diagnosis and intervention of lymphedema.

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Section: Discussionmentioning

confidence: 99%

Early Stage Lymphedema in Breast Cancer Patient Detected by Indocyanine Green Lymphography but not by Lymphoscintigraphy: A Case Report

et al. 2019

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“…Qualitative lymphoscintigraphic patterns were also described by analyzing the uptake patterns of the axillary LNs and the symptomatic areas of the upper limbs [ 15 18 ]. Patterns were defined as follows: a normal pattern showed a normal lymphatic system with visualization of the superficial lymphatic system and a normal axillary LN.…”

Section: Methodsmentioning

confidence: 99%

“…In contrast with other measurement tools that only reflect lymphedema volume or soft tissue composition, lymphoscintigraphy offers an objective and reliable approach to diagnosing and specifically characterizing the severity of lymphedema with visualization of regional lymph nodes (LNs), lymphatic channels, collateral lymphatic channels, interrupted vascular structures, and the deep lymphatic nodes [ 15 ]. Until recently, lymphoscintigraphic interpretations have generally been qualitative.…”

Section: Introductionmentioning

confidence: 99%

“…Hwang et al [ 16 ] used a qualitative lymphoscintigraphic interpretation as a prognostic tool for breast cancer-related lymphedema patients, and the lymphoscintigraphic findings of the main lymphatic vessels without collateral lymphatic vessels were the best predictors of a positive response to lymphedema treatment. A number of studies have assessed the value of lymphoscintigraphy in gynecological cancer-related lower limb lymphedema, which is a common complication after treatment [ 15 17 ]. Because Stanton et al [ 18 ] used the drainage rate constant (k) of lymphoscintigraphy to quantitatively diagnose ipsilesional hand lymphedema following breast cancer treatment, we decided that quantitative lymphoscintigraphic findings could provide more objective data for treating patients who have lymphedema after breast cancer surgery with ALND.…”

Section: Introductionmentioning

confidence: 99%

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Validity of Quantitative Lymphoscintigraphy as a Lymphedema Assessment Tool for Patients With Breast Cancer

et al. 2015

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ObjectiveTo evaluate the validity of quantitative lymphoscintigraphy as a useful lymphedema assessment tool for patients with breast cancer surgery including axillary lymph node dissection (ALND).MethodsWe recruited 72 patients with lymphedema after breast cancer surgery that included ALND. Circumferences in their upper limbs were measured in five areas: 15 cm proximal to the lateral epicondyle (LE), the elbow, 10 cm distal to the LE, the wrist, and the metacarpophalangeal joint. Then, maximal circumference difference (MCD) was calculated by subtracting the unaffected side from the affected side. Quantitative asymmetry indices (QAI) were defined as the radiopharmaceutical uptake ratios of the affected side to the unaffected side. Patients were divided into 3 groups by qualitative lymphoscintigraphic patterns: normal, decreased function, and obstruction.ResultsThe MCD was highest in the qualitative obstruction (2.76±2.48) pattern with significant differences from the normal (0.69±0.78) and decreased function (1.65±1.17) patterns. The QAIs of the axillary LNs showed significant differences among the normal (0.82±0.29), decreased function (0.42±0.41), and obstruction (0.18±0.16) patterns. As the QAI of the axillary LN increased, the MCD decreased. The QAIs of the upper limbs were significantly higher in the obstruction (3.12±3.07) pattern compared with the normal (1.15±0.10) and decreased function (0.79±0.30) patterns.ConclusionQuantitative lymphoscintigraphic analysis is well correlated with both commonly used qualitative lymphoscintigraphic analysis and circumference differences in the upper limbs of patients with breast cancer surgery with ALND. Quantitative lymphoscintigraphy may be a good alternative assessment tool for diagnosing lymphedema after breast cancer surgery with ALND.

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“…The lymphatic system provides the paths for the spread of cancer (metastasis) from one part of the body to another. Hodgkin´s disease, lymphocytic leukemia, various metastatic diseases, and many lymphnode disorders can be assessed by lymphoscintigraphy (Dalia et al, 2005, Bernardo-Filho et al, 2007. Lymphnode disease is demonstrated by diminished or absent flow of lymph.…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymphnode in breast cancer: an experience with 53 cases

Abreu

Melo

Abreu

et al. 2007

Braz. arch. biol. technol.

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The value of sentinel lymphnode biopsy or selective linfadenectomy in assessing axillary status in breast carcinoma is well established in medical literature. This work presents a briefy study from our preliminary experience with 53 patients submitted to pre-surgical limphoscintigraphy and intraoperatory detection of sentinel lymphnode and compares our records with those of current medical literature.
O valor da biópsia de linfonodo sentinela (linfadenectomia seletiva) na avaliação do status axilar no carcinoma da mama está bem definido na literatura médica. Neste breve relatório apresentamos um estudo retrospectivo de nossa experiência inicial com 53 pacientes submetidos à linfocintigrafia e detecção intraoperatória do linfonodo sentinela, comparando nossos dados com o da literatura atual

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Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

Abstract: ABSTRACT

Cited by 9 publications

References 2 publications

Early Stage Lymphedema in Breast Cancer Patient Detected by Indocyanine Green Lymphography but not by Lymphoscintigraphy: A Case Report

Early Stage Lymphedema in Breast Cancer Patient Detected by Indocyanine Green Lymphography but not by Lymphoscintigraphy: A Case Report

Validity of Quantitative Lymphoscintigraphy as a Lymphedema Assessment Tool for Patients With Breast Cancer

Sentinel lymphnode in breast cancer: an experience with 53 cases

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