Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema

Purpose: The primary difficulty in evaluating and treating peripheral lymph edema is visualization of the lymphatics. Functional lymphatic studies have been performed on patients with peripheral edema to diagnose lymphedema, t o determine its severity, and to understand the varied drainage patterns. Methods: After intradermal injection in the hands or feet, initial flow and whole-body images were taken using Tc-99m human serum albumin in more than 700 patients with possible lymphedema. Results: Clear images of truncal lymph transport and draining lymph nodes w ere obtained, and pattern differences between primary and secondary lymphed ema were seen. Follow-up studies showed any functional change in lymphatic dynamics. Conclusion: Peripheral lymphatics can now be easily visualized. Because lym phangioscintigraphy can be performed before and after medical treatment, fo llow-up evaluation of patients with lymphedema is possible. The procedure i s noninvasive, repeatable, easy to perform, and harmless to the lymphatic e ndothelium.