Lymphoscintigraphy for the evaluation of limb lymphatic flow disorders: Report of technical procedural standards from an Italian Nuclear Medicine expert panel

Publication date: Available online 23 April 2019Source: Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)Author(s): Marco Maccauro, Giuseppe Villa, Augusto Manzara, Giulia Anna Follacchio, Gianpiero Manca, Girolamo Tartaglione, Sotirios Chondrogiannis, Lucio Mango, Domenico RubelloAbstractLymphoscintigraphy represents the “gold standard” for diagnosis of lymphedema, but an important limitation is the lack of procedural standardization. The aim of this Italian expert panel was to provide a procedural standard for lymphoscintigraphy in the evaluation of lymphatic system disorders. Topic anaesthetic gels containing lidocaine should be avoided. Patients should remove compressive dressings. Total recommended activity for Tc-99m-nanocolloid administration in adults is 74 MBq, or 37 MBq per limb and per investigated compartment, in single or multiple aliquots. 2–3 subcutaneous injections should be performed (II–III ± I interdigital space of each hand/foot), avoiding intravascular injection. Deep lymphatic system of lower limbs should be evaluated in presence of dermal back-flow or lymphatic stasis (1–2 subfascial administrations in retro-malleolar or plantar region). Planar images should be acquired from injection site to liver with whole-body or serial static acquisitions 20’ and 90’ after subcutaneous administration. Additional information on lymphatic pathways is obtained after a quick and/or prolonged exercise protocol....
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research